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Secret Diary of a Practice Manager: Modern Day Complaints

I don’t know about you, but I have seen a steady rise in the number and type of complaints coming into the surgery. I cannot help feeling that the nature of comments made by the Government about the NHS, which are then hyped up by the media, have left patients thinking that they should complain about everything they are not happy with.

Now don’t get me wrong - it is right that there is a complaints system in place, and that people should be able to complain. However, for argument’s sake, if a patient says they cannot get an appointment for a month, in our case that is just not true. We have so many types of appointments that usually a patient can be seen within 48 hours, if not on the same day.

Perhaps they are really saying, “We cannot get an appointment with the doctor we want, at the time we want for a month”. For that I make no apology, and I wonder who it is that is saying this should be possible!

If you are ill you will see any doctor, and if a doctor says come back and see me in a month surely you should make an appointment as you leave, rather than waiting three weeks to request an appointment!

We then get patients saying the doctor has got it wrong in their diagnosis or used the wrong medication.  The internet in some way has a lot to answer for, as how many times do we go online to research our symptoms? 

It is also very telling that when we make any changes recommended by the CCG at the Government’s request, the number of complaints go up. Where is the publicity supporting these initiatives? Sadly it is nowhere to be seen, and so we are viewed as the instigators, who will somehow make money out of the situation. Hence the flood of complaints being experienced at the moment.

Since moving to a much bigger practice I have altered the way I handle the complaints. In the smaller practice, I was often around and so invariably heard the complaint coming in. If I felt it was appropriate I would intervene, usually with a positive outcome.

This is not possible where I manage now. I do not have the same interaction as I had in the smaller practice, and so I have stopped being available upon demand to every patient wanting to see me. In most cases, I insist on the complaint being put in writing so I can investigate each point.

This often causes yet another complaint, but how often do we go into a situation not knowing all the facts, only to suddenly be faced with every problem the patient has ever had? Having it in writing makes the response easier, as we address the written issues and not what the patient thinks they said or meant. It also means we have an audit trail and of course this helps with CQC compliance.

My staff are excellent and either try to handle issues themselves, or will transfer to the reception manager who will once again try to find a resolution. In a few cases the staff may ask me to intervene as they think the issue is urgent - and they are normally correct.

Every complaint is investigated thoroughly and I insist that the truth is revealed both to me and in any response. It is always better to be upfront and explain what happened and why -and most importantly explain what changes we will be making as a result if they are found to be necessary.

We always discuss complaints at both the weekly partners meeting and the monthly practice meetings to try to learn from the issues raised. I do feel we worry too much about complaints and that in some instances they can be positive, helping us recognise a need to change processes and improve our service.

So, should we be worried about the rise in the number of complaints? I’ll leave that to you to decide!

Do you find patients can have unreasonable expectations about the services a practice can provide? Let us know your thoughts in the comments sections. Plus, FPM members can visit our Policies Library to access a wide range of documents on handling complaints.


Derek Roe 23/03/2017

What a good article, and how true. More than any other area of the NHS, General Practice seems to be "fair game" Some of the niggles and gripes originate from unreasonable comments made by a politician, then ramped up by the Daily Mail / Express reader. after all if its in the Express it must be true? However, I must still believe that the moaners are the minority and the vast majority of the patients we serve are positive and appreciative and realistic as to what we can provide

Tony Gover 23/03/2017

Great article, but my thoughts on complaints are that I welcome them, sometimes the British way is not to complain. But I actively seek them as it is the only way we can try and get things right. Obviously I understand that we cannot appease all, but if we meet them head on I feel we can achieve more.

Ghislaine Morton 23/03/2017

Patient list size is 11,400 I also have a lot of complaints regarding patients not being able to get appointments at a time that is suitable to them, i.e. NOW! I make no apology when I hear that their problem is not urgent and let the patient know that they will have to book at least 2 weeks in advance for a routine appointment if they want more choice. We too offer urgent on the day appointments; most of them unattended when booked the same day! We have 48 hour appointments and we have appointments with our GP Alliance weekdays between 4-8pm and at weekends. It’s not that the patient “can’t get an appointment” it’s that they will not take responsibility for their care and book in advance. We (practice managers) should not bend over backwards or take the blame when we still offer an excellent service for free!

Linda van Bregt 22/03/2017

I thought I had written this article myself. Really pleased it is not just my distorted experience but obviously a much wider one. I think the media has a lot to answer for.

David Cripps 22/03/2017

The nature of some complaints has changed over the years.I have 11 years in a practice in another county before starting here late 2004 and share your experience moving from an average sized practice operating across two sites to one with over 23,000 patients operating from five sites. Interestingly, the larger practice has the same number of complaints pro rata and averaged across 13 years as the smaller practice in that golden age when all was well with the world (as if): 1 per 1,000 registered patients per annum. What has changed is that more are about misdiagnosis (and mostly we too blame the internet) and many about trivia arising from the inability of the younger generations (yes, plural - I'm now 60) to care for themselves or who have the expectation that there is a pill to solve all ills instantly and painlessly. A recent example is a 17 year old who demanded Emla cream if she was to have blood taken. Though every complaint is an opportunity to learn and I learnt that Emla cream is available OTC! I would agree that asking a complainant to write does help focus on what it is they are complaining about and does aid in responding to the complaint. Especially when you are dealing with a patient who was a barrister.....

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