Complaints Handling – Key Learning Points for GP Practices

The LMC has been fortunate to have delivered a series of Complaints Events to local LLR practices, this has been delivered by Lee Bennett and Cathie Cunnington. The sessions always received positive feedback from delegates and the main learning has been summarised below.

A copy of the presentation is available here

1. Have a clear, accessible complaints process

• Every practice must have a complaints policy that reflects the regulations and local arrangements.
• The process should be well publicised, with a simple complaints leaflet/poster available to patients.
• Consider appointing a deputy so complaints are not delayed when key staff are absent.

2. Understand what constitutes a complaint

• A complaint can be verbal or written and does not have to be justified to qualify.
• Patients cannot be told that they must put a complaint in writing.
• If an oral concern can be resolved to the patient’s satisfaction within 24 hours, it does not need to be treated as a formal complaint.
• When unsure, ask the patient whether they consider it a complaint or feedback.

3. Get the timescales right

• Acknowledge complaints within 3 working days.
• The acknowledgement should offer discussion about how the complaint will be handled and agree a response timeframe.
• There is no fixed regulatory deadline for the final response; the timeframe should be agreed with the complainant.
• Complaints should normally be made within 12 months, although practices can investigate later complaints where appropriate.
• If no response has been provided within six months, the complainant can approach the PHSO.

4. Make the acknowledgement count

The first response should:

• Thank the patient for raising the complaint.
• Acknowledge/apologise for their experience.
• Clarify the issues being investigated.
• Explain who will investigate and how.
• Give a realistic timeframe and named contact.
• Address any immediate care concerns.
• Reassure the patient that making a complaint will not adversely affect their care.
• Offer information about complaints advocacy.

5. Investigate properly and impartially

• Break the complaint down into every individual issue that requires a response.
• Identify who needs to provide information.
• Consider whether the investigation needs to be independent.
• Review the clinical records and relevant evidence.
• Avoid assumptions such as “my staff would never…”.
• Obtain statements where appropriate and establish a factual, chronological account.
• Consider what should have happened, as well as what actually happened.
• it as requirement to have the senior partner as the one who is named and signd the responses

6. Make responses meaningful

A good response should:

1. Acknowledge the complaint and apologise where appropriate.
2. Explain the investigation undertaken.
3. Give a clear factual account of what happened.
4. Explain what should have happened.
5. Clearly identify any failings.
6. Give a meaningful apology where warranted.
7. Explain what will be done to prevent recurrence.
8. Explain what will be done to put things right.
9. Tell the patient what they can do if they remain unhappy.

7. Don’t be afraid to apologise

An apology does not, in itself, amount to an admission of legal liability.

Avoid phrases such as:

• “I’m sorry if you were upset…”
• “I’m sorry, but…”

If something went wrong, acknowledge it clearly and apologise genuinely.

8. Treat complaints as an opportunity to learn

The key question should not just be “Have we answered the complaint?”, but “What have we learned and what are we changing?”

Practices should:

• Identify learning and actions.
• Record the action plan.
• Monitor whether actions have been completed.
• Share relevant learning with staff.
• Make complaints a regular practice meeting agenda item.

The presentation highlighted that 93% of complainants surveyed said ensuring others do not experience the same issue was important to their decision to complain. Showing patients that learning has taken place is therefore particularly important.

9. Remember that complaints can escalate

A patient needs to make a choice on whether they make a complaint to the practice or ICB (commissioner) they cannot complain to both. Complaints may also involve a variety of different partner agencies e.g. secondary care, EMAS, local authority etc and the lead should be agreed. Complaints may ultimately involve:

• PHSO
• GMC
• Clinical negligence claims

A complaint and a negligence claim can run concurrently. A good, thorough complaint response can also be helpful if a matter subsequently reaches the GMC or PHSO.

10. Think about CQC

CQC expects practices to have an effective and accessible complaints system, to investigate complaints thoroughly and to take action where failures are identified – GP mythbuster 103: Complaints management – Care Quality Commission

Practices should be able to demonstrate:

• A complaints log.
• Staff training.
• A clear complaints policy/leaflet.
• Complaints being dealt with consistently with the policy.
• Evidence of analysis, learning and actions taken.

The key message for practices

Don’t just deal with the complaint – use it to improve the practice.

The presentation’s final messages were to expect complaints, have a process and use it, focus on the patient’s experience, see complaints as an opportunity, and take responsibility for the practice’s reputation.

In practical terms: get the process right, acknowledge promptly, investigate fairly, answer every point, apologise genuinely where appropriate, and most importantly demonstrate what you have learned and changed.

Complaints and the Use of Artificial Intelligence (AI)

With the ever evolving world of AI, we know that this is a tool that is being increasingly used by patients to make complaints, which in the past would have been a simple complaint to resolve are now much more challenging. The following has been designed to assist practices.