MDU Review Of Ombudsman Complaints Highlights Importance Of Apologising, UK

An MDU analysis of members' complaints reaching the Parliamentary and Health Service Ombudsman underlines the importance of apologising, thorough investigation and a detailed response to complaints. The findings echo those in a report into complaints handling that has just been published by the Ombudsman.*



The Medical Defence Union (MDU) analysed 38 complaints which reached the Ombudsman, notified by its GP and hospital doctor members over a 12 month period - April 2009 to April 2010. The majority of complaints were notified by GP members (32).



Amongst the reasons for complaints were delay or failure in diagnosis (16 cases), problems in communication (7), dissatisfaction with the standard of care (5) and removal from a GP's list (4). Only 11 cases resulted in the Ombudsman launching an investigation as the rest were either referred back to the practice/hospital to look at again (8), or closed without action (6), or nothing more was heard from the members (13), so presumably these were resolved.



Of the complaints investigated, emerging themes include problems with the way complaints were managed such as not explaining the complaints procedure at the outset; failing to apologise where appropriate; and failing to act in line with regulations or fairly and proportionately when removing a patient from the GP list.



Dr Jacqui Phillips, MDU medico-legal adviser said:



"The MDU advised members with over 2,300 GP and 580 hospital complaints over the year and of these only a small minority reached the Ombudsman. When the complaints procedure was revised in April 2009, it rightly placed far greater emphasis on GPs and hospitals investigating and resolving complaints themselves. This is successful in the majority of cases, with the practice or hospital providing an explanation of exactly what happened, an apology where appropriate and the reassurance that it has taken steps to prevent a similar incident happening in future.



"However, every complaint has the potential to escalate if not managed to the patient's satisfaction. If a complaint is referred to the Ombudsman, it can be distressing and time consuming for all involved. It is vital that members consider involving the MDU at an early stage for guidance in responding to a complaint."



The MDU's advice on resolving complaints includes:



- Practices and hospitals are expected to publish information for patients about the complaints procedure and explain to patients who wish to complain how they can do so and where they can find assistance.


- Ensure all complaints are investigated thoroughly. Talk to complainants about their concerns and the outcome they expect. Have a clear management plan in place and agree with the complainant how long you will take to investigate and respond.


- Offer to meet complainants, and consider whether a conciliator may help.


- Take account of the seriousness of the concerns, lessons learned and ensure that the response is balanced and appropriate.


- Try to remain objective. If possible, complaint responses should be reviewed by someone who is not the subject of the complaint.


- Consider seeking an independent clinical opinion if appropriate and the complainant agrees.


- Respond to each and every concern raised.


- Be open and honest, acknowledging mistakes and the distress caused by them.


- Where appropriate, offer a clear and unambiguous apology.


- Have a system in place for reviewing and learning from complaints and inform the complainant of any action taken.


- Involve the MDU early so that we can help guide you through the complaints procedures and help prevent the complaint escalating.


- Practices and hospital trusts are obliged to monitor complaints and produce annual reports on them, recording the lessons learnt.


- Only consider removing a patient from a practice list as a last resort, such as where the doctor patient relationship has irrevocably broken down despite reasonable efforts to rectify the situation. In most cases, the patient should have received a warning before removal, and this is a contractual requirement for most GPs.



Further information


* Listening and Learning: the Ombudsman's review of complaint handling by the NHS in England 2009-10, Parliamentary and Health Service Ombudsman, 19 October 2010


Source:

The MDU

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