Not Them Again - Dealing with Complaints Flashcards Preview

Year 3 - Medical Ethics and Law > Not Them Again - Dealing with Complaints > Flashcards

Flashcards in Not Them Again - Dealing with Complaints Deck (35)
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1
Q

what is a complaint?

A

The NHS states that a complaint is an expression of dissatisfaction

But we need to add: That requires a response

“a statement that something is wrong or not satisfactory”

NHS Scotland - The NHS regards a complaint as “any expression of dissatisfaction about our action or lack of action, or about the standard of service provided by us or on our behalf”

2
Q

Who complains?

A

Patients

Colleagues

Employers

Health Boards / Heath Trusts

The GMC

The Police

The Courts

3
Q

What do People Complain About?

A

Everything that you can think of

Alleged poor treatment

Alleged poor performance

Rudeness

Not listening

Failure to comply with job plans

Health Problems

Fraud

Criminal Offences

4
Q

what are the majority of complaints about?

A

Communication issues

5
Q

what sort of things can a patient complain about?

A

The things you can complain about using NHS procedure include:

Care or treatment you have had or having from the NHS

Anything to do with the place you are seen, e.g. GP practice, hospital, dental practice, optician, pharmacy, prison health centre or an ambulance

Any NHS staff member involved in your care

How NHS services are organised in your local area if this has affected your care or treatment

6
Q

when should a complaint be made in relation to the incident?

A

Should be within 6 months of the incident or within 6 months of becoming aware assuming that it is not 12 months from the incident

7
Q

What if your are the person complained about? What do you do?

A

Take these issues seriously

Apologise where it is necessary

Explain to the patient what has happened and why

If you are going to try and sort something out tell the patient what you are doing, when it will be done, and when it is done

Keep a record of this

Direct to the complaints procedure

Inform seniors

Inform university

Good opportunity for reflection

8
Q

How do you protect yourself when dealing with complaints?

A

Join a Defence Organisation

Be aware of and follow the GMC’s Advice, “Good Medical Practice”

Be aware of the local complaints procedure / deal with complaints expeditiously

Put patients first and always try to act in their best interests

Do not be judgmental

Do not be afraid to refer or get a second opinion

Clinical Audit

Peer Review

Act responsibly

Do not break the law

9
Q

Remember that complaints about you as a student, your behaviour / perceptions etc. could lead to a student _______ to practise hearing

A

fitness

10
Q

deadling with complaints can be significantly ________

A

stressful

11
Q

who may you seek help form when dealing with complaints?

A

Seek support of supervisors and colleagues

Should be disclosed to supervisors anyway

GP

BMA Counselling service

Student support etc

12
Q

The main complaints in the NHS will be patients or colleagues complaining about a doctor, their behaviour or their treatment

hwo do NHS boards/trusts deal with complaints?

A

All NHS Boards, Trust etc. follow a universal complaints procedure that is very similar wherever you are working

If a complaint involves you a complaints officer will deal with it and you may well be interviewed to provide your response to the complaint.

If your employer thinks the disciplinary procedure needs to be followed, the procedure now is the same for all staff; doctors and dentists are no longer treated differently.

13
Q

which proffesion tends to get the most ocmplaints?

A

GPs

14
Q

What is the New Scottish Complaints Procedure?

A
  • Must have a written compliant complaints procedure with clear notice of the complaints officer and the procedure. Must be available for patients – they should not need to ask for it if they make a complaint
  • The main April 1st change in Scotland is that there is now a period of 5 days when the complaints officer can decide whether the complaint can be dealt with informally and during that period deals with it successfully as far as the complainer is concerned – need to tell the complainer immediately that you wish to deal with the complaint informally and gain the complainer’s agreement – DOCUMENTATION IS VERY IMPORTANT
  • If following a formal procedure MUST acknowledge within 3 working days. (Prudent to do this even if using the Informal Procedure)
  • Decide whether it requires written or verbal response, or a meeting, gather full information
  • Give a full response within 20 days unless impossible in which case must let the patient know when they will get a response and why the delay – respond as quickly as possible is always best. Note in the response that if they are dissatisfied they can contact the complaints officer again or go to the Public Services Ombudsman; (giving full contact details of the PSO)
  • Ask the patient to respond if dissatisfied but try to have responded to every point they make
  • If the patient remains dissatisfied might wish to consider mediation
  • Respond again and if an NHS patient advise that they can contact the NHS Ombudsman within 28 days if still dissatisfied
  • The Health Board will require details of complaints quarterly
  • Must comply with the Patient Rights Act
15
Q

Patients have the right to have:

Any complaint made about NHS services _____ with ________ and to have it properly investigated

A

dealt

efficiently

16
Q

Patients have the right:

To know the ________ of any investigation into their complaint

A

outcome

17
Q

Patients also have the right:

To take their complaint to the independent Health Service ________ if they are not satisfied with the way their complaint has been dealt with by the ___

A

Ombudsman

NHS

18
Q

Patients have the right:

To make a claim for ______ review if they think they have been directly affected by an unlawful ___ or _______ of an NHS body or individual

A

judicial

act

decision

19
Q

Patients have the right to __________ where they have been harmed by negligent treatment

A

compensation

20
Q

The NHS commits when mistakes happen, they do what?

