A GP’s failure to refer a patient for specialist psychiatric treatment did not amount to misconduct or impairment

The GMC alleged that Dr. T had failed to refer a patient suffering from bipolar disorder to a specialist consultant in psychiatry in breach of the NICE Guidelines and in breach of his duty. It was also alleged that Dr. T had prescribed lamotrigine outside the British National Formulary and in breach of the NICE Guidelines. The patient committed suicide by hanging himself in a park.

Following the inquest, Dr. T was referred to the GMC by the Coroner for failing to refer the patient for treatment.

The Medical Practitioners Tribunal concluded that Dr. T should not only have referred the patient, but he should not have prescribed lamotrigine outside the BNF.  It was held that the patient needed specialist treatment.

The GMC submitted that Dr. T’s failings amounted to significant and serious failings. It was submitted that Dr. T’s care of the patient fell seriously below expected standards, posed a risk to patient safety and therefore amounted to misconduct.

Following a highly contested hearing before the Medical Practitioners Tribunal, which included hearing evidence from a number of experts, including Professor David Taylor, Professor in Psychopharmacology, Dr. Kahtan, Consultant Psychiatrist, Dr. Longwill, General Practitioner and Dr. Bicknell, General Practitioner, the Tribunal upheld submissions on behalf of Dr. T that, as a matter of law and fact, his failings did not amount to professional misconduct.  

The Tribunal held that even though Dr. T (a) should have referred the patient for specialist treatment, (b) should not have prescribed lamotrigine and (c) was in breach of Good Medical Practice (2006), they did not consider that they were sufficiently serious to amount to misconduct.

It therefore followed that Dr. T’s fitness to practise was not impaired by reason of misconduct.

Simon Butler was instructed on behalf of BSG Solicitors LLP to represent Dr T.