Even if I say so myself, I am really good at dealing with patients’ complaints. I can see all sides of the problem without fear or favour, thoroughly explore the issues without letting my feelings get in the way and effortlessly work towards a resolution fair to all parties. But when it comes to the complaints about me, I wonder: who do these people think they are? How dare they make me feel so low?
There was an 8.2% increase in written complaints made against GP practices in 2011/12, with nearly 55,000 received. This must be set into context – only 35% concerned clinical problems, and most of the rest were over alleged poor communication, attitude or administration. Crucially, only one in three was upheld.
And consider the numbers of patients who didn’t complain: in 2006, the NHS Information Centre estimated that there were nearly 30,000 consultations in each typical surgery. GPs are still among the most trusted and appreciated professionals and patients continue to attend in ever larger numbers. More complaints are, at least in part, an inevitable consequence of rising numbers of consultations. According to a report by Deloitte in May, if the pattern of GP consultations remains unchanged there could be a total of 433 million practice consultations annually by 2035.1
I do not believe that anyone goes into medicine to do a bad job, but a vocation is a double-edged sword – it is precisely because we care that even a single complaint can make so many of us question our worth. If two-thirds of patient complaints fail, that is a lot of GP misery for nothing.
I am not suggesting we should effectively ignore all patient feedback – from time to time we can learn lessons from a minority of genuine complaints. But a rise in the number of remarks about our practice is only to be expected if we run more consultations.
In our brave new consumerist society, complaining is positively encouraged and, whether we like it or not, general practice services are seen as just another part of it. There is a management theory that describes complaints as ‘pearls of great price’ that enable a business to learn and grow. This is true, but only to a point.
General practice cannot set itself apart entirely from consumer society. Practices are, after all, small businesses that are often in competition to attract patients.
But we are not making tins of beans, we are dealing with complex and unique individuals using systems and techniques that can never be perfect. And even the very best members of our profession are mere imperfect beings striving to be professional. We are not employed by Tesco (yet), nor are we in the nuclear power or civil aviation business – so why do these other industries inspire so many of the ideas used by managers and media commentators to target our profession?
Service makes a difference
The solution for improving general practice is simple: listen to your patients. In 1998 I joined a small practice that had consistently failed to build up a decent list size. The village was close enough to a large town for patients to have a wide choice of practices and, unfortunately, there had been long-term illness in the team, which added to the failure to thrive.
I was determined to raise the practice’s profile without actually advertising and made a point of telling every new patient to get in touch directly if they encountered any problems. If we did not know why they were unhappy, how could we change? There were other factors to the practice’s improvement over the next few years, but I am happy to say list growth was one of them.
We have all experienced good, bad and indifferent service in our own lives. Who has not been frustrated when trying to contact a helpline ‘presently experiencing a high volume of calls’? Who has not sat in a dispiriting waiting room, studiously ignored by staff who seem to be having a great time without worrying about you?
By the same token, a promptly answered telephone call or an email from someone who sounds interested in helping us can make all the difference. Why should general practice be any different? I think most practices and practice managers understand this. An efficient, productive practice is a happier place to be a GP as well as a better place to be a patient.
Dr Barry Moyse is a GP in Taunton and assistant medical secretary of Somerset LMC