A

to acknowledge them, apologise, explain what went wrong and put things right quickly and effectively; and to ensure that the organisation / practitioner learns lessons from complaints and claims and uses these to improve NHS services

21
Q

Public Service Ombudsman
Lets Examine a Case More Closely:

Ms C complained on behalf of her son (Mr A) about the care and treatment he received following a road traffic accident. Ms C said Mr A had suffered a serious injury to his arm in the accident, which had required two operations. Following surgery, Mr A was transferred for a third operation to another NHS board

Ms C said she was told following the third operation that Mr A’s original surgery had not been properly performed and had had to be revised. She was told that the original surgery had damaged a nerve in Mr A’s arm and that he had developed a life-threatening infection

Following her complaint to the board, Ms C and her son met the board. Ms C said the board would not explain why Mr A’s first operation had been incorrectly carried out. Ms C also believed that her son’s infection had been caused by a failure to clean his wounds correctly and that the board should have identified this sooner

A

The PSO took independent medical advice from a consultant orthopaedic surgeon on the standard of care provided to Mr A. The adviser said that the board’s position that Mr A’s operations had been properly performed and his nerve left in the correct position was not logical. Mr A had as a consequence suffered further damage to his nerve. The adviser noted that Mr A’s wounds were heavily contaminated and at high risk of infection. However, the cleaning of his wounds and provision of antibiotics to prevent infection were carried out to a reasonable standard. Overall, the PSO found the board had failed to provide Mr A with a reasonable standard of care and treatment. The PSO were highly critical of board’s failure to acknowledge that Mr A’s surgery had not been carried out correctly, resulting in damage to the nerve in his arm

The PSO also found that the board’s handling of Ms C’s complaint was inadequate as it did not properly acknowledge the failures in care, despite the board being aware of these at the time. The PSO found that the board had failed to handle Ms C’s complaint in an open and transparent manner and failed to address the concerns of the family properly

Carry out a significant event analysis ensuring that Surgeon 1 reviews the findings of Operation 3; and

provides evidence that Surgeon 1 has reflected on the failings identified in this report as part of its appraisal process;

review its complaints investigation in light of the comments from the Adviser and provide Ms. C with a full explanation for the findings of Operation 3; and

review its handling of Ms. C’s complaint in order to identify areas for improvement and ensure compliance with the ‘Can I help you’ guidance.

Apologise unreservedly in writing to Ms. C and Mr. A for the failings identified in this report.

22
Q

What is the guidance that appleis to doctors?

A

The General Medical Council

Good Medical Practice

23
Q

Professional Behaviour and Fitness to Practise:

in relation to a doctors fitness to practice the GMC states what?

A
24
Q

what needs to be thought about when deciding whether to refer students to fitness to practice?

A
25
Q

What needs to be thought about in regards to is it an isolated incident or part of a pattern?

A
26
Q

if a medical school has tried to support a student and it hasnt worked then what should be done?

A
27
Q

has a student abused a patients trust or violated a patients autonomy or other fundemental rights? if so what should be done?

A
28
Q

is a students health or disability compromising patient saftey?

A
29
Q

You must take part in systems of quality assurance and quality improvement to promote patient safety. This includes:

A

Taking part in regular reviews and audits of your own work and that of your team, responding constructively to the outcomes, taking steps to address any problems and carrying out further training where necessary

Regularly reflecting on your standards of practice and the care you provide. Reviewing patient feedback where it is available

30
Q

To help keep patients safe you must:

A

Contribute to confidential inquiries

Contribute to adverse event recognition

Report adverse incidents involving medical devices that put or have the potential to put the safety of a patient, or another person, at risk

Report suspected adverse drug reactions

Respond to requests from organisations monitoring public health. When providing information for these purposes you should still respect patients’ confidentiality

31
Q

What Does Good Medical Practice State?

A

Contribute to and comply with systems to protect patients

Respond to risks to safety

Risks posed by your health

Establish and maintain partnerships with patients

Treat patients and colleagues fairly and without discrimination

Openness and legal or disciplinary proceedings

Honesty in financial dealings

32
Q

What are the Steps to raise a concern?

A

You must follow the procedure where you work for reporting near misses and incidents. This is because routinely identifying incidents or near misses at an early stage, can allow issues to be tackled, problems to be put right and lessons to be learnt

If you have reason to believe that patients are, or may be, at risk of death or serious harm for any reason, you should report your concern to the appropriate person or organisation immediately. Do not delay doing so because you yourself are not in a position to put the matter right

Wherever possible, you should first raise your concern with your manager or an appropriate officer of the organisation you have a contract with or which employs you – such as the consultant in charge of the team, the clinical or medical director or a practice partner. If your concern is about a partner, it may be appropriate to raise it outside the practice – for example, with the medical director or clinical governance lead responsible for your organisation. If you are a doctor in training, it may be appropriate to raise your concerns with a named person in the deanery – for example, the postgraduate dean or director of postgraduate general practice education

You must be clear, honest and objective about the reason for your concern. You should acknowledge any personal grievance that may arise from the situation, but focus on the issue of patient safety

You should also keep a record of your concern and any steps that you have taken to deal with it

33
Q

“I understand and will uphold that all those caring for and treating patients are bound by a Duty of Candour

What is the duty of candour?

A

This means that you must be open and honest with patients when something goes wrong with a patient’s treatment or care which causes, or has the potential to cause, harm or distress

If you are unsure of the consequences immediately seek the advice of an appropriate senior colleague to peer review your view and subsequently tell the patient (or the patient’s advocate, carer or family) when something has gone wrong even if the patient is not aware or has not complained

34
Q

What Might the Outcome of a Complaint Be?

A

Sleepless nights

Anxiety

Dissatisfied patients

Litigation

Loss of reputation

Discipline

Loss of job

Fitness to practise at the GMC

Restrictions on licence

Erasure (the removal of all traces of something)

35
Q

Conclusion:

A

Complaints are jewels to be treasured!!!!!!

Complaints can be beneficial

Complaints can be destroying

Have a written complaints procedure and train all staff how to administer it and to follow it

Have preventive mechanisms in place

Guidelines

Protocols

Read and follow the GMC’s ‘Good Medical Practice’

Remember your duty if patients are at risk

Remember your duty if your behaviour might put patients at risk