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GPs growing more anxious over complaints

By Christian Duffin

Medical defence organisations are being swamped with calls from doctors seeking advice about patient complaints.

Experts say the sharp rise is a consequence of the increasing number of avenues that can be used to complain about GPs. Local procedures for resolving complaints early are also failing, putting more stress on GPs as cases drag on.

Medical Defence Union advisers answered 3,000 more GPs' calls to its helpline in 2006 than in 2005 – a 13% rise. The Medical Protection Society recorded a 28% rise over the same period. In 2006/7 there were 236 calls compared with 185 in 2005/6.

MDU chief executive Dr Michael Saunders said: ‘There are more lines of criticism of doctors, so they get more anxious. At the GMC there might be an interim panel, a performance review and a fitness-to-practise panel.

‘It is not uncommon for us to assist a doctor with an employer's disciplinary investigation, coroner's inquiry, police investigation, GMC complaint and medical negligence claim, all arising from the same facts. These take several months and even years to resolve.'

MPS medical director Dr Priya Singh said the 2004 out-of-hours opt-out had been responsible for some additional complaints. ‘Patients are being triaged by someone they do not know, who may not have access to their medical record. This causes communication problems and means that patients are more likely to complain.'

Complaints against GPs and other health professionals used to be dealt with by independent review panels, convened from a list of lay people and health professionals approved by the Department of Health. But these have been scrapped and PCTs often pass complaints on to the Healthcare Commission to resolve, increasing delays and frustration, added Dr Singh.

Steven Ainsworth, a former independent review panel chair, said complaints had been rising for some time. ‘It does not mean there are any more problems with GPs, but people are less deferential and uninhibited as each generation goes by.'

He added that PCTs and hospital trusts had become ‘sloppy' at dealing with complaints and just handed them over to the Healthcare Commission ‘if they do not like the look of them'.

The department is consulting on plans for new procedures for complaining about health and social care services in its Making Experiences Count document. One GP in Scotland, who did not wish to be named, demanded improvements to complaints procedures after a complaint against her was allowed to drag on for two years.

It was finally thrown out by the GMC without her even being called to give evidence. ‘Someone from my health board apologised to the patient – without asking me for my views,' she told Pulse.

A Healthcare Commission report from February showed 66% of complaints about GPs concerned delays in diagnoses or failures to diagnose. About 15% were from patients angry after being removed from a practice's list.

How complaint pressure is on the rise

- Increasing avenues for patients, including GMC interim panels, performance reviews and fitness-to-practise panels
- Patients are less deferential and more willing to complain
- Out-of-hours opt-out means patients more often see doctors they don't know
- Changes to standard of proof may make GPs more vulnerable to legal action

Dr Michael Saunders: patinets now have more opportunities to complain Dr Michael Saunders: patinets now have more opportunities to complain

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