How to... respond to a complaint
We may feel disillusioned when our hard work and compassion result in a complaint. But the outcome, whether the complaint is withdrawn or ends with an independent review, depends on how we react.
1) Every practice should have a written complaints procedure in line with the NHS procedure. If the complaint ends up in an independent review or a civil case, you may need to produce it in evidence.
2) When a complaint is received, contact your defence organisation before you make any response. If the complaint is not from the patient, ensure the patient involved in the complaint has given consent. If the patient has died or lacks capacity, ensure the complainant has the appropriate authority. Confidentiality extends beyond the grave.
3) If the complaint is trivial and has a simple solution, it may be possible for the GP or manager to reply and cover the points within 48 hours. But be careful. What may seem trivial to a health professional may appear serious to the complainant.
4) Some letters of complaint can be abusive. Try not to react emotionally but read the letter carefully to tease out the actual complaint from the vitriol.
5) A response to the complaint should be sent within 48 hours. If it is not possible to deal with the problem quickly a 'holding' letter must be sent. This should apologise for the fact that the patient feels aggrieved. Saying you are sorry for the way the patient feels is not the same as admitting liability. The holding letter should include an offer to arrange a meeting with the complainant and the relevant clinician. Point out that they can also bring a friend or advocate. Also enclose a leaflet explaining the NHS complaints procedure. Mention that the commission is independent but will only look at the case if it is less than six months after the final response from the practice.
6) Complaints need to be discussed at the clinical governance meeting as a significant event. Even if no error was made, it is worth discussing where communication broke down. This should be mentioned in the initial response.
7) The relevant clinicians should study the notes and reply specifically to all the points made, however ludicrous they may appear. This will include details of any relevant consultations, working diagnoses, investigations, treatments and follow-up that was planned. Comment whether, in retrospect, you would now do anything differently.
8) If the detailed response is going to take more than four weeks, send another holding letter.
Many complainants simply want an explanation and reassurance that lessons have been learned. By listening and handling the complaint seriously the situation may be defused. After responding to the complaint, remember all the patients who have been grateful for everything you've done, the thank-you letters and the occasional bottle you received. They vastly out number the complainants.
Dr Peter Moore is a GP in Torquay