Complaints in the NHS
Awes Siddique
STGP1
“ 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, if appropriate, an apology. You must not
allow a patient’s complaint to affect adversely
the care or treatment you provide or arrange.”
GMC (Good Medical Practice)
Objectives
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Burden and impact of complaints
Measures to avoid complaints and potential
claims
Legislation
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133,600 NHS complaints in 2007 – 32%
linked to Primary Care
New regulations governing NHS complaints
in England came into force on 1 April 2009
following the White Paper commitment to
develop a single comprehensive complaints
procedure across health and social care by
2009
The Local Authority Social Services and
National Health Service Complaints
(England) Regulations 2009
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Aim to make complaints handling open and accountable, fair and
proportionate, and patient-focused – with a view to seeking
continuous improvement.
Oblige NHS organisations to have arrangements in place to deal
with patient complaints
Sets out the following rights for patients:
 You have the right to have any complaint you make about NHS
services dealt with efficiently and to have it properly investigated.
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You have the right to know the outcome of any investigation into
your complaint.
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You have the right to take your complaint to the independent
Health Service Ombudsman, if you are not satisfied with the way
your complaint has been dealt with by the NHS.
Competence
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Always act within your limitations
Never undertake a task that is beyond your
competence
Chaperone
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Applies whether or not you are the same
gender
Always document when a chaperone is
offered and declined
Confidentiality
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1998 Data Protection Act
GMC guidance (Confidentiality: Protecting
and providing information)
Take steps to avoid potential leaks
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Reception areas – overhearing sensitive info
Restricted access to electronic records to only
those who require it
Encryption software
Consent
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GMC guidance
Capacity
Always obtaining consent – even for the
briefest of physical examinations!
Civil claim in negligence/ assault
Clinical Records
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“You must keep clear, accurate and legible records,
reporting the relevant clinical findings, the decision
made, information given to the patient, and any
drugs prescribed or other investigation or treatment”
GMC
Never rewrite notes at later date – make clear any
retrospective entries by signing and dating
alterations
Patients have legal right to access their records
Avoid derogatory statements, offensive patient
acronyms and criticism of colleagues!
Careful prescribing
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25% of NHS claims from prescribing errors
Generic drug names
In accordance with BNF
Commonest errors
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Wrong dosage
Inappropriate medication
Failure to monitor treatment (SEs and toxicity)
Communication failure
Conduct
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20% of all complaints about GPs in 2007
were in response to poor attitude
Calm, sympathetic and professional manner
‘Physician-Patient Communication’ – Drs who
never received a claim used humour and
laughed more and spent approx 3 min longer
per consultation
Cover
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Check with your medical protection
organisation for appropriate cover to reflect
the work you do
Communication
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43% of complaints to Healthcare Commision
were related to limited discussion about
treatment options
Cover your back
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Seek advice from senior colleagues or your
medical protection organisation
Respond promptly
Finally
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In 2002, 72 per cent of people were very or quite
satisfied with their local NHS doctors or GPs
In 1 in 10 cases referred to the Healthcare
Commision (2007-8) – the complainent was simply
seeking apology or an acknowledgment that the
care could have been improved
Survey of MPS members revealed that 90%
believed an explanation and apology reduced
potential for complaints
Saying sorry doesn’t necessarily equate to admitting
liability
Thank You!
…..any complaints?