Receiving a complaint from a patient can be stressful, and responding often requires time and commitment during a period when you might be feeling at your most vulnerable.
With a welcoming and responsive culture, it is possible to prevent formal complaints. Encouraging patients to speak up and provide feedback, comments and compliments can result in the early resolution of problems and also be used in a positive and constructive way to improve services.
It is essential that all practice staff are trained in good customer care and the complaints process, and that complaints information leaflets reflect current guidelines and are widely accessible throughout the practice and online.
On receipt of a complaint
On receipt of a complaint, a file should be opened in a dedicated complaints system (which should be located separately from patient medical records). You should check if there is any immediate action that needs to be taken with regard to the patient’s care and whether there are any consent issues that need to be addressed, and consider whether you need to seek advice from Medical Protection or your medical defence organisation. It is also important to arrange support for the staff member /s involved in the complaint.
Acknowledging a complaint
Unless the complaint has been received via NHS England, it must be acknowledged by the practice within three working days. This response should include reference to the patient’s complaint, an apology for the difficulties/distress the patient has experienced, condolences (where appropriate), and an invitation to discuss how the matter is going to be handled. It would also be advisable to include details of the local complaints advocacy service and a copy of the practice’s complaints leaflet.
The investigation plan
Developing a plan as to how the complaint will be handled is an opportunity to clarify issues and manage expectations, and should be done in conjunction with the complainant, where possible.
Creating a template check list to work through each time an investigation plan is required may help you and your colleagues to systematically and efficiently record:
- The complaint reference number
- The complainant’s name, contact details and preferred method of communication
- The patient’s name and details (if different from complainant)
- Consent details
- A summary of the complaint with dates of incidents
- A list of issues to be investigated
- The outcome the complainant is seeking
- The team member who will be leading on the investigation
- The agreed timeframe for sending updates and a full written response to the complainant
- Sources of advocacy
- How feedback will be obtained
- Any further information which may be helpful (e.g. language or disability issues).
Once the investigation plan has been completed, a copy should then be shared with the complainant.
An investigation should begin by conducting interviews and obtaining statements from all relevant staff involved in the matter, and attempts should also be made to contact any staff who have since left the practice as well as other sources, such as other agencies who may have been involved, if necessary. Statements should be objective and factual, and recorded in the complaints file.
Records from the investigation should then be reviewed and any service or care provided should be measured against the practice’s policies and / or clinical guidelines. This is likely to allow you to draw conclusions from your findings, which should then be discussed as a practice, along with any further action to be taken.
Once the investigation has concluded, a formal response should be sent to the complainant. It is important that this letter includes:
- An apology and condolences (where appropriate)
- A summary of the main issues raised
- The action you have taken to investigate the complaint
- A clear explanation in response to each of the issues raised
- The conclusions drawn
- The action / s, if any, being taken to reduce the risk of a reoccurrence.
You may like to offer an invitation to meet with the complainant so they can ask any further questions. You also have an obligation to provide details of the Ombudsman should they not be happy with the action taken, and remind them of the advocacy service.
Meeting with the complainant
Meetings with complainants are an important part of resolution, and all parties should be fully aware of what to expect so they can prepare in advance. This may involve agreeing who will be present and their roles, points for discussion, arrangements for recording the meeting and ground rules to ensure everyone is treated with respect.
It is a good idea to arrange for someone removed from the matter to chair the meeting, and you may like to begin by offering an apology and your sincere intention to resolve the matter. Allow the complainant to outline their outstanding concerns and respond in an honest and objective way with reference to supporting evidence and a focus on any learning from the investigation.
The draft notes of the meeting should be shared with the complainant and their comments invited on their accuracy. A further letter should also be written to the complainant to confirm to conclusions reached, any action being taken and to confirm their right to approach the Ombudsman if they remain unhappy.
- Terri Bonnici and Sue Taylor are medical complaints advisers at Medical Protection. This article is based on a workshop Terri and Sue held at NHS England’s Primary Care Complaints Conference. Medical Protection supports over 1200 GP members with complaints every year.