Chapter 6: The General Medical Council
Findings of fact in relation to note taking
- Dr Barton did not keep clear, accurate and contemporaneous notes in relation to all 12 patients and Dr Barton admitted in particular that she did not sufficiently record,
the findings upon each examination
an assessment of the patient’s condition
the decisions made as a result of examination
the drug regime
the reason for the changes in the drug regime she prescribed and/or directed.(GMC100948, p206)
- The FtP found proved that Dr Barton did not sufficiently record the reason for the drug regime she prescribed.
- Dr Barton admitted that as a result her actions and admissions in keeping notes were inappropriate and were not in the best interests of her patients. (GMC100948, p240)
Findings of fact: failure to assess patients before prescribing opiates
- The panel found proved that Dr Barton failed to assess Alice Wilkie’s (Patient D’s) condition appropriately before prescribing opiates.
- The panel said that there was no documentary evidence to suggest that Dr Barton assessed Alice Wilkie, an opioid-naïve woman, prior to prescribing opiates (GMC100948, p228). Dr Barton had told the panel that she could not be sure she had formally assessed her as she was away around that time. On her return on 17 August 1998, there was “mayhem occurring” and although Dr Barton may have seen the patient, she would have relied upon the verbal reporting of assessments made by the nursing staff (p229).
- The panel found proved that this was not in Alice Wilkie’s best interests.
- The panel did not find proved that Dr Barton failed to assess all other 11 patients’ conditions appropriately before prescribing opiates.
- The panel said that, in view of the paucity of evidence in this regard, to which Dr Barton’s own poor record keeping contributed, it could not be sure as to the appropriateness or otherwise of any assessment which she may have carried out (GMC100948, p206).