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Rise in patient complaints after being removed from GP lists

The Health Ombudsman has claimed GPs may not be fit to take on commissioning responsibilities after complaints about patients being ‘unfairly’ dismissed from practices rose for a second year.

The claim comes as the Ombudsman revealed complaints about GPs ‘unfairly or hastily’ removing patients from their practice lists rose by 16% in 2011/12 compared with 2010/11.

Her annual report also re-iterated last year’s warning that some GPs were failing to handle ‘even the most basic complaints correctly’, but the GPC said that practices were following the proper procedures in most cases.

The report – published today - shows there were 94 complaints about this issue in total in 2011/12, compared to 81 the previous year. 10 formal investigations about unfair removal were concluded in 2011/12, the same number as the year before.

Overall there were 2,951 complaints against GPs in 2011/12, compared to 2,581 in 2010/11.

Some 82 complaints against GPs were ‘accepted for formal investigation’ by the ombudsman in comparison with 66 in 2010/11, with 80% of these complaints either fully or partly upheld.

After last year’s report was published, the ombudsman told Pulse that cases could be referred to the GMC if GPs did not accept their recommendations.

This year, the Ombudsman’s report was even more strongly worded, suggesting their data raised questions over GP leadership of CCGs.

The report concludes: ‘The failure to improve in this area gives us wider concerns about GP-led CCGs effectively delivering their responsibilities for dealing with complaints.’

CCGs will need to use complaints data from providers to inform future commissioning decisions, as well as dealing with complaints about commissioning decisions and ensuring contracted providers also handle complaints appropriately, said the report.

Health Service Ombudsman Dame Julie Mellor said: ‘Our casework tells us there needs to be a clear shift in the attitude and practice of some GPs towards complaints.

‘Our concerns about how GPs are handling complaints about their practices need to be addressed as a priority.

‘As the new NHS begins to take shape, GPs and other providers, GP-led CCGs and the NHS Commissioning Board will need to work to embed good complaint handling across the NHS.’

But GPC negotiator Dr Peter Holden said practices were only removing an average of one patient a year and were following the proper arrangements for this.

He said: ‘We don’t throw patients off willy nilly. As GPs frequently experience abuse, aggression and violence, it’s no surprise the shutters come down.

‘There’s a difference between being mad and being bad, but for the bad it’s time we said “‘No- I’m sorry, look after yourself.”’

Rising complaints might be because of patients’ increased propensity to complain, rather than any wrongdoing by GPs, he said: ‘Society is getting much more consumer-orientated so patients are more likely to demand and complain.’

 ‘When we’ve got something wrong we’ll admit it. I’ll listen to a complaint from a vulnerable person any day, but there are some people in the middle who just need to man up. Just because you don’t like what I’m telling you it doesn’t mean it’s wrong.’

RCGP Chair Dr Clare Gerada suggested the rise could be due to list-cleansing schemes run by PCTs.

She said: ‘Any complaint or breakdown in the relationship between GP and patient is  regrettable. However, we query the rise in the number of patients being “unfairly or hastily struck off” and ask the Ombudsman to clarify whether this is being confused with the regular reviews of practice lists by PCTs, which GPs have no control over.

‘We will always do their best to resolve issues speedily and fairly and removals from the practice list should be used only as a last resort. Unfortunately, patients sometimes have to be removed, for example, where there has been a violent incident, but the College and the BMA have specific guidance on this.’

NHS Confederation chief executive Mike Farrar said the figures should ‘not be taken lightly’ but that it important to remember that a high number of complaints ‘does not necessarily equate to poor care’.