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Managing Complaints in General Practice

Complaints are a common aspect of medical practice, and at some point in your career, you are likely to receive one. This guide is designed to help you understand the complaints process and provide support in navigating it effectively.

The Impact of Complaints

Receiving a complaint can be distressing, affecting both your professional confidence and personal well-being. It is natural to feel upset, frustrated, or even angry. However, it is crucial to remain calm and professional to avoid escalating the situation. Support is available from colleagues, family, partners, your defence organisation, and, of course, the LMC.

We strongly recommend that any complaint—whether against you personally or your practice—be discussed with both the LMC and your defence union to ensure the appropriate steps are taken from the outset.

Handling Complaints Locally

Complaints are typically managed at a local level and may be received by the practice, the Integrated Care Board (ICB), or NHS England. If a complainant is dissatisfied with the outcome or believes the correct procedures were not followed, they have the right to escalate the matter to the Health Service Ombudsman for further review.

Practice-Level Complaints

Practices have discretion in managing complaints in collaboration with the complainant. A robust complaints procedure should be in place to ensure matters are handled professionally and efficiently. Compliance with the complaints process set by NHS England or the ICB is a contractual obligation.

Each practice must have:

  • A nominated responsible person (a contract holder) ensuring compliance with complaints regulations.

  • A nominated complaints lead, who may be the same person or have delegated responsibilities.

Oral Complaints

Oral complaints can be handled informally if resolved within 24 hours, ideally to prevent escalation.

Written Complaints

  1. Acknowledgement – Within three working days, the practice must acknowledge the complaint, confirming an investigation will take place. This can be done via letter or telephone (with a record of the call).

  2. Investigation – The investigator should engage with the complainant to discuss concerns and agree on a resolution plan. While a face-to-face meeting may be offered, experience suggests patients often prefer telephone or written communication.

  3. Resolution – The agreed action plan should be implemented in a timely manner.

Formal complaints must be addressed if raised within 12 months of the incident or from when the complainant became aware of it. Beyond this, the decision to investigate is at the practice’s discretion.

Record-Keeping

  • Complaints records must be kept separate from clinical notes.

  • Records of resolved formal complaints must be retained for 10 years.

Complaints Escalated to the ICB or NHS England

When a complaint is received by the ICB or NHS England, it may be handled in one of the following ways:

  1. Referred Back to the Practice – The ICB’s complaints screening group may determine that the matter is best resolved at the practice level and refer it accordingly.

  2. Reviewed by the Maintaining High Professional Standards (MHPS) Group – The screening group may work with MHPS to gather information, triage the complaint, and formulate an action plan.

  3. Immediate Suspension – In rare cases, NHS England’s Medical Director may recommend immediate suspension if the complaint involves serious concerns requiring urgent action. Any such decision will be reviewed at the next MHPS committee meeting.

Many complaints are resolved at the screening stage without the GP being directly involved. However, if evidence suggests a significant shortfall in care standards, the clinician may be contacted for further information.

Responding to NHS England

If NHS England requests a written response:

  1. Acknowledge immediately – Confirm receipt and state that a response will follow.

  2. Seek advice – Contact your defence organisation and the LMC for guidance. Discuss the matter with trusted colleagues for additional support.

  3. Provide records if requested – If medical records are required, send photocopies promptly. If records are no longer held, contact: Primary Care Support England 3 Caxton Road, Fulwood, Preston, PR2 9ZZ

  4. Draft a response – Remain factual, objective, and chronological in your account. Avoid speculation or jargon. Express sympathy for any distress caused, where appropriate.

  5. Submit the response – Forward your reply to NHS England after review by your defence organisation.

Key Considerations When Handling Complaints

  • Confidentiality – Maintain patient confidentiality at all times.

  • Seek expert advice – Do not respond without consulting your defence organisation.

  • Do not alter records – Patient records must remain unmodified after an incident.

  • Keep thorough documentation – Retain copies of all complaint-related correspondence.

  • Patient removal – A patient cannot be removed from the practice list solely for making a complaint.

  • Transparency – All complaint documentation is accessible to relevant parties.

  • Cooperation – It is your duty to assist in the investigation of complaints against you.

Final Thoughts

Complaints are an inevitable part of medical practice, but they do not define your professionalism or ability as a clinician. By approaching them with a structured, professional, and calm mindset, you can navigate the process effectively while maintaining your well-being and upholding the highest standards of care.

 

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