A GP has been suspended after failing to make face-to-face appointments for a patient who was later hospitalised.
Dr Alyn Williams, who worked at Chapel Street Surgery in Billericay, was chastised for failing to provide “adequate clinical care”.
The doctor, who has worked as a GP since the 1990s, conducted a series of telephone consultations with the unidentified male patient during 2020 and 2021.
But he had repeated did not report symptoms in medical records, arranged face-to-face follow-up consultations, and registered with the patient about their symptoms.
Over the course of nine months, the patient’s health “deteriorated significantly” as Dr. Williams failed to perform vital in-person temperature and oxygen checks.leaving him hospitalized with a potentially life-threatening heart infection.
Dr Alyn Williams, who worked at Chapel Street Surgery in Billericay, was chastised for failing to provide “adequate clinical care”. The doctor, who has worked as a GP since the 1990s, conducted a series of telephone consultations with the patient during 2020 and 2021. But he repeatedly failed to report symptoms in medical records or arrange face-to-face follow-up consultations. . and follow-up with the patient about their symptoms
The proportion of GP appointments in England that took place face to face in May was 69.8 per cent. This is down from 70 percent in April, which was the highest number on record since the pandemic.
TO medical court panel suspended Dr. Williams for failing to provide “adequate care” and falling “seriously below expected standards.”
It was “clear” that the patient’s illness “might not have reached the severity that it did, had Dr. Williams provided the necessary and appropriate care,” they concluded.
Dr Williams said he chose not to do face-to-face consultations during Covid in 2020 and 2021 because he was obese and more vulnerable to the virus at the age of 66.
The male garage worker, known only as Patient A to the panel, had been registered in surgery for 20 years.
initially he developed a persistent cough and runny nose, a buildup of mucus in the back of his throat, in May 2020, during the height of Covid.
At that time, Dr. Williams prescribed a nasal spray in a phone consultation.
But still battling the same symptoms, after another phone consultation and treatment with antibiotics, he was referred for a full-body CT scan.
Dr. Williams gave the patient the go-ahead in a fortnight. However his symptoms persisted.
Blood tests returned in December also revealed high CRP levels, 117 milligrams per liter (mg/L), indicating inflammation of the blood vessels.
Generally, a CRP level between one and five milligrams per liter (mg/L) is considered normal.
The patient then had a phone consultation with Dr. Williams on December 14, after complaining that he still felt exhausted and had continued to lose weight.
But again they prescribed a course of antibiotics.
He told the panel that he “did not remember” Dr. Williams asking him about his breathing or whether he had a temperature.
During a further telephone consultation on January 4, the patient complained that he had been in bed for most of the day due to lack of energy.
The medical records of the appointment, made by Dr Williams, noted: “I still feel unwell, I have started to stop eating and drinking, I always feel cold now, I have not had a Covid test, I should try to book one because it seems have a viral infection. ‘
In a final phone consultation on January 7, Dr. Williams arranged for a community referral to have the patient’s blood retested.
The medical records did not mention hospital referral or face-to-face follow-up.
But his condition deteriorated further and just two days later, on January 9, he was hospitalized, where it was found that he had also lost 3.5 stone (22 kg) in just four months.
Doctors diagnosed endocarditis, an infection of the inner lining and valves of the heart, which required surgery and hospitalization.
It is usually diagnosed by looking for symptoms such as fever or nodules (small bumps) on the fingers and toes, and a check of the heart with a stethoscope, which detects unusual sound caused by impaired blood flow through the heart.
Over the course of nine months, the patient’s health “deteriorated significantly,” leaving him hospitalized with a heart infection that, if left untreated, can be life-threatening. But without any face-to-face appointment, Dr. Williams failed to complete the patient’s vital temperature and oxygen checks. Pictured, Chapel Street Surgery in Billericay
If left untreated, endocarditis can lead to life-threatening heart failure. Surgery may be required to repair heart damage.
In oral statement filed with the court, Dr C, a GP and medical expert working on behalf of the General Medical Council, said: “If patient A had been assessed face to face (on December 14), then there could have been other symptoms like a high temperature.’
They added: ‘On 4 January 2021, when his symptoms included loss of appetite and he was significantly worse than before Christmas, he needed to be seen.
‘A doctor would need to know the patient’s temperature and whether their oxygen levels were low.
Patient A had unresolved underlying symptoms. Antibiotics had been tried, his symptoms were getting worse and he had new symptoms and was deteriorating.’
In his defense, Dr. Williams said that she knew that some GP offices saw patients in person in 2020 and early 2021, but hers did not, partly due to construction that limited available rooms and the need to keep patients isolated.
The rate of face-to-face GP appointments in England fell by as much as 10 per cent in the first wave of the pandemic, as Britons were told to stay at home to limit the spread of the virus.
Normally, he would have sent Patient A to a ‘medical evaluation unit’, but this was closed in 2020 due to Covid, Dr Williams also claimed.
However, there was a ‘Respiratory Red Centre’ he could have referred the patient to, which treats respiratory infections.
Dr Williams also argued that Patient A was “adamant that he did not want to go to the hospital” because he was concerned about the care of his wife, who was terrified of covid.
But IIn its ruling, the Practicing Physicians Court Service concluded that Dr Williams should be suspended.
He repeatedly failed to make an in-person appointment with Patient A and referred him to the hospital, he found.
The ruling states that “patient A would most likely have gone to hospital if advised to do so.”
The patient had attended surgery for his Covid vaccine in September 2020, the hospital for a CT scan in November and again in December for blood tests and his flu shot, they added.
They also criticized Dr William’s conduct and the ‘contradictory’ evidence.
They wrote: “While he took responsibility for very poor record keeping, he insisted that nothing more could have been done for Patient A because he had full capacity but refused to come to the hospital.
‘He erroneously recorded December 13 as the date of the telephone consultation where going to hospital was first discussed in the undated document.
“He did not record in the GP’s notes that he recommended that patient A go to hospital or that patient A refused any of the consultations.”
The panel also found that Dr. Williams failed to repeatedly record reported symptoms of weight loss.
During the week-long hearing, he acknowledged that his notes recording the patient’s symptoms “were appalling.”
But the court noted that he attended a record keeping course, which had been recommended as a result of the local inquiry in May 2021.
He had also been practicing in the UK as a GP since 1993 and no other complaints or references have been made against him or his practice.
The Court concluded that there was a low risk of repetition of the misconduct.
However, they determined that his actions “failed to adequately protect Patient A” and “the public’s confidence in the profession was undermined by this failure.”
The court said the suspension would send a message to the profession and the general public.
