Revalidation – complaints being overlooked

20th November 2008 by NASGP

I’ve just returned from the bi-monthly meeting of the RCGP’s Revalidation Stakeholder Group, so I thought I’d give you a brief update. Please bear in mind that a lot of what goes on in these meetings is still “under development” so I’m talking mostly in general terms.

When I’ve got my revalidation hat on, I talk mostly in terms of locums as, generally, salaried GPs will be covered by practice based systems:

  • Audit – probably looking like every GP – locums of course included – will have to do a clinical audit cycle twice every 5 years. In my opinion, locums who are spread among many practices and/or who are isolated from other locums could find this really tough. What I’d really appreciate here is your help – please, I’d love to hear from any of your locum members who’ve done some audit on their locum practise so that I can further develop the Audit For Locums section on the NASGP website at https://www.nasgp.org.uk/cpd/auditaudit so that we’ve all got a central resource for ideas over the coming months and years.
  • MSF – I thought this was something to do with DIY before I realised it stands for Multi-Source Feedback or 360 feedback. Again – a couple of times possibly (I did say it was all still vague, didn’t I?) over the course of the 5 year revalidation cycle. As locums, we’re going to have to apply to colleagues –either other GP locums or GPs in practices where we’re “well known” – to formally provide us with feedback on our clinical ability and professional behaviour from up to 5 clinicians and/or other non-clinical staff. Again, any experiences from you in doing this as a locum would be really helpful.
  • I did get a tadge irritated today as yet again I felt we (all 15,000 of us!!) were being overlooked on the issue of complaints – not so much how locums are involved in the process, more the fact we’re often entirely overlooked and simply aren’t told about them – just not booked again! The solution, I fear, warrants a tidal shift in the attitude of many practices (which is why we so need the NASGP).

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Complaints FAQs

How does the NHS complaints procedure work?

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.

England:

Scotland

Wales

Northern Ireland

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.

What do I do if I’m involved in a complaint?

  • 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.

How do I make a secure clinical handover?

  • 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.

How do I put a complaints strategy in place?

  • 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.

How do I reflect on a complaint?

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.

Recording and reflecting on a complaint

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Recording significant events – Standard

NASGP is committed to the system learning based approach to any form of adverse event, so a ‘standard’ event would be a situation you’ve come across that hasn’t lead to a serious untoward event. Just grabbed a new tube of dipsticks and spotted it’s two years past its ‘use by’ date (true story)? Then use one of these forms.

SEA – Recording significant events – Standard

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If you have been involved in a serious significant event that caused harm, or had the potential to cause harm, consider also looking at Recording significant events – Enhanced.

See also

Significant events and Swiss cheese

Recording significant events – Enhanced

If you have been involved in a serious significant event that caused harm, or had the potential to cause harm, you may find the process of enhanced significant event analysis helpful.

‘Significant event analysis’ here is different from a ‘significant event’ for the purposes of appraisal and revalidation; 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.’

SEA – Enhanced significant event analysis

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If you have come across something that hasn’t yet led to any harm, try using our other AppraisalAid SEA ‘Standard’ template.

See also

Significant events and Swiss cheese

Appraisal during Covid 19

Now that appraisals are back, we’ve adapted AoMRC’s helpful pdf guide into a Google Doc and Word template.

Download – Word Save as – Google Doc

"I've tried simple templates or hard copies of locum packs before but find they so quickly become out of date. I like the way the NASGP's Standardised Practice Information Portal is easier to navigate and update than these paper-based systems."

Dr Amy Kerstein

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