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CCGs could handle complaints about GPs in future

NHS England is considering allowing CCGs to handle patient complaints about GPs, after a parliamentary committee criticised the current system.

In a new report on complaints and raising concerns in the NHS, the House of Commons Health Committee said there were instances of primary care complaints from Devon, Cornwall and the Isles of Scilly which are now passed to a call centre in Leeds and dealt with by a commissioning support unit in NW London.

The group of MPs said this example, submitted in written evidence to the body, ‘illustrates the opportunity for confusion, dissatisfaction of service users, unacceptable delays and breakdowns in working relationships’.

In response, NHS England said it is ‘prepared to design’ a different approach to complaints management in partnership with CCGs as part of the move to co-commissioning.

The MPs’ report said: ‘The committee is concerned about the effects of centralising complaint handling in primary care by NHS England. We do not believe that primary care complaints should be investigated in a different region. This has led to fragmentation and disconnection from local knowledge and impaired the ability to deliver a timely response and learn from complaints.

‘We recommend NHS England reports on progress on providing a primary care complaints system that is responsive to patients in a timely manner and which results in local learning and improvement.’

Responding to the committee’s concerns within the report, NHS England’s director for improving patient experience Neil Churchill said the committee’s point was ‘well made’ and that NHS England was ‘open to ideas’ about how it could handle complaints differently to benefit patients.

He added that ‘this will need to be in the context of the further 15% cut in our running costs from next April, which will inevitably mean reductions in the number of staff in our local teams’ but that co-commissioning by CCGs may provide the solution.

He said: ‘It may be the case, for example, that the greater involvement of CCGs in complaints will help drive improvements in clinical practice or the administrative systems used by GPs, dentists and optometrists. As you know, NHS England is currently exploring co-commissioning of primary care with CCGs and as part of that we are certainly prepared to design, pilot and evaluate a different approach to complaints management in partnership with a CCG, or a cluster of CCGs. This will enable us to measure levels of patient satisfaction, learning from complaints and value for money against our existing models of delivery.’

Readers' comments (11)

  • It would be a positive change as CCGs are better placed to deal with complaints because of their knowledge of local providers and conditions. It would be far better than having an anonymous remote body with no clue of realities on the ground undertaking this crucial work.

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  • Vinci Ho

    It goes around a circle. Don't you think with this and co-commissioning , CCGs are 'evolving' back to PCTs. Of course , CCGs are by definition GPs instead. Remember the old argument of simply putting more GPs in charge of PCTs . But of course, current regime must destroy anything left over from the last government . This is partisan politics , ladies and gentlemen. Same old story is to repeat itself again and again, God bless........

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  • In the 'old days' of not so long ago some complaints could be resolved by practice managers, but they were often not impartial enough; then managers at PCT's who were often too reliant on the goodwill of local practitioners who could make life difficult through networking with others to undermine them when they needed good relationships to work with them on other issues ; then also PALS who were sometimes connected too closely with practices and then also the Community Health Councels......many of which were totally ineffectual and again the problem was in having too many links which mitigated against independance or impatiality. Then of course there is the local MP; the local councillor may take an interest...Uncle Tom Cobley and all with a last resort the GMC with it's nightmare of 'screeners' unnamed investigators so that connections or vested interests were not transparent eg more than one Unfit to Practice P panel members have had concerns raised against them yet have still been allowed to sit in judgement of their peers. It doesn't work. Local resolution hasn't been the answer, the reliance on local people only in handling complaints has too many pitfalls. How would it deal with complaints about colleagues from other healthworkers - is there to be yet another separate arm to the system.surely all those 'experts' should be able to come up with something acceptable to all parties

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  • As long as the CCG remains membership organisation this is a path to disaster via conflict of interest.
    If it stops being a membership organisation then we can all be resolved of responsibility when the rationing decisions come crashing through.
    NHSE cannot have it both ways.
    Don't let your CCG go for co-commissioning or your income will be used to pay of the CCG deficit, just look at prescribing in Bedford

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  • While I am positive of CCG handling complaints, there is a dark side to this too.
    3 years ago the Trust tried to close my Practice. In the tussle that followed, a Commercial Director of a local APMS provider came over for a chat - at my invitation as I was talking to all providers looking for partnership options.
    He advised me to make a deal with the local PCT Contracts Manager. He said 'X is a nice guy. He'll give you a good exit deal. Take it and walk away' ( ie leave your Surgery).
    I was surprised and looked askance. So he carried on- 'or they will get you struck off'. I was aghast and asked ; 'Can they do that?' The answer was ''That's what we do.''
    I was now more confused and asked ' What do you mean 'we' - who are you, just a Commercial Driector for an APMS?'
    The gentleman explained that he was a former Medical Director of a London PCT and he had got a Doctor struck off because he was being difficult. 'Difficult' like me? - I asked. Well, possibly he said. Intrigued, I asked him how did they(PCT) do it and that I felt it was quite an unscrupulous thing to do. He painstakingly explained- 'It's simple. We take a small complaint and escalate it to a higher level and then pass it on to the GMC. The GMC strikes of the Dr with ease because it is coming from the PCT!!
    I thanked the gentleman and contacted the GMC Ethics Committee, the LMC, PCT and the Contracts Director who had been named. Within 2 days I got a letter from this Director saying ' On the basis of an internal meeting, we have come to the conclusion that you are an unreliable partner for the PCT and therfore your Contract will terminated on the .... which was 30 days from the date. This chap did not even try to deny any association with the APMS commercial director.
    The moral is: If you have any animosities or any over-riding interests in the local Trusts/CCGs, then God bless you if they are dealing with a complaint against you.
    The aftermath was interesting and we are still here.
    I still do not sleep at times thinking of that colleague in the North London PCT who was removed from the Register by the GMC and whose life was ruined because of manipulation by this former Medical Director - now a Commissioning Champion.

