Caroline Fryar, Medical Defence Union (MDU) head of advisory services, looks at how the pandemic has shaped patient complaints and offers advice on how to protect your practice
As we approach the anniversary of the first confirmed coronavirus case in the UK, it’s become clear that the pandemic has magnified existing challenges in general practice and presented many new ones.
Most people have been understanding about the constraints and compromises forced on practices by the health crisis. However, patients and their representatives have continued to make complaints against MDU members. While case numbers have been lower than in recent years we have still opened well over 3,000 complaint and adverse incident case files from the start of the first lockdown to the end of 2020.
During this period of heightened anxiety, some complaints are perhaps inevitable. However, it can help to anticipate likely problems in order to pre-empt them. This article looks at two issues that featured prominently in our complaint files during 2020 and provides some advice for practice teams on avoiding common pitfalls.
In an MDU survey of GP members at the end of last year, 90% of respondents felt that working practices had significantly changed since the beginning of the pandemic with 97% increasing their use of telephone consultations and 75% adopting video consultations in their practice.
Remote consultations and triage are necessary in order to prevent the risk of infection and also offer greater convenience and flexibility. However, there are also limitations, such as the difficulties of communicating effectively and making a clinical assessment, which heighten the risk of a missed diagnosis.
These allegations are already starting to feature in the MDU’s Covid complaint files. These included cases in which there were alleged delays in diagnosing serious conditions such as bowel cancer, septic arthritis or stroke during remote consultations, which were later picked up during a face-to-face consultation and examination.
Advice to protect against complaints:
The growing waiting lists caused by Covid pressures on NHS hospitals are outside the control of GPs but unfortunately as gate keepers, GPs may face criticism about delays. For example, delays in investigations for suspected breast or prostate cancer referrals. It can help to manage patient expectations and ensure you take reasonable steps to prevent patients coming to harm when making a referral.
Advice to protect against complaints:
Ultimately, the key to avoiding complaints during the pandemic is effective communication. Clear communication with patients about what to expect from the practice such as appointment availability, remote consultations and triage, and the importance of mask-wearing and social distancing when attending the practice in person can help avoid misunderstandings.
If you do receive a complaint, it is important to investigate it in the usual way, notifying the complainant if there are likely to be delays caused by the pandemic. Showing someone that their concerns are being taken seriously will increase your chances of resolving a complaint successfully.
If you need help responding to a complaint or believe it has the potential to become a GMC investigation, seek prompt advice from your medical defence organisation.
Caroline Fryar is head of advisory services at the Medical Defence Union
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