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