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Case Study – Lasting Powers of Attorney (LPA’s) – it’s worth a double check!

Dr X, a Consultant Physician in Stroke Medicine received a complaint from the deceased patient’s son in relation to prescribing a medication that was contra-indicated and prescribing a medication without obtaining the consent of the patient’s Lasting Power of Attorney (LPA). The matter was referred to the GMC for further investigation.

MDS Advice
MDS medico-legal advisers comprehensively advised and supported Dr X in relation to drafting a detailed statement regarding the clinical aspects of the matter. MDS Legal team explained the full GMC investigation process to the Doctor and worked closely with the medico-legal advisers to help build Dr X’s case.

The GMC instructed an expert in this case and the mater concluded prior to reaching the Rule 7 stage. The GMC meticulously referred to Dr X failing to consider alternative causes of the patient’s symptoms and that there was a lack of communication with colleagues before prescribing medication that was contra-indicated. The GMC also heavily referred to Dr X’s failing to enquire in respect of any Lasting Power of Attorney’s (LPA) of the patient and a lack of communication with the patient’s family.

MDS advised Dr X in relation to the clinical aspects including the importance of checking whether any LPA’s are involved prior to making relevant clinical decisions. It was clear in this case that the LPA form had not been uploaded on the patient’s medical records at the time Dr X was treating the patient and therefore could not have known about contacting any LPA’s. MDS assisted Dr X in addressing these issues within his statement which was disclosed to the GMC.

Due to Dr X’s clear statement and reflection, the criticisms did not warrant any further concerns. Therefore, after a lengthy investigation process, the GMC concluded the matter with no further action against Dr X.

Learning points
• The use of LPA’s is ever increasing, and all doctors must be mindful that one may exist when treating elderly patients in particular.

• When providing clinical care, doctors must pay attention in particular to ‘The Good Medical Practice paragraph 33’.

• If you are concerned there may be an LPA – Stop! First ascertain whether there is one, double check patient records and with colleagues who have treated the patient, and if so, ensure that the relevant consent is obtained, and the parties involved are fully informed. Good communication is key!