Reducing the Risk of Litigation When Providing Ultrasound Services Under an SLA or AQP Arrangement

Setting the Scene

A patient attended their GP surgery with stomach pain; after clinical review it was determined that they required an ultrasound (US) scan.

The GP referred the patient to their local hospital, who in turn referred the patient to a second GP surgery who held the any qualified provider (“AQP”) contract for providing US services locally.

The GP surgery holding the AQP in turn subcontracted to a private ultrasound provider under a service-level agreement (“SLA”).

Once the initial GP referral had navigated a very convoluted services delivery chain, the patient was scheduled to attend an US appointment with the private ultrasound provider.

The US was performed by the private ultrasound provider and the results were provided to the GP holding the AQP agreement for onwards transmission to the patient’s GP.

A claim was brought against the private ultrasound provider for failing to deliver the US report to the referring GP, despite them having delivered results to the GP holding the AQP contract.

Reducing the Risk of Litigation.

SLA and AQP arrangements between GP surgeries and private ultrasound providers do not always clearly document pathways for service delivery, such as how reports are delivered and how to confirm delivery has been successfully achieved. This can present problems when trying to defend a case of clinical negligence.

To assist in the defence of any claim of clinical negligence, private ultrasound providers should always therefore endeavour to ensure that any SLA and/or AQP arrangement clearly sets out:

  • Basic service deliverables (i.e. what services are being provided, within what timescales, etc.)
  • A clear explanation as to how appointments are arranged
  • A clear explanation as to how results are delivered and to whom
  • State who has ultimate liability for delivering results to the original referring GP
  • State clearly who holds indemnity in the event of a failure outside the control of the private ultrasound provider (i.e. if results are lost in the service delivery chain, despite successful delivery in the first instance)

In addition to the above contract recommendations, all report deliveries should be clearly recorded, with successful safe receipt request logged.

In summary

It is vital private ultrasound providers have up-to-date, clear and definitive SLA agreements with GPs, ensuring the risk of litigation is minimised.

THEMIS’s defence team have a great deal of experience in defending disputes that arise as a result of providing ultrasound services and can advise on the wordings of AQP/SLA agreements as part of its offering to existing policyholders.

Important Note

This article is intended to raise awareness to clinical risk issues in an effort to reduce incidence recurrence and improve patient safety. This is not intended to be relied upon as advice. Facts have been altered to ensure this case is non-identifiable, albeit clinical learning points remain applicable.