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Independents' Day

Rise in patient complaints after being removed from GP lists

The Health Ombudsman has claimed GPs may not be fit to take on commissioning responsibilities after complaints about patients being ‘unfairly’ dismissed from practices rose for a second year.

The claim comes as the Ombudsman revealed complaints about GPs ‘unfairly or hastily’ removing patients from their practice lists rose by 16% in 2011/12 compared with 2010/11.

Her annual report also re-iterated last year’s warning that some GPs were failing to handle ‘even the most basic complaints correctly’, but the GPC said that practices were following the proper procedures in most cases.

The report – published today - shows there were 94 complaints about this issue in total in 2011/12, compared to 81 the previous year. 10 formal investigations about unfair removal were concluded in 2011/12, the same number as the year before.

Overall there were 2,951 complaints against GPs in 2011/12, compared to 2,581 in 2010/11.

Some 82 complaints against GPs were ‘accepted for formal investigation’ by the ombudsman in comparison with 66 in 2010/11, with 80% of these complaints either fully or partly upheld.

After last year’s report was published, the ombudsman told Pulse that cases could be referred to the GMC if GPs did not accept their recommendations.

This year, the Ombudsman’s report was even more strongly worded, suggesting their data raised questions over GP leadership of CCGs.

The report concludes: ‘The failure to improve in this area gives us wider concerns about GP-led CCGs effectively delivering their responsibilities for dealing with complaints.’

CCGs will need to use complaints data from providers to inform future commissioning decisions, as well as dealing with complaints about commissioning decisions and ensuring contracted providers also handle complaints appropriately, said the report.

Health Service Ombudsman Dame Julie Mellor said: ‘Our casework tells us there needs to be a clear shift in the attitude and practice of some GPs towards complaints.

‘Our concerns about how GPs are handling complaints about their practices need to be addressed as a priority.

‘As the new NHS begins to take shape, GPs and other providers, GP-led CCGs and the NHS Commissioning Board will need to work to embed good complaint handling across the NHS.’

But GPC negotiator Dr Peter Holden said practices were only removing an average of one patient a year and were following the proper arrangements for this.

He said: ‘We don’t throw patients off willy nilly. As GPs frequently experience abuse, aggression and violence, it’s no surprise the shutters come down.

‘There’s a difference between being mad and being bad, but for the bad it’s time we said “‘No- I’m sorry, look after yourself.”’

Rising complaints might be because of patients’ increased propensity to complain, rather than any wrongdoing by GPs, he said: ‘Society is getting much more consumer-orientated so patients are more likely to demand and complain.’

 ‘When we’ve got something wrong we’ll admit it. I’ll listen to a complaint from a vulnerable person any day, but there are some people in the middle who just need to man up. Just because you don’t like what I’m telling you it doesn’t mean it’s wrong.’

RCGP Chair Dr Clare Gerada suggested the rise could be due to list-cleansing schemes run by PCTs.

She said: ‘Any complaint or breakdown in the relationship between GP and patient is  regrettable. However, we query the rise in the number of patients being “unfairly or hastily struck off” and ask the Ombudsman to clarify whether this is being confused with the regular reviews of practice lists by PCTs, which GPs have no control over.

‘We will always do their best to resolve issues speedily and fairly and removals from the practice list should be used only as a last resort. Unfortunately, patients sometimes have to be removed, for example, where there has been a violent incident, but the College and the BMA have specific guidance on this.’

NHS Confederation chief executive Mike Farrar said the figures should ‘not be taken lightly’ but that it important to remember that a high number of complaints ‘does not necessarily equate to poor care’.

Readers' comments (20)

  • Given a population of 62.6million, most of whom must be registered with a GP and on average 300million GP consultations a year this number is near pointless to create a fuss about.

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  • Gary Young

    65 complaints upheld following formal investigation from 300m consultations is not bad; something to think about when GPs are being urged to be more customer focused like Sainsbury's (Kings Fund, Pulse yesterday).

    However, what I particulary like is the opening paragraph about GPs being unfit to take on commissioning responsibilities as a reult of removing patients from their lists.

    1. I recall it was this government that decided to dismantle the NHS and put GPs in charge of a large amount of funding and not something that most GPs wanted, then or now.

    2. Is this the government realising too late that it wasn't really very well thought through and looking for an excuse to blame GPs as to why they have to u-turn?

    3. If GPs are discouraged from removing abusive patients from their lists, is this at odds with a zero tolerance policy?

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  • I dont understand how the Ombudsman can link this issue to commissioning - this smacks of political interference and they should just stick to what they are asked to do

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  • Lets see - so 81 complaint out of 66mil people = 0.000012% of the population complained about unfair removal from the list.

    I would say that's an excellent figure for any organization to have

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  • Just because patients complain it doesn't actually mean the GP has been at fault or does it?
    Weve had a complaint about information held in the patient records. It is lodged as a complaint but it is clinical information which is correct and cannot be removed. There has been no wrong doing. It still appears as a complaint even when not upheld.

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  • I think what should be noted is that PCTs are seeing more patients being deregistered in the middle of a on-going complaint. Practices are then saying that as the patient is no longer on their list they do not need to respond to the complaint raised. It appears to be to get out of dealing with the complaint. There may be a justified reasons for deregistration but when this occurs in the middle of a dispute then it does appear as a cop out. The DH complaint regulations state patients have the right to complain without fear or retribution- deregistration during a complaint is the ultimate retribution.

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  • We have a policy where we would only ever remove a patient based on valid reasons after following the RCGP guidance. We also endeavour to get PALS involved in a Liaison meeting and always if a patient is willing to change the behaviour that would precipitate consideration for removal from our list we would identify an agreement contract with the patient and with the assistance of the PALS officer. We have done this recently with a patient who has failed to attend multiple appointments this year and two letters informing they could be removed if they failed to give the practice an opportunity to help them address this. We obviously are continuing to monitor the agreement. It would also seem from the figures quoted out of the total population that if only 82 patients out of the the complaints required formal investigation then that suggests that the vast GP population do not just remove patients from their list.
    Again this appears to be totally exgaerated and blown out of proportion.

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  • Nhsfatcat

    HMG are softening us up for the big blow in the contract!
    The public won't care because all we get is bad press.
    Overpaid, useless, don't know enough about XXX (XXX insert any medical topic,) too many complaints, won't visit, won't work OOH the list is endless.
    All public servants are being hammered. Once we're no longer willing/able to cope- privitisation. And look to see who are the shareholders .
    Anyone else been seeing lots of teachers and policemen with stress?

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  • Perhaps if 95 of us complain about the Ombudsman (number of complaints about removal from list) making spurious political remarks, he will find himself unfit to hold office.

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  • Vinci Ho

    (1) The Ombudsman is actually against the Health and Social Health Bill ??
    (2) So there is a belief that GPs should adopt the attitude ,' Customers are always right'???

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