Cauda equina is the source of some of the highest value claims against Medical Protection members. This case report highlights how important it is to keep an eye out for the ‘red flags’ associated with the syndrome.

Problems arising from an employee’s capability are frequently issues which can hinder the smooth running of any operation. Dealing with such issues in a timely and legally compliant manner can stave off many long term problems. However it can be a tricky area to get right legally with many potential hurdles to overcome. The following are some questions and answers on the topic of capability Croner has received to its advice lines from practice managers.

Dr Iain Barclay, Medical Protection Head of Underwriting Policy, examines what conditions are responsible for some of the highest claims against members in general practice

When Mrs C, a keen golfer in her early forties, began to experience constant pain in her lower back, she consulted a GP at her local surgery. Dr P took a history of slow onset of pain with restricted mobility. He did not examine her, but prescribed an NSAID and advised Mrs C to return in two weeks if there was no improvement.

A recent report from the CQC has highlighted where general practice could improve in the provision of end of life care. Dr Rachel Birch, Practice Matters Editor-in-Chief, offers advice on how to put the CQC recommendations into practice.

We have teamed up with NHS Improvement for a new series of risk warnings based on data from the National Reporting and Learning System (NRLS), the NHS’s national database of patient safety incidents in England and Wales. Each article will tackle a different risk commonly reported to the NRLS. In this issue we tackle a commonly reported incident type, medication errors associated with anticoagulants.

Medicolegal Adviser Dr Gordon McDavid answers some of the most common social media queries we receive from practices

Under the Pensions Act 2008, every employer in the UK must put certain staff into a pension scheme and contribute towards it. Whether you’re a hairdresser, an architect or a partner in general practice, if you employ at least one person you are an employer and you have certain legal duties.

This case demonstrates some of the risks practices face when working at scale, and the importance of ensuring effective systems and communication across practices.

Dr Nick Clements, Head of Risk and Underwriting Policy, answers questions about how new care models and other changes in primary care can affect your medical indemnity.

Clinical Risk Education Manager Diane Baylis explains how our risk education team can support GP federations and other organisations working at scale.

Dr Rob Hendry, Medical Director at Medical Protection, explains how we are adapting to the changes affecting primary care

In this issue we focus on Priory Medical Group, which is pioneering a new joined up care model across the City of York. Managing Partner Martin Eades explains the initiative his organisation has put forward in the past two years

Medicolegal Adviser Dr Helen Hartley provides advice on the top medicolegal challenges posed by new care models.

Croner provides advice on the key considerations on staffing for organisations working at scale.

Dr Michael Holmes, RCGP Clinical Lead for the Supporting Federations Programme, looks at what is next for general practice.

With increasing pressure on GPs, many practices are looking towards super-practices and federations as solutions. In theory, working at scale makes for better contracts, more funding opportunities and the benefit of shared resources. But is this the reality of the new care model? Rosie Wilson investigates

Dr Rachel Birch shares a recent case where a member asked for advice on how to deal with a patient who persistently emailed a doctor at the practice about medical issues, instead of attending for a consultation.

Keeping good clinical records is an important duty for the whole practice team. Kate Taylor, Clinical Risk Education Manager, examines why and provides tips for clinicians on how to do so.

HR experts Croner share a case where a practice sought their advice to deal with an employee with a disciplinary issue who was on long-term sick leave.

Medical Protection has seen a steady rise in the number of claims involving practice nurses. Kate Taylor and Diane Baylis, Clinical Risk and Education Managers, examine what areas of practice nursing carry the most risk.

Editor-in-Chief and MLA (medicolegal adviser) Dr Rachel Birch answers some recent queries from practices.

Data from the NHS National Reporting and Learning System shows that more than 800 reported patient safety incidents relate to test result management.

Dr Rachel Birch shares a recent case, where a member asked for advice on how to deal with a request from a patient to record his consultations