§ GUIDE · GP NEGLIGENCE

When a GP does not refer,
and the delay costs you.

Most GP negligence claims are about something not done: an examination not carried out, a referral not made, a result not acted on. The courts hold GPs to the standard of a reasonably competent general practitioner, which is not the standard of a specialist. Here is what that means in practice.

Gahir: treated late by

55 hours

Cullen future care

£1,285,844

Judgments here

6

Of which failed

3

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§ RED FLAGS

Some combinations of symptoms demand action.

Gahir v Dr Ola [2024] EWHC 390 (KB) is the clearest example. A patient attended his GP with fever, severe headache, nausea and confusion. The GP diagnosed migraine. He was not admitted to hospital until 55 hours later, when herpes simplex encephalitis, a brain infection, was treated. He was left with permanent brain damage and lost the capacity to manage his own affairs.

The judge found that the combination of fever, headache and confusion required urgent hospital referral, and that with earlier treatment he would have been far less disabled and independent for daily living. The family's account of his confusion during the consultation was accepted.

§ EXAMINATION AND FOLLOW-UP

A telephone review of results is not a substitute for looking at the patient.

Hodgson v Dr Hammond and another [2025] EWHC 1261 (KB) concerned a locum GP who suspected pelvic inflammatory disease but did not examine the patient or arrange urgent follow-up, and a second GP who reviewed her blood results by telephone without referring her for examination. The delay led to a tubo-ovarian abscess, removal of a fallopian tube, chronic pelvic pain and an increased risk of ectopic pregnancy.

The judge held that the claimant had made out her case in negligence against both defendants, with damages to be decided separately. Where a GP suspects a serious infection, the court expects an examination or urgent referral to rule it out.

§ DELAYED CANCER REFERRAL

The claim is about what the delay made necessary.

Cullen v Dr Henniker-Major [2024] EWHC 2809 (KB) involved a GP who saw the patient three times over five weeks with a persistent cough, sore throat and tiredness and did not make an urgent cancer referral. Her laryngeal cancer was diagnosed at stage III about three months later. She needed chemoradiotherapy, a total laryngectomy and bilateral neck dissections, and was left with a permanent stoma and a voice valve.

Liability was admitted, so the trial was about the value of her future care. The judge assessed the care multiplicand at £96,680 with an agreed multiplier of 13.3, producing £1,285,844, and rejected the defendant's allegation that she had been fundamentally dishonest. Social media posts relied on to allege dishonesty were found not to contradict her evidence.

§ THE LIMITS OF THE DUTY

Compensation covers the risk the advice was meant to guard against.

Khan v Meadows [2021] UKSC 21 sets an important boundary. A GP negligently failed to arrange proper testing, so a woman wrongly believed she did not carry the haemophilia gene. Her son was born with haemophilia and, unrelatedly, autism. The trial judge awarded £9 million including autism-related costs. The Court of Appeal reduced it to the £1.4 million attributable to haemophilia alone, and the Supreme Court dismissed the mother's further appeal.

The reason is scope of duty: the purpose of the advice was to guard against the risk of haemophilia, not the unrelated risk of autism. Negligence leading to a child's birth does not make the doctor liable for every consequence.

§ WHY GP CLAIMS FAIL

Early symptoms often look ordinary.

Graham v Dr Altaf [2023] EWHC 156 (KB) involved a three-year-old diagnosed with tonsillitis who turned out to have meningococcal meningitis. The court found no causative breach of duty. Hepworth v Dr Coates [2025] EWHC 1907 (KB) failed because the judge accepted the GP asked the right cauda equina red-flag questions and the patient answered no.

Both show how much rests on the contemporaneous record: what was asked, what was reported, and what was written down at the time.

§ THE JUDGMENTS BEHIND THIS GUIDE

Six judgments involving GPs.

Three claims that succeeded, a Supreme Court case on the limits of a GP's duty, and two that failed on the evidence.

Claimant succeeded

Gurmukh Gahir v Dr Ayodele Olusgun Ola

[2024] EWHC 390 (KB)·2024·Liability decided at trial

Mr Gahir went to his GP with fever, severe headache, nausea and confusion; the GP diagnosed migraine, and he was not admitted to hospital until 55 hours later, when herpes simplex encephalitis was treated with acyclovir. The judge found the combination of fever, headache and confusion required urgent hospital referral and that earlier treatment would have left him far less disabled.

Fever, headache and confusion together are a recognised red flag for brain infection, and a GP who attributes them to migraine without arranging urgent admission may be found negligent. The judge accepted the family's account of the patient's confusion during the consultation.

Claimant succeeded

Philipa Hodgson v Dr Daniel Hammond & Anor

[2025] EWHC 1261 (KB)·2025·Liability decided at trial

Ms Hodgson saw a locum GP who suspected pelvic inflammatory disease but did not examine her or arrange urgent follow-up, and a second GP reviewing her blood results by telephone did not refer her for examination. The delay in treatment led to an abscess, removal of a fallopian tube and chronic pelvic pain.

