GP quality: Welcoming feedback and complaints can help practices improve

Many GP practices handle complaints well, says Parliamentary and Health Service Ombudsman clinical adviser Dr Tony Dysart, but many others could significantly improve their approach. Writing for GPonline, he explains how opening up to feedback and complaints is key to improving patients' experience of general practice.

I am a GP from a busy practice in north-west England. I love my job but like the rest of you we are under pressure.

That is why I understand why a call for some of us to improve how we encourage feedback from patients could be viewed as a challenge.

For the last two years, however, I have worked for two days a week as a clinical advisor at the Parliamentary and Health Service Ombudsman, which investigates unresolved complaints about the NHS. I have done this as well as working in practice.

I have learned in this role that welcoming feedback, concerns and complaints is invaluable to help us improve our services and the experience for our patients.

Handling GP complaints

My role as a clinical advisor is to study the relevant clinical records related to a complaint, describe what happened in layman’s terms to a case investigator and compare it with what should have happened, according to established guidelines.

The Parliamentary and Health Service Ombudsman concluded 696 investigations about GPs in 2014/15 and either fully or partly upheld 222 (32%) of them.

We don’t uphold a case when we find an organisation has acted in line with the guidelines or when they have already responded appropriately to the complaint and put things right.

I see many cases of excellent GP complaint handling, including one example I looked at recently, when the practice had responded to the complainant in a personalised way and addressed the issues point by point. They then set up a meeting with the patient in a supportive environment to listen carefully to their complaint. The end result was an apology for the patient.

Professional complaint handling such as this can have a very good impact on how a patient views their GP practice.

GP professionalism

Unfortunately, I also see responses from GPs that are defensive, impersonal and that show a clear lack of reflection or insight.

In one case, the GP’s response had corrections in Tippex and the tone lacked any empathy or compassion.

Most of the cases I see fall between these two extremes, but it is clear from the report published today that many GPs could handle complaints better.

In my own practice, we have a robust complaint handling process. We follow NHS guidelines on managing complaints, we have posters and leaflets in the practice about how to make a complaint, as well as information on our website.

Last year, we had 12 complaints and themes from these emerged around prescribing, task allocation, and dealing with urgent phone calls. We fed these back to staff with recommendations and lessons learned from each of the complaints.

We have also recently appointed a 'safety champion' in the practice who will be responsible for ensuring this process remains robust and that lessons learned are sustained.

Very little of this has to impact on a GP’s working day as practice managers deal with the administrative elements of the process. We (the GPs) get involved in the stages of a complaint relating to clinical issues.

There is no doubt that my experience at the Parliamentary and Health Service Ombudsman has given me insight into how to handle complaints effectively and I know that not every GP has access to that experience.

That is why GP practices need support to help us improve our feedback and complaints processes.

The recommendations in today’s report - such as complaints handling training for GPs and their staff and support for practices to share learning from complaints with each other - go some way in providing that help.

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