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Managing a patient complaint

As hard as we might try, sometimes patients are not satisfied with their care, and may wish to make a complaint. While it might not seem like something you can prepare for, having a clear understanding of the process can be helpful both for you and for patients, so it’s worth taking a little time to understand how this works in your practice or trust.

Managing a complaint needs a structured, empathetic process that complies with any regulations. Wherever you work, these are the steps that you should follow:
 

1. Active listening and de-escalation


If a patient makes a verbal complaint, you should listen carefully without interrupting them and record the details. If a verbal complaint can be resolved by the end of the next working day, and the patient is satisfied with the outcome, it may not need to go through the full formal complaints process. If you cannot resolve the complaint to the patient’s satisfaction within one working day, you should treat it as a formal complaint. Patients who make a verbal complaint should not normally be asked to put it in writing themselves. The staff member receiving the complaint should make a written record and ask the patient to confirm that the details are correct.

2. Acknowledge the patient


Follow your organisation’s complaints policy and the requirements applicable in your UK nation. In England, a formal NHS complaint must be acknowledged within three working days of receipt. The acknowledgement should explain how the complaint will be handled and agree an appropriate timescale for the response.

3. Establish the facts


Make sure you have the full context before responding further. This might involve:

  • Obtaining the relevant clinical records
  • Talking to any staff members or other witnesses involved
  • Establishing a clear timeline of events.

 

4. Apologise and respond


A sincere apology should be offered where appropriate. An apology is not necessarily an admission of liability; however, staff should follow their organisation’s policy and seek advice where a complaint may involve serious harm, legal action or professional concerns. Scotland also has specific legislation on apologies. However, staff should always follow their organisation’s local complaints policy and seek advice where a complaint involves serious harm, legal action, safeguarding or professional concerns. The response should address each specific concern raised by the patient, explain what the investigation found and, most importantly, detail any actions that are being taken to stop it happening again in future. Preventing the same thing happening to other patients is often the motivation for patient complaints and clearly outlining how this will be done helps to reassure the patient that their concern has been addressed.

5. Signpost to the Ombudsman


If the patient is not satisfied with the resolution from the practice or trust, they have the right to take their concerns further. The response must include details on how to contact the relevant Ombudsman, which varies depending on where the service is based.

In England, they should contact the Parliamentary and Health Service Ombudsman, in Scotland the Scottish Public Services Ombudsman, in Wales the Public Services Ombudsman for Wales, and in Northern Ireland the Northern Ireland Public Services Ombudsman.





 

Good practice - signposting and support


Within the practice, there should be clear details to make the process easier for patients by giving them information about independent advocacy or support services. These include Healthwatch in England (https://www.healthwatch.co.uk/), which is a network of local charities whose role is to make sure that NHS leaders and other decision makers hear patients’ voices and use their feedback to improve care, and PALS (Patient Advice and Liaison Service) for your local trust. PALS offers confidential advice, support and information on health-related matters, and provides a point of contact for patients, their families and their carers. You can find out more about PALS here https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/

Taking the positives from complaints


It is only human to feel disheartened if you receive a complaint about your care, or the care provided by your team or service. However, complaints also provide you with opportunities – for team education, to support a request for additional resource or training, for discussions within the practice or service on how to avoid these sort of complaints in future and to increase engagement with patients – as outlined recently, by the Bladder, bowel and pelvic health team, Lewisham and Greenwich NHS Trust, London:

‘We've got a focus group of five patients who work with us ... The interesting thing is that three out of the five members came to us with complaints about the product service, but when we explained why we're doing what we're doing, they've changed and become our biggest advocates because they've seen what we can do.’ 

(https://www.clp-hub.com/personal-development//service-redesign-how-to-get-started)