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Navigating the complaints procedures

A legal expert answers some common questions on complaints procedures for GPs

It's an uncomfortable reality that every GP is likely, at some stage of his or her career, to receive a patient complaint. While it's natural to feel shock upon receiving a complaint, it's helpful to have a clear understanding of what has happened and how to try to resolve things to everyone's satisfaction.

How common are complaints?

In 2009 to 2010 there were over 40,000 written complaints about general practice in England [1]. While this is a tiny proportion of the 300 million or so GP consultations that took place, every complaint represents a dissatisfied patient but also a potential opportunity to identify and eliminate problems.

What is the procedure for dealing with NHS complaints?

The English NHS and social care complaints procedure has two stages: local resolution within the practice, and the Health Service Ombudsman for patients who remain dissatisfied with the local response to their complaints. There are some differences in the way the procedures operate in Scotland, Wales and Northern Ireland.

Do I have to keep a record of complaints?

Practices (known as responsible bodies) have to monitor and record complaints, and demonstrate that lessons have been learnt. They are also required to compile an annual report of complaints to send to their PCT.

Should the doctor referred to in the complaint be the one to respond?

All responsible bodies must have a complaints manager who is readily accessible to the public. He or she will deal with all complaints and may, if authorised, sign on behalf of the responsible person – usually a senior partner. The response should be based on comments provided by the GPs and healthcare professionals involved. The responsible person must sign off each complaint response and ensure action is taken if necessary. He or she may delegate the responsibility of signing off a complaint response but they will remain accountable for the complaints procedures generally.

Do I need to respond formally to a written complaint?

Other than simple oral complaints which can be resolved within 24 hours, all other expressions of dissatisfaction require a formal written response.

The response should contain an explanation of how the complaint was investigated and details of conclusions reached, together with an apology if appropriate. It should identify any matters that need remedial action and what action the practice has taken or plans to take as a result. Complainants should also be told about the right to take the matter to the Ombudsman within 12 months if dissatisfied with the response.

I have received a written complaint about a child's immunisation error but the practice nurse is away from the practice on holiday for three weeks. How long do I have to respond?

The regulations require complaints (other than oral complaints that can be resolved in one working day) to be acknowledged within three working days. If you expect there will be delay in responding to the complaint, for example if key staff are away or if the complaint is complex, contact the complainant to explain the reasons for the delay.

Do I have to respond within a specific timescale?

The complaint must be acknowledged within three working days. All responses should be thoroughly investigated in a timely manner and usually within six months of the date of the complaint. The complainant must be kept informed at all stages as to how the investigation of the complaint is progressing.

If I feel that the complaint is unjustified, may I give a forthright response?

The GMC advises that patients who complain about the care or treatment they have received have a right to expect a prompt, open, constructive and honest response, including an explanation and, as appropriate, an apology.

The tone of any written response should be professional, measured and sympathetic. In my experience, many complaints arise from a simple misunderstanding and often a carefully worded response can prevent the complaint escalating and may even enhance your relationship with the patient. Your medical defence organisation can advise you about drafting your response.

On reviewing a complaint I have identified a prescribing error. What should I do?

You should tell the patient involved, apologise and arrange any necessary monitoring or follow-up treatment. As part of the investigation of the complaint, you should look further than immediate human error to the root causes of any incident to determine why it happened and identify and eliminate risks that could lead to a recurrence. This should be documented in your annual report.

Dr Yvonne McCombie is a medico-legal adviser at the Medical Defence Union,

Navigating the complaints procedures

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