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  • Sanjeev.huge respect for publishing this - if there is any negative come back on you - there will be massive support for someone with real guts and morallity.,,unless accounts like this become known it can seem to the uninitiated that a lot of fuss is being made by the disgruntled.

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  • Hello Sanjeev
    I found your experience interesting and an eye opener. Can you complete your story by letting us know what happened to you since? did they terminate your contract? what action did you take since? Are you still in business?

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  • Well, my negotiator was LMC who stabbed me in the back by making an agreement with other Practices in the area and the PCT that the Practice would close and they explored taking on who could take on my patients.
    The main benificiary was a GP who was a member of the LMC.
    I found out about this when 2 Managers from neighbouring Practices came and offered me a job in my own Surgery and whether I would lease or sell my Premises. I was gob-smacked when they explained that my Surgeery was going into liquidation. The next thing I knew, I was on the phone to LMC and believe me, I was not polite - I can manage a lot of stress but this time the cap had gone.
    I got a campaign on with support from our local Councillors both labour and conservative and began an online campaign collecting more than 1500 signatures - 57 online and the rest collected by patients on the streets within record time. Our local MP Mark Reckless got personallyinvolved and supported the Practice telling me to relax while he would do the campaigning with his Team. Mark Reckless's wife was pregnant at the time but he spared no pains commuting to Tunbridge Wells, talking to NHS leaders trying to get things sorted. I was impressed and grateful for his help and supported him heartily in his recent election bid in Rochester after he had switched to UKIP.
    I contacted Hempsons at Manchester as had heard of their good work in the Pulse for another Practice. Was afraid of local solicitors being connected with the establishment.
    2 weeks before the closure, we had a meeting in the Practice.
    A Commissioner and the Contract Director sat cutting jokes and using pub language. The Commissioner had his hands in his pockets and stretching his legs he jeered as the LMC representatives watched passively ;''You are finished Dr Juneja, you are finished'and then turning to the Director ; You watch me, mate.''
    I sat peacefully during this chat and only said' You do what you have to do, I'll do what I have to''.
    But I was confused and a bit anxious. We had had a teleconference with the solicitor and a barrister on the previous day and i did not know whether they had managed to send a letter to the Trust Chief Exec or not. If they had, then I was finished beacuse thee guys were closing my Surgery despite the warning from Solicitors and there was no stopping them. But I kept quiet.
    Next day, I got a telephone from the Trust asking me to come and sign an agreement for a 3 month extension.
    After the extension came Easter. I drove to Poland as always through Dover and Dunkirk to spend time with my kids.

    On the way, I was thinking, ruminating over the months of agony I had gone through. As we passed through Germany, I asked the question Job had in the New Testament - Why me?. Why did I have to go through all this torment for months, why did I have to spend sleepless nights shared my my wife and Mum? At that point, I asked my wife to pull over. I got out of the car and tears streamed from my eyes, I am not ashamed to say, I cried like a baby. I don't remember when I had last cried and but it did me good, real good. I got back into the car and put on my sax selection - light at heart and drained of negative emotions.
    Yes, we negotiated a GMS Contract, we lost our MPIG in one blow and we raised the list size by 800 patients to recover the money but we have struggled all along.

    3 days after the the Contract was reinstated, in the monthly GP Meeting, the Doctor from LMC stood up and asked a question ''Who will get the patients from my neighbouring Practice if the Doctor there is struck off?. You could have seen 70 GP head shake in disbelief. A complaint did go through to the GMC from somebdoy else but in it there was a line that where the complainant claimed that the issues he had raised had been 'independently verified' by this GPs Practice Manager.
    The GMC rejected the complaint as they had been contacted months earlier when the threat had been made by the Commercial Director and because they did not find any substance.
    Marlowe Park Medical Centre has grown and has 4150 patients. It is a happy and safe Practice where patient satisfaction levels are amongst the top in Medway. We have one GP- me and locums as and when finances allow - with a global sum of only 21500 per month you can't have 2 f/t GPs.
    I wonder if I haven't bored you to death. But I love telling this story. The people involved are all Heads and the atmosphere can be intimidating. But we carry on, aware that the day I twist my ankle, somebody will not hesitate in putting me down.
    But who cares,,,,,

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  • Sanjeev - have you set up another practice - what happened to you took place in N London is that right? bit confused as you are in Rochester now so does that mean they did close you s in London.? If you don't want to go into details about which area it went on that's understandable but there were several threats of closures in London - one campaign was in Camden area.wonder how much this has gone on.?

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  • I'm at the same Practice. Quite likely, behaviour patterns repeat and a simlar thing happened in N London. Unfortunately, I don't know of any Doctor struck off in N London but there would be somebody out there who has unjustly suffered if one was to believe the former Med Director's bragging.

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