GP Negligence Claims

GP Negligence: Overview

General practitioners occupy a critical gatekeeping role in the UK healthcare system. As the first point of contact for most patients, GPs are responsible for identifying conditions that require investigation or specialist referral, managing chronic disease, prescribing medication safely, and coordinating care across services.

When a GP fails in these responsibilities — through inadequate assessment, failure to refer, prescription error, or missed diagnosis — the consequences for patients can be severe: conditions progressing to an advanced stage, serious drug reactions, or missed time-critical emergencies.

A GP is assessed against the standard of a reasonably competent general practitioner — not a specialist. This is an important distinction: a GP is not expected to have the diagnostic precision of an oncologist or cardiologist, but is expected to recognise symptoms that should prompt urgent investigation or specialist referral.

Missed and Delayed Referrals

The two-week wait (2WW) referral pathway for suspected cancer in England (and equivalent urgent pathways in Wales, Scotland, and Northern Ireland) exists precisely because timely specialist assessment is critical for cancer outcomes. A GP who fails to make a 2WW referral when NICE guidelines indicate one is required may be liable for the consequences of delayed diagnosis.

Referral negligence is not limited to cancer pathways. A GP who sees a patient with symptoms consistent with a transient ischaemic attack (TIA) and fails to refer urgently to a TIA clinic — where same-day or next-day assessment can prevent a completed stroke — may face a serious negligence claim if the patient subsequently suffers a stroke within the untreated window.

The relevant standard is what referral decision a responsible body of GPs would have made faced with the same clinical picture.

Prescription Errors in General Practice

GPs are responsible for safe prescribing. Prescription errors in primary care include:

Prescribing contraindicated medication

Prescribing a drug to a patient with a known allergy or contraindication documented in their records — including drug-drug interactions with existing prescriptions — is a serious and frequently litigated failure.

Incorrect dose

Prescribing an adult dose to a child, or prescribing a loading dose without adequate monitoring, are examples of dosing errors in general practice.

Failure to monitor

Certain medications require regular blood monitoring to assess therapeutic levels and detect toxicity — for example, lithium, warfarin, methotrexate, and amiodarone. Failure to implement or maintain a monitoring protocol is a recognised source of GP negligence claims.

Long-term repeat prescribing without review

Issuing repeat prescriptions for potentially dangerous medications without adequate clinical review — particularly in elderly patients with multiple medications and changing renal or hepatic function — is an established category of prescribing negligence.

Failure to Act on Test Results

GPs routinely order blood tests, urine tests, imaging, and other investigations. Where an abnormal result is returned and the GP fails to:

• Review the result promptly
• Communicate the result to the patient
• Act on the result with appropriate clinical follow-up or referral
• Ensure the patient attends for follow-up when they do not respond

...a negligence claim may arise. The failure to action abnormal test results is one of the most commonly identified systemic failures in GP negligence cases.

This is particularly acute where abnormal results indicative of serious pathology — elevated PSA, abnormal cervical smear, raised inflammatory markers in a symptomatic patient — are lost, overlooked, or not communicated.

Inadequate Examination

A GP who fails to conduct a clinically appropriate examination — or who conducts an examination so perfunctory as to miss an obvious abnormality — may be in breach of the standard of care. Examples include:

• Failure to examine the abdomen in a patient presenting with abdominal symptoms, missing a palpable mass
• Failure to examine the breast in a patient presenting with a breast lump, or dismissing a lump without imaging referral
• Failure to conduct a neurological examination in a patient with neurological symptoms, missing signs of serious pathology

In the context of remote consultations — telephone or video appointments — the standard is adapted but not abrogated. A GP conducting a remote consultation must recognise the limitations of that format and refer or bring the patient in for examination when clinical uncertainty cannot be resolved remotely.

Missed Diagnosis of Serious Conditions in Primary Care

GP negligence claims most commonly involve missed or delayed diagnosis of:

• Cancer (breast, bowel, lung, prostate, cervical, ovarian)
• Myocardial infarction
• Stroke and TIA
• Meningitis and sepsis
• Pulmonary embolism and deep vein thrombosis
• Ectopic pregnancy
• Appendicitis
• Diabetes and diabetic complications

In each case the analysis returns to the Bolam question: given what the GP knew and what could reasonably have been elicited at the consultation, was the diagnostic pathway followed one that a responsible body of GPs would have followed?

Who Is the Defendant in a GP Negligence Claim?

In England and Wales, NHS GP practices are independent contractors to NHS England. They are not NHS trusts, and NHS Resolution does not automatically handle their claims. Claims against NHS GPs are typically brought against the GP partnership or the individual GP, with indemnity cover provided through a medical defence organisation (MDO) such as the Medical Defence Union, Medical Protection Society, or NHS GP indemnity scheme.

In Scotland, GPs contract with the relevant Health Board, and claims may proceed against the Health Board or the individual practice depending on the circumstances.

Private GP services are defendants in their own right and carry their own professional indemnity insurance.

Compensation for GP Negligence

The value of a GP negligence claim depends entirely on what harm the negligence caused. Missed cancer referral claims involving advanced-stage diagnosis typically compensate for the worsened prognosis, additional treatment burden, reduced life expectancy, and financial losses. Missed cardiac events may involve claims for permanent cardiac damage or death. Prescription error claims vary from modest awards for temporary harm to very substantial awards where permanent disability results.

Full guide to medical negligence compensation →

Time Limits for GP Negligence Claims

Three years from the date of the negligent consultation or date of knowledge — whichever is later.

Full guide to medical negligence time limits →