PALS and Formal Complaints

Notes by Greg Cranston

(CC14 – Complaints and medical error)

Stages:
  • Manage concerns/sort issues early (frontline staff)
  • PALS team – can facilitate sorting concerns early (ideally 2/7)
  • Formal written complaints process  (only 1.5% go to this stage)
National complaints regulations (for formal complaints):
  • Acknowledge within 3 days
  • Response within 25 days
  • Concerns graded:  Green / Amber / Red
  • All logged – contribute to appraisals
  • Reported to trust board, Quality assurance committee, CCG, Health ombudsman
Complaints can be made up to 1yr, and usually stem from:
  • Waiting / communication / attitude
  • All aspects of care / unmet or unrealistic expectations
  • Staff not introducing (#hellomynameis campaign by Kate Granger)
They want:
  • To be acknowledged / taken seriously / a response / an apology
  • To know what we’ve learnt
  • ‘open policy’
Practical tips:
  • Involve patient / family in planning and decision making
  • Keep good records – it’s easier to provide statements
  • An apology is not an admission of guilt or culpability and makes no judgement, it just acknowledges feelings
  • Patients pick up on non-meaningful apologies
  • Patients are very tolerant as long as we communicate well and apologise if we know problems are occurring
  • Usually communication is at fault rather than the actual care
  • Avoid conflicting information
  • Don’t deny if we are responsible.  Be open and transparent
  • Learn from complaints, and communicate this
  • Don’t be defensive, stop and listen to what is wanted
  • Make responses timely if involved, everything goes more smoothly (less likely to escalate)
  • Don’t rely on memory, stick to the facts, answer the questions
  • The litigation route is separate, but may become concurrent with future legislation coming
  • Litigation more likely if delays / poor initial response

Tom Mitchell – added comment

  • Each trust should have its own complaints procedure on the trust intranet.
  • The MPS has a five booklet series about complaints.
  • The MDU also has a factsheet but you have to be a member to download.
  • If you are involved in a complaint then it can really knock your confidence and cause a lot of stress. Even if the complaint is eventually not upheld it can have lasting effects. The BMA lists some useful organisations for help.
  • Here is an exert from the BMA website 11/06/2014:

The NHS also has a duty of care towards it staff and your employer should offer you access to occupational health services and should ensure that proper confidentiality procedures are put in place so as to limit any damage from malicious complaints.

BMA support

Receiving a complaint can be a very stressful experience for the doctor as well as the patient or advocate. For help, counselling and personal support, doctors can call the BMA’s 24 hours counselling service on 08459 200 169.

Other sources of support for doctors

  • The DoH has developed a guide called ‘Listening, responding, improving: a guide to better customer care’ which can be a useful resource for those involved in complaints procedures. It was designed to help complaints professionals and healthcare staff to learn from the negative experiences of patients and to improve services.

  • Many doctors are not particularly good at visiting their own GP when they are feeling unwell. GPs can be a good port of call for offering advice to doctors who are stressed or in difficulty.

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