When a GP suspects a serious infection, the court expects an examination or urgent referral to rule it out, and a telephone review of test results does not replace that. Both GPs were held liable, with damages to be decided separately.

Claimant succeeded

Wilma Agnes Cullen v Dr Ruth Henniker-Major

[2024] EWHC 2809 (KB)·2024·Damages assessed at trial

A GP saw Ms Cullen three times over five weeks with a persistent cough, sore throat and tiredness but did not make an urgent cancer referral; her laryngeal cancer was diagnosed at stage III about three months later. Liability was admitted, and the trial dealt with disputed care costs and the defendant's allegation that she had been fundamentally dishonest, which the judge rejected.

A delayed cancer referral claim turns on what extra treatment the delay caused; here the admitted delay meant chemotherapy, a total laryngectomy and neck dissections that earlier diagnosis would have avoided. Social media posts relied on to allege dishonesty were found not to contradict her evidence.

Claim failed£1.4M

Khan v Meadows

[2021] UKSC 21·2021·Appeal decision

A GP negligently failed to arrange proper testing, so a woman wrongly believed she did not carry the haemophilia gene and went on to have a son with haemophilia who also had autism. The Supreme Court held the GP was liable only for the haemophilia-related costs, because the purpose of the advice was to guard against that risk, not the unrelated risk of autism.

Damages are limited to losses falling within the scope of the duty the doctor undertook. Even where negligence clearly led to a child's birth, unrelated conditions that the advice was never meant to address are not recoverable.

Claim failed

Edward Graham v Dr Simone Altaf

[2023] EWHC 156 (KB)·2023·Liability decided at trial

A three-year-old was diagnosed with tonsillitis by a GP registrar, deteriorated over the next two days and was then referred to hospital, where meningococcal meningitis was diagnosed. The court found no causative breach of duty and dismissed the claim.

Meningitis claims against GPs often fail because early symptoms genuinely resemble common childhood infections; the claimant must show both that the GP fell below a reasonable standard and that earlier referral would have changed the outcome.

Claim failed

Rebecca Hepworth v Dr Amanda Coates

[2025] EWHC 1907 (KB)·2025·Liability decided at trial

A 27-year-old flight attendant saw her GP with severe back and leg pain, having mentioned perianal numbness in a message two days earlier; she had emergency surgery for cauda equina syndrome four days after the consultation. The judge accepted that the GP asked the right red-flag questions and that the patient answered no, so there was no breach of duty.

In cauda equina cases the court looks closely at what safety-netting questions the GP actually asked and what the patient answered on the day. Contemporaneous notes and messages matter greatly for both sides.

Browse the whole case library →

Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

§ QUESTIONS

Common questions

My GP dismissed my symptoms. Is that negligence?

Only if a reasonably competent GP would have acted differently and the delay caused harm you would otherwise have avoided. Gahir v Dr Ola succeeded because fever, headache and confusion together are a recognised red flag; Graham v Dr Altaf failed because early meningitis resembled tonsillitis.

Can I claim if my GP reviewed my results over the phone?

Possibly. In Hodgson v Dr Hammond the court held that reviewing blood results by telephone, without referring the patient for examination, was negligent where a serious infection was suspected.

Who is the claim against, the GP or the NHS?

GPs are usually claimed against personally or through their practice, and in England claims about NHS GP care have been handled by NHS Resolution under a dedicated scheme since 2019. You do not pursue an individual for the money yourself.

What if a delayed diagnosis made my treatment worse but I survived?

That is the usual shape of a delayed cancer claim. Cullen v Dr Henniker-Major turned on the extra treatment the delay made necessary, including a laryngectomy, rather than on survival.

Can I claim for everything that followed the negligence?

No. Khan v Meadows limits damages to losses within the scope of the duty the doctor undertook. There, only the haemophilia-related costs were recoverable, not those relating to the child's autism.

How long do I have?

Usually three years from the negligent care or from when you first knew something had gone wrong, with longer for children and no limit while someone lacks capacity.

§ MORE GUIDES

Plain answers to the other questions people ask.

Why claims fail →

Eleven real judgments where the claim failed, and what each one teaches about proving breach of duty, causation and loss in a medical negligence claim.

Antibiotic delay claims →

How courts judge delays in giving antibiotics for sepsis and meningitis: the causation battle, material contribution, and admissions of liability.

Payout examples →

UK medical negligence payout examples by claim type, typical compensation ranges, and what decides the amount. Then check your own claim free.

Fatal negligence payouts →

What compensation after a death caused by medical negligence can include: the bereavement award, dependency, funeral costs and the estate's claim.

Time limits →

The 3-year time limit for medical negligence claims, the date-of-knowledge rule, and the exceptions for children, mental capacity and fatal claims.

NHS payout data →

Official NHS Resolution figures, band by band, for 2024/25.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.