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A blog reviewing the Parliamentary and Health Service Ombudsman’s report which has gathered evidence from their own casework and intelligence from the Care Quality Commission, NHS England and Healthwatch England to review how well GP surgeries in England are handling concerns and complaints when things go wrong with patient care.
By Lucy Norton
Complaints about medical treatment are extremely important. They matter to the individual patients who deserve an explanation when things go wrong and want to know that steps have been taken to prevent the same mistakes from happening again. They also matter to health and social care organisations, because they provide an opportunity to improve, re-train and avoid further errors being made.
Action Against Medical Accidents (AvMA) a charity which promotes patient safety had campaigned for over two decades for there to be more transparency between medical professionals and patients. In November 2014, there was an historic advance in patients’ rights and patient safety in England with the introduction of a statutory duty of candour which is a legal duty for medical professionals to be open and honest with patients about incidents that have caused or have the potential to result in significant harm.
Since this historic change, however, the Ombudsman’s investigation has found that unfortunately not all GP practices are implementing this new duty successfully. They found that 55% of general practices were doing a good job and dealing with complaints swiftly, taking them seriously and being open and honest. But 45% of practices were falling short by failing to acknowledge mistakes, not providing proper apologies and not following guidance on handling complaints.
The investigation found five areas which required improvement:
1. Develop a listening culture by encouraging patients to give feedback, voice their concerns and make a complaint, and to provide reassurance to patients that their care will not be compromised if they complain.
2. Practices need to do more to understand their statutory duties and what is expected of them.
3. There should be a professional approach to complaint handling at all times.
4. Sincere apologies should be given and practices need to be open and honest and communicate clearly to help individuals understand what happened.
5. Practices need to learn from their mistakes and share this with others and their patients to ensure learning can be achieved.
The Ombudsman’s report makes the following recommendations:
1. Education and training: there is a need to support GPs through education before and after they qualify.
2. Sharing what has been learned: Clinical Commissioning Groups (CCGs) (clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area) and local medical committees could share how practices have dealt with complaints in the area.
3. Time: One of the main reasons for poor responses was limited time staff had to review complaints and respond promptly and thoroughly and so time should also be provided to staff in practices to review feedback from patients and action accordingly.
4. Communication: an apology is not about accepting blame but an important part of providing closure for everyone involved and therefore apologies are encouraged when things have gone wrong.
It is hoped that the new policies and models will make the complaint process in general practice more straightforward, simple and open for patients and GP’s.
Despite this, making a complaint can still be a daunting and scary prospect particularly if you have had the same GP for many years or if you are really not sure whether you have standing for a complaint. Accordingly, if you have a clinical negligence enquiry and would like to make a complaint to your GP but you have concerns about the impact of doing so, would like information on what the procedure involves or would like assistance with writing a letter, then you can contact the me or one of my colleagues who can assist with this.
Alternatively, if you would like to make a complaint only, you can also visit AvMA’s website and call their helpline and they can help to point you in the right direction of where you can find helpful resources online or in your local area or advise you over the telephone about what to do.