'HELP! I've received a complaint. What do I do?'

Receiving a complaint can be stressful. It can also knock your confidence. Yet it’s important to remember that even the most experienced doctor can receive a complaint at some stage in their career.

A patient can be unhappy with the level of care for many reasons, and a claim isn’t necessarily an indication of poor clinical performance. However, if not handled properly, a complaint can lead to a claim, inquiry, inquest, or disciplinary or regulatory investigation.

So to help, we’ve produced these six steps, explaining how to effectively handle a complaint and reduce the risk of it escalating.

Step 1:
Stay calm and follow your process

Handling a complaint requires time and commitment, often during a period when you might feel anxious or unjustly accused. It can be tempting to respond quickly to complaints you feel are frivolous, but this often inflames rather than resolves the problem.

Understand the full issues before you respond

Instead, first understand exactly what your patient is complaining about. Is it your diagnosis, your attitude, a clinical error, or something else? Establishing this from the start can bring huge rewards. It also marks you out as a true professional.

KEY POINTS:

• Log the complaint
• Review your complaints procedure
• Identify concerns that have been raised
• Check whether there’s any action you need to take in relation to the patient’s care
• Be aware of patient confidentiality and check if there are any consent issues. Not all complaints are made personally by the patient. Where a complaint is made about the service provided to a patient who has the capacity to give valid consent, that patient’s confidence must be respected.
• Review your records and carry out an initial risk assessment
• When you’re happy that you understand the complaint, plan how to respond.
• The next thing to do is contact Medical Protection. Our medicolegal advisers can support you and help you formulate your response.

We're here to support and guide you

Step 2:
Let them know you're listening

Remember, your complainant wants to know their concerns are being listened to. When responding, treat them with respect and courtesy, and don’t make them wait too long for answers: doing these simple things can help prevent a claim from escalating.

Remember, it's important to express sympathy and understanding

It also helps to acknowledge the complaint quickly. So first try to contact the complainant personally by phone and express sympathy and understanding. If making contact by phone isn’t possible, send a letter of acknowledgement within seven working days. This should include:

• An apology for the difficulties the patient has experienced
• An invitation to discuss the way forward by phone or in person

KEY POINTS:

• Avoid jargon – use plain language
• Type all written communication so that it is clearly legible
• Contact your Medical Protection medicolegal adviser for help and guidance

Step 3:
Make a plan

We’re often asked to assist members when a complaint has been referred to the Medical Council. Many of these cases could have been resolved much earlier if more care had been taken to investigate the complaint and draft the initial response.

It’s important that you draft a plan for investigating the circumstances surrounding any complaint. This can then be supplied to the complainant and their response requested within a set timescale.

Your plan should include the following:

• Complainant’s name and contact details
• Their preferred method of contact – if this is email, point out that this isn’t a secure method
• Patient’s name and details, if different from the complainant
• Confirmation that consent had been obtained, if appropriate
• Name of person who contacted the complainant
• Date of contact
• Complaint summary, with incident dates
• List of issues to be investigated
• Outcome the complainant is seeking
• Agreed investigation plan (eg. internal/external investigation and who this will be carried out by)
• Consent to share information with any investigators
• Agreed timescale for response
• How you will respond
• Additional helpful information (eg, language/disability issues)

Your most productive response is to make a thorough plan

Step 4:
Investigate

Before you make a full response to any complaint, you should first establish the facts. Even though the complaint may seem frivolous, it should still be investigated thoroughly.

Save time by taking time to investigate the matter thoroughly

This helps you identify the concerns raised and respond to all issues covered. It often helps to set out a chronological account of what took place, even if this is background information. But don’t lose sight of the main issues.

When carrying out your investigation, you should:

• Obtain statements from staff/staff interviews
• Review records/policies/procedures
• Obtain information from other sources is necessary
• Draw conclusions from your findings
• Discuss these conclusions as a practice
• Decide on the actions to be taken
• Draw up an action plan to improve patient care and reduce future complaints

It may be helpful to ask a doctor who has not been involved in the patient’s care to review the clinical management. This can bring some objectivity and independence into the process.

Step 5:
Respond

When responding, your aim should always be to resolve the complaint and not lead to more unnecessary correspondence. Clearly, a thorough letter of response is far more likely to be successful than an incomplete one. So take time to present a measured and considerate response.

Be courteous, objective and professional, and apologise if an error has been made.

While being mindful of the plan agreed with the complainant, also include the following elements in your response:

• An apology and an acknowledgement of distress or condolences
• A summary of the main issues raised (this will help focus your response too)
• The action you’ve taken to investigate the complaint (spoken to staff, reviews polices, etc)
• A clear explanation in response to each issue raised. If this relates to a consultation, refer to the history; any examination and findings; treatment or advice provided, plus any follow up
• A reiteration of your apology if appropriate
• The action you are taking to reduce future risk and lessons learned
• An invitation to meet or contact you again to answer any further questions
• Details of their redress, through the complaints procedure

Finally, if appropriate, check your draft with your Medical Protection adviser before sending.

Don't be afraid to apologise if an error has been made

KEY POINTS

• Avoid blaming or judging others
• Avoid jargon – use plain language
• Type your response so it’s clear and legible

Step 6:
Learn from experience

It’s always useful for you and your team to review the actions arising from a complaint. For example:

• Would it help to share the lessons learned more widely?
• Was the agreed action taken within the set timescale?
• Did you provide feedback to your team and the complainant, if appropriate

Learning from complaints helps avoid them in the future

 

We’ve been protecting doctors in Hong Kong for over 70 years. Supporting and defending our members gives us a unique insight into why complaints and litigation occurs, and how to avoid this happening in the first place. We’re here to help.

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