Prevention is better than cure, so first read our comprehensive article written with our colleagues at MPS on how to avoid complaints.
Complaints are a form of significant event and rarely happen purely because of the failings of one person. Beneath the surface there is often a thread of system failings that put the clinician working at the sharp end - that's you - on a collision course with a complaint; the so-called Swiss cheese effect, with its supporting enhanced significant event analysis, may therefore, be a suitable option for looking into a complaint. Alternatively, for a less in depth approach to significant event analysis, try the other template below based on fields suggested by the RCGP.
If you have been involved in a serious significant event that caused, or had the potential to cause harm, you may find the process of enhanced significant event analysis helpful.
Apologies for using the term 'significant event analysis' having only just clarified that significant event analysis is different from a Significant event for the purposes of appraisal and revalidation, but this is the name given to this very enlightened and useful form of incident analysis by its developers at NHS Education for Scotland and the Health Foundation.
If you have been involved in a serious significant event that caused, or had the potential to cause harm, consider also looking at Recording significant events - enhanced - it may save your sanity.
You must declare at your appraisal if you have been involved in a formal complaint or if any cause for concern about your practice has been raised. Failure to disclose is considered a serious breach of probity.
Use the NASGP template to record your reflections and changes made as a result of the complaint.
- Prepare for complaints as part of your working life. Try to see them as an inevitable part of feedback that we all have to learn from.
- Perhaps make this one of your PDP items to familiarise yourself with the NHS complaints procedure.
- Make it a requirement in your Terms and Conditions that all employing practices will work closely with you in the event of a complaint. This will allow you access to records and a right to respond directly to the complainant if appropriate, or have active involvement in preparing and agreeing the response via the complaints manager.
- Most practices will treat GP locums with respect and will want to learn lessons from complaints, but be aware of the risk of being scapegoated.
- If you see a patient of concern, always consider handing over your concerns to their named responsible or usual GP.
- Document any verbal handover you make.
- If the GP is unavailable to talk to, find out the practice’s communication procedures to hand over concerns.
- Where possible use traceable, electronic messaging attached to the patient record via the clinical IT system. Loose pieces of paper and messages left at reception are liable to go missing.
- Insist on being properly equipped to work in the practice. GPs need constant access to up-to-date information, equipment to help us with our assessments and knowledge about how to refer and arrange further treatment for our patients.
- Make it part of your Terms and Conditions that you have access to a Practice Induction Pack, an induction tour of the building, an introduction to key staff and a point of contact for queries during your session.
- Refer MPS complaint series.
- Work closely with the practice complaints manager (usually the practice manager) and the responsible person (usually a partner) to understand the reason for the complaint and the motivation of the complainant.
- If it becomes clear that some act or omission on your part is involved in the complaint, then prepare your response with help from your defence organisation.
- Remember that the majority of complaints can be resolved locally with a sensitive, early apology, an acknowledgement of the problem and a description of what will be done differently to prevent the problem arising again.
The NHS complaints system aims to be open and accountable, fair and proportionate and above all patient-focused. Practices must involve GP locums in handling complaints from the outset, even if they have left the organisation.
If a patient cannot resolve their complaint locally, they can take it forward to the Parliamentary Health Service Ombudsman (PHSO). Often, as a GP locum doctor, you will only learn of a complaint once it has escalated to PHSO. This is when you can contact us for advice.
It is important that you familiarise yourself with the current complaints procedure.
- Read MPS’s guide, NHS complaints procedure in England
- Complaints Procedure for NHS Scotland;
You should be aware of the complaints manager’s role in the practice and of your own role when it comes to complaints handling. Read “From the outside looking in”, written by Terri Bonnici, general practice complaints manager at MPS.