GP practice provided reasonable care but inappropriately removed patient from its list

What happened

Mr J went to the Practice three times complaining of tiredness and pins and needles. On the third occasion, his leg was swollen. The GP suspected DVT and referred Mr J to hospital. The hospital confirmed DVT and prescribed Mr J warfarin as an anticoagulant. This ran out two weeks later and Mr J asked the Practice for a repeat prescription. No face-to-face appointments were available that day, so a telephone appointment was arranged. Mr J did not receive a call that morning and he went to the Practice. He says that he had to insist on being seen, while the Practice says that he was 'aggressive' in his demand to see the doctor. Mr J's medication was prescribed, but the Practice removed him from its list. It said that he was aggressive and that it had a zero tolerance policy towards such behaviour.

What we found

The Practice provided appropriate care in relation to Mr J's DVT, because he had not shown symptoms of this condition until the third appointment, when he had swelling in his leg. He was appropriately referred to A&E at this point.

We could not say if Mr J had been aggressive when he went to the Practice. But in any event, regulations require GPs to give a patient a warning before removing them from a practice list (unless doing so poses a risk to health or safety or where it would be unreasonable or impractical to do so). As there was nothing to suggest that these conditions applied in Mr J's case, it was not appropriate for the Practice to remove him from its list without warning.

Putting it right

The Practice apologised to Mr J that removing him from its list was not done in line with the regulations. It also amended its zero tolerance policy so that it accurately reflected these regulations.