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Independents' Day

How to make sure complaints stay in the practice

Sue Taylor, Terri Bonnici and Patricia Berlyn advise

In a recent Medical Protection survey* just under half (43%) of the public said they would complain directly to their GP or the GP practice responsible for the cause of the complaint. This compares to 32% who would complain to the GMC, 25% to the CQC and 25% to NHS England. 

There could be a number of reasons for this. In some cases patients may feel that their complaint was too serious to be handled by the practice, or perhaps they feel they wouldn’t receive an objective and open response. Alternatively, it may just be a case of patients simply not being aware of the complaints procedure.

While it can be distressing to receive a complaint from a patient, it is often even more so if the complaint is received via the GMC or another outside agency, and so it is best for the practice to encourage complaints directly to them.

A practice can influence the journey of a complaint by encouraging patients to speak up and approach them when they have a concern. By doing so, the matter can often be resolved before it escalates or comes to a point where it is too difficult to resolve locally. Another approach that can be used in partnership with the above is to ensure procedures are up to date, communicated properly and displayed clearly.

As well as ensuring you have the right policies and procedures in place, here are a few ways to try and ensure that any complaints are dealt with effectively inside the practice.

1. Encourage people to speak up when they have a problem or concern

Doing this will mean they speak to the practice about any concerns, rather than go to an external organisation. Here are some things to consider:

  • Do you have an ‘open door’ policy for any patients wishing to discuss concerns, and is this policy publicised?
  • Ensure all staff, particularly those at front of house, know how to swiftly signpost patients to someone who can help both within the practice and to an independent advocacy – for example the NHS Complaints Advocacy Service.
  • Give patients the means of communicating their suggestions for improvements via websites, suggestion boxes, PPGs etc.
  • Make patient feedback (good and bad) a regular item on your practice meeting agendas. Don’t forget to obtain input to these discussions from your front of house staff. They will have a wealth of anecdotal feedback.
  • If you feel that a consultation did not go well or a patient has voiced concerns to your receptionist following a consultation, consider following this up. It may be that the matter can be resolved quickly and a complaint can be prevented.
  • Let your patients know when you have altered your practices or procedures due to their feedback – 'You told us... so we have...' If you can demonstrate to patients that you listen when they speak up, they are more likely to approach you when there is a problem.

2. Publicise your complaints procedure

This ensures patients know how to complain to you so won’t go elsewhere.

You can do this by having leaflets on display. Consider having these in different formats and languages depending on your practice population. You can discuss this literature in your local networks and forums as it may be possible to share resources on translations and to gain some consistency in approach.

Also ensure your staff are fully trained in the complaints procedure so they can answer questions and correctly signpost patients. The knowledge of your staff on the complaints procedure could be tested during a CQC visit.

3. Emphasise your openness and honesty

Many patients will take their concerns elsewhere because they do not think that they will achieve an objective investigation through the practice. It is important to prove them wrong. Here are ways you can do this:

  • Discuss with the patient who is complaining at the outset how they would like the investigation to take place, the outcome they are seeking and explain how long the investigation is likely to take. There is a statutory obligation to do this in the 2009 complaint regulations.
  • Don’t investigate your own complaints. Where possible get another partner in the practice who has not been involved to take the lead.
  • Reflect on matters as an individual and as a practice, and act on any learning.
  • Be ready to offer an early apology for any distress or misunderstanding. Remember that an appropriate apology is not an admission of liability and could prevent the complaint from escalating.

In summary, familiarise yourselves with the practice’s complaints procedure, ensure procedures are displayed and clear, and consider where improvements could be made. These steps could help to ensure more complaints are received, handled and resolved locally and prevent escalation. If in doubt or you need further advice on handling complaints, you can contact your medical defence organisation.

* Figures are from YouGov Plc. Total sample size was 2021 British adults. Fieldwork was undertaken between 2 – 3 August 2016. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Sue Taylor, Terri Bonnici and Patricia Berlyn are medical complaints advisers at Medical Protection

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Readers' comments (4)

  • Any initial complaint sent to an organisation other than the GP practice should be bounced back with a note requesting a copy of their complaint to the practice and the response. If they lie and claim there was no response or lie significantly in their complaint, then no matter how serious, it should be declared null and void.
    About 12 years ago we had a complaint which went directly to the Health Board, who correctly asked for it to be initially handled at practice level. A (different) letter of complaint was then sent to us and the complainant remained dissatisfied so it returned to Health Board level.
    At that stage all communications were made available to all parties and the initial complaint to the Health board was scarcely credible! Three total lies and several statements that were severely exaggerated and embellished, presumably so that the Health Board would take it more seriously.
    The matter was then dealt with appropriately, the complainant remaining dissatisfied. I wanted to sue the bitch for the stress caused to us but my more sane partner advised against.

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  • We had a complaint go dierctly to NHSE .They didnt send it back to us to deal with but investigated the complaint themselves being very demand of mine and my PMs time and alsohaving to use my defence union a lot with increasing stress.The complaint was completely dismissed eventually but after many weeks and lots of stress .NHSE didnt know best practice and bypassed us.My opinion of NHSE is pretty poor before and even more so after this event.If it was initially allowed to be the practice complaint procedure it would have been sorted quickly effectively and I bet in a more cost eefective manner.

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  • Dear MPS

    everybody is apologising to patients. Perhaps if you actually fought for doctors a bit more robustly rather than encouraging the culture of complaints then we would not be in this mess. The entire model of profuse apologies for matters which are often not in the control of doctors is encouraging people to complain more. I know you are not bothered at all about doctors' health but rather keeping your own costs down. Ultimately this policy of yours for apologising for everything is conveying to patients the false premise that doctors are responsible for systemic failings which they are NOT. maybe you could persistently write to the government suggestions about improving funding and not blaming every failure of policy on GPs rather than telling GPs repeatedly to say sorry.

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  • 1. We've been speaking up for the last few years but it's falling on deaf ears. The silence from the regulators over the state of the NHS is deafening.
    2. The last thing we want to do is encourage complaints. They eat resources and the more that occur the more likely people are to escalate which is what the entire system is designed to do (If you are not satisfied, you may also contact the Ombudsman...
    3. Investigations are structured and there are certain boxes we have to tick for SEA so choice doesn't help much, I really don't think partners 'investigating' each other is a healthy working environment, the majority of these reflections just make us more bitter and angry, saying sorry may be pragmatic but some people want a kidney as well!

    The overall situation has become utterly toxic and is harming both patients and doctors. Regulatory reform is long overdue but there are too many people making money from this to stop now.

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