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Independents' Day

Up to third of GPs raising alarm over hospital care see complaints ignored

Exclusive: Nearly a third of GPs who complained about their local hospital’s care of patients within the past year found their concerns were not acted upon, a Pulse survey reveals.

The survey, part of an investigation which questions the feasibility of the Francis Report’s recommendation that GPs should take a lead in monitoring standards in secondary care, found that in some of the worst cases even complaints about delays to the care of seriously ill and vulnerably patients were simply brushed off or not responded to.

The Francis Report into failings at Mid Staffordshire NHS Foundation Trust criticised GPs for not speaking up and concluded that they need to take on a more prominent, independent role in monitoring the standards of hospital care.

Prime Minister David Cameron backed the call, saying GPs need to be ‘more enquiring’ about their patients’ time in hospital, while Stephen Dorrell MP, chair of the Commons Health Committee, told Pulse that GPs should act as ‘guarantors’ of their patients’ hospital care.

However, the survey findings suggest that many GPs already actively seek to address problems their patients have experienced, but are often ignored.

Some 41% of the 343 GPs who responded to Pulse’s snapshot survey said they had raised concerns about patient care with their local hospital in the past 12 months.

Yet of these, 31% stated that the complaint was not listened to or, where appropriate, acted on. A similar proportion said they did not know if their complaint had been taken on board.

One GP from a practice in north London, who asked not to be named, said several complaints had been ignored. The GP told Pulse: ‘They’re just not responded to, or I’m told I’ll get a response within a certain time and then it is either half-baked or doesn’t really answer the query.’

In a recent case, the GP lodged a complaint with a local hospital on behalf of a man with learning difficulties whose care was hindered by long delays and a prescription error.

‘I never got an answer from the hospital, and even when I took it to the ombudsman I didn’t get anything back. What’s the point of making a complaint and writing up a case if no one does anything with it?’

A GP in Birmingham, also speaking anonymously, raised concerns about a patient turned away from A&E who ended up needing to be admitted to intensive care with renal failure at another hospital.

Although the practice received a letter from the senior consultant to say it would be investigated internally, no further explanation was given.

The GP said: ‘The patient was discharged eventually – but this immediate refusal of admission caused him a lot of distress. This one decision led to a sick patient having to come back to us and we had to find another hospital for him to go to – so this put a lot of pressure on other services.’

GPC negotiator Dr Chaand Nagpaul told Pulse: ‘I think all too often GPs’ complaints don’t get handled in the right way. We need better systems for GPs to raise concerns at an early stage in a simple way, rather than having GPs writing isolated, ad hoc letters hoping it will reach the right person, and better systems for how hospitals receive complaints, their response times and how things are fed back.’

‘But part of that requires CCGs to be equipped to be able to fulfil that function. Many CCGs are overstretched and the Francis recommendation was predicated on increasing capacity for support and resources for GPs to take on this monitoring.’

RCGP chair Professor Clare Gerada said: ‘Patients and their GPs need to be confident that they will receive good and safe care in hospital. [But] we do need to be clear about where the boundaries lie in terms of the GP’s role here.’

‘GPs should not ultimately be responsible for the standards of care in hospitals but it is important that any concerns GPs have are raised, to help hospitals improve patient care.’

‘The RCGP supports the development of better systems through which GPs can feed back patient concerns about hospital care.’

A spokesperson for NHS England said: ‘We strongly support the recommendation that GPs should take a greater role in monitoring the quality of their patients’ hospital care.’

‘The introduction of clinical commissioning groups provides an unprecedented opportunity for GPs and GP practices to work together more collaboratively and systematically in sharing intelligence about quality of care for their patients.’

‘As commissioners of most hospital services and GP practice membership organisations, CCGs are ideally-placed to raise any concerns about quality with providers and hold providers to account for improving quality.’

Readers' comments (5)

  • As a patient, SOME complaints get genuine effective action. What made commenting worthwhile was when I was in front of Assessment Nurse prior to an op. Told her I had had polio and therefore needed special care re anaesthesia.

    She dismissed my concerns; I wrote down her words, contacted PALS, and had an hour-long interview with Head of Anaestheology - and got impression Nurse had been subjected to a similar length process, but not so pleasant.

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  • Patient's complaints are taken seriously. Unfortunately, GP's aren't.

    I've written a stern letter about frankly negligent care my patient recieved by my local hospital - instead of a resonable reply, I had a dressing down from my senior partner about GMC's conduct on how to treat "colleague". That's the world we live in.

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  • It is just as difficult to raise concerns about unacceptable care in general practice. When I have tried to raise a serious concern in the past, I have been stonewalled or met with a hostile, defensive response to examples of truly awful care.

    I also think we're falling for government spin here. They are encouraging us to be at each others throats. People in glass houses shouldn't throw stones ... (and we all know that is where we reside, often because of a lack of resources)

    Why don't we stick to reporting the government and its lackeys for the abject failures in health service redesign which have led us here.

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  • because GPs are just PERFECT and have short memories from when they were clueless hospital doctors.

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  • It is disappointing to hear our secondary care consultants are having difficulties raising concerns with the primary care. I always try and talk to the consultants if they ring me but often I'm rung in middle of surgery - I can't chat, even for a couple of minutes when I have a patient every 10 min and I'm already 15 min behind!

    Perhaps what's needed is a common forum to discuss such things. Only problem is the worst of us, who are the problem, will never attend such thing.

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