Advice centre

Baby T was eight weeks old when his mother brought him to his GP’s morning surgery. His mother had become increasingly concerned about his general irritability and frequent crying episodes, which lasted up to two hours. These had become apparent over the past three days, not settling with breast feeding.

Mr S was a 60-year-old lorry driver. He was overweight and smoked, and couldn’t walk far because he suffered with pain in his calves.

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.

Removing patients from the practice list is an emotive issue, risking criticism from bodies such as the Northern Ireland Ombudsman, the General Medical Council (GMC) and the media and should only be used after careful consideration and as a last resort.