Decision Report 201405098

Summary

Ms C complained that, during a phone consultation, an out-of-hours GP asked a care home nurse if Ms C's father (Mr A) had a do not attempt cardiopulmonary resuscitation (DNACPR) note in his records. Ms C said the GP asked about the DNACPR with the implication that, if there was one in place, the GP should not bother coming to visit Mr A. Ms C also complained that the GP inappropriately prescribed amoxicillin (an antibiotic drug used to treat bacterial infection) to Mr A, which she said was not effective for him, and could be detrimental to his health.

We looked at Mr A's clinical records and a copy of the board's complaint file, and we took independent advice from one of our medical advisers. We asked the board for the audio recording of the phone call between the GP and the care home nurse, but it was no longer available. We found that DNACPR refers to cardiopulmonary resuscitation in circumstances where a patient's heart stops, and does not refer to any other element of a patient's clinical care. We concluded that it was normal for a triaging doctor (triage is the process of deciding which patients should be treated first based on how ill or injured they are) to ask whether a DNACPR form has been completed for a patient.

We also found that there was nothing in the available medical records to indicate that Mr A was allergic to amoxicillin. We concluded that the final prescribing decision has to lie with the doctor who is assessing the patient at the time, that the GP prescribed medication in line with relevant guidance, and that Mr A was provided with a reasonable standard of care in the circumstances. We did not uphold Ms C's complaints.