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Dealing with complaints avoiding litigation

Dealing with complaints avoiding litigation. Dr S L Brown, Coventry & Warwickshire GPST 2007. We are poor!. Health watchdog urges NHS to improve dealings with dissatisfied patients Published: 23 June 2005

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Dealing with complaints avoiding litigation

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  1. Dealing with complaints avoiding litigation Dr S L Brown, Coventry & Warwickshire GPST 2007

  2. We are poor! • Health watchdog urges NHS to improve dealings with dissatisfied patients • Published: 23 June 2005 • The Healthcare Commission today urges the NHS to improve its dealings with dissatisfied patients and service users. The Commission, which handles complaints the NHS cannot resolve, makes the call as it publishes figures which show the NHS is not doing enough to resolve grievances locally. The figures show over 25%

  3. We are poor • Healthcare Commission calls for better complaints handling • The Healthcare Commission has called for better complaints handling in the NHS. • This follows the publication of a report, which shows that 25% of complaints referred to the Commission are sent back to the NHS because the Commission’s investigators believe the trust has not done enough to resolve the issue. The Healthcare Commission will be contacting those with the highest referral rates to offer more training and support on handling complaints at local level.

  4. Complaints damage us • General practitioners' experiences of patients' complaints:Ashok Jain, Jane Ogden BMJ 1999;318;1596-1599 • Shock panic indigation • Emotional conflict • Resolution with long term effects • See also the case of Dr Phillip Evans who committed suicide as a result of depression caused by a complaint. Call for change after GPs suicide http://news.bbc.co.uk/1/low/wales/1631238.stm 5/7/06

  5. Key message and key question • Stay calm • An angry putting down or defensive answer will perpetuate the complaint • Reasoned, measured reply may end the complaint • What is a satisfactory outcome to the complaint?

  6. Start with the end in mind • Covey, seven habits of successful people • Be courteous • Do not put your self in a blind alley • Good practice • Good notes • Good end to the consultation

  7. Report writing and dealing with complaints • Are these the same? • Consider how you are going to respond to a complaint • And you will get them!!! • Consider writing a report. • Written correctly it will deal with all the issues raised, show you have been thorough and perhaps settle the issue.

  8. Complaints • Treat it as a report • What are you trying to achieve • What are your aims • What is the structure of your report • What is the status of your report • What are your responsibilities • What if you/your practice is at fault

  9. How important is your reply • Make or break sometimes • Most replies I see vary from factual to useless • What are the complainants ideas, concerns and expectations • Failure to address these may inflame the situation • Your aim is to close the whole thing amicably

  10. Some will fly whatever • Some complaints will fly whatever you do • Follow the procedure • Failure to do this allows reactivation • Tell them they can go PALS, HC, HA, PCT, ICAS Ombudsman, if your procedure fails

  11. Recognise typical complainant • Angry person, with or without cause • Anxious, worried, frightened • Mistaken beliefs • Errors of facts • Lack of understanding, “no diagnosis” • Grief, sad • Easily led

  12. What does the claimant want? • Sorry, does it hurt to say that? • Explanation, in words they can understand • Acknowledgement of the problem • Facts without the need for litigation • Things to be put right • Money, NO!!

  13. Report layout • Courtesy, every complaint is a gem • Basis of complaint, prepared to adjust • facts • Explain diagnosis, rarity • Working process, red flags • What have you done, SEAM, NPSA, changes • Conclusion, sensitive not dismissive • Make sure they feel heard and important

  14. Worries • Defence organisation or not • Give them ammunition • Fuel complaint by taking it seriously • What have you got to lose?

  15. REF • Kohn L, Corrigan J, Donaldson ME, 1999, to err is human, National Academy Press, Washington, DC • An organisation with a memory learning from adverse events in the NHS, DoH, 2000, The Stationary Office, London • The Shipman enquiry six reports, Includes final report 27th January 2005 http://www.the-shipman-inquiry.org.uk/reports.asp

  16. REF • Good doctors, safer patients: Proposals to strengthen the system to assure and improve the performance of doctors and to protect the safety of patients. A report by the Chief Medical Officer Published 14 July 2006. 276071 • Handling clinical negligence claims in England, Report by the Comptroller and Auditor General, HC 403, 3 May 2001, The Stationary Office,

  17. REF • Making Amends:A consultation paper setting out proposals for reforming the approach to clinical negligence in the NHS. A report by the Chief Medical Officer June 2003 www.doh.gov.uk/makingamends

  18. Useful sites • www.avma.org.uk/index.asp • www.npsa.nhs.uk

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