Recipient

GP surgery

First report 15 Apr 2020•Latest report 15 Apr 2020

Recipient record

Reports, concerns and published responses

This page brings together reports naming this recipient and response statements clearly connected to concerns raised in those reports.

Reports
1

Naming this recipient

Published responses
0%

Found for named reports

Concerns addressed
0

Across all linked responses

Stated actions
0

Described in responses

Reports over time

Reports over time

Reports naming this recipient by issue year.

Evidence profile

Report topics

Share of this recipient’s reports compared with all other recipients.

0%published responses found
0stated actions described

Topic comparisons are not available in the current evidence snapshot.

Concerns and recipient responses

Statements from GP surgery linked to the concerns in each report. Select any concern, action or position to view the source wording.

  1. London (South)

    AI-generated summary

    Mrs Patricia McAdam · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Mrs Patricia McAdam was wheelchair-bound with arthritis and peripheral vascular disease and was cared for at home by her daughter. She was admitted to hospital in extremis with severe pressure sores and leg ulcers and died of sepsis on 11 June 2018. The principal concern was that, despite declining contact and care, her repeat prescriptions continued without an obvious regular attempt to assess or check on her, and that patients refusing care should still be regularly assessed.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to GP surgery; that does not assign responsibility.

    PFD Monitor interpretation

    Failure to ensure regular assessment of patients declining healthcare contact and care

    Wider context from the report

    “Mrs McAdam was known to be wheelchair bound due to arthritis and was a smoker with peripheral vascular disease. She was cared for at home by her daughter. She died at Croydon University Hospital on 11th June 2018 from complications associated with infected leg ulcers. She had not been seen by a GP since 13th July 2015. Although there was a large element of the patient herself declining contact and care from healthcare providers, her repeat prescriptions (Oramorph, co-codamol, Amitriptyline and Furosemide) continued despite there being no obvious regular attempt, or any, to assess and check up on her. Caring for patients refusing patient care is obviously challenging. However, I am concerned that there is a system in place in the future to ensure that these patients are regularly assessed, even if that assessment bears no fruit due to a competent patient declining help. I am reassured that the GP practice has put into place a system now whereby these patients do not get forgotten but this report asks for confirmation of such a system. ”
    Open source report
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Published response patterns

Compared with other recipients in reports included in PFD Monitor

Describes published response evidence, not performance.

Published responses found

0%
0%All other recipients 58%
0%100%

How actions were described at the time

This respondent
All other recipients
47%25%27%<1%<1%
  • Completed
  • In progress
  • Planned
  • Unclear
  • Partially completed

Statuses reflect what recipients said at the time. PFD Monitor does not verify whether actions happened.

Types of action described in responses

Percentages use all actions described by each group. An action may have more than one type, so percentages do not total 100%.

Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026