BMJ  2004;329:350 (7 August), doi:10.1136/bmj.329.7461.350-a

Letter

Investigation into GPs with high patient mortality

Situation is even more complicated

The first 100% of the full text of this article appears below.

EDITOR—This primary care trust inherited the Shipman affair and also had another general practitioner highlighted as having a high mortality in patients older than 65.¹ As medical director I had the task of sifting through 150 medical records and reconciling them with death certificates. There certainly seemed to be a nursing home effect.

Moreover, to apply the model as described will be difficult: even in our case deaths were ascribed to a particular general practitioner, although in some cases the doctor had never seen the patient, simply on the basis of registration. If mortality monitoring is to become part of routine assessment it will have to become highly complex to account for care by the whole of a multidisciplinary team. Attributing care to just one general practitioner will become difficult when patient lists are held on a practice basis.

Tameside and Glossop Primary Care Trust, Denton M34 2GP anner@tamesideandglossop.nhs.uk

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Competing interests: None declared.

1. Mohammed MA, Rathbone A, Myers P, Patel D, Onions H, Stevens A. An investigation into general practitioners associated with high mortality flagged up through the Shipman Inquiry: retrospective analysis of routine data. BMJ 2004;328: 1474-7. (19 June.)[Abstract/Free Full Text]

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Relevant Article

An investigation into general practitioners associated with high patient mortality flagged up through the Shipman inquiry: retrospective analysis of routine data

Mohammed A Mohammed, Anthony Rathbone, Paulette Myers, Divya Patel, Helen Onions, and Andrew Stevens
BMJ 2004 328: 1474-1477. [Abstract] [Full Text] [PDF]

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