Safe Practice

Issues, Concerns and Complaints

As a registered practitioner you must understand the NHSScotland complaints system and be able to inform patients/clients and their carers about it appropriately. It is well recognised that if situations that could lead to complaints are dealt with promptly, honestly and focus on a solution, that many complaints can be avoided.

NHS complaints and the media

NHS complaints and the media

Media reporting is probably where you hear about NHS complaints most often and they are frequently often reported in a very emotive way.

Look for information about NHS complaints that are currently in the news:

  • carry out a web search for information about healthcare complaints.
  • access a website that will provide this information e.g. BBC Scotland News, a newspaper website or another website providing current affairs coverage.

You will find what you learn in the 'Developing your Critical Appraisal Skills' and other activities in the Research for Practice section useful when completing this activity.

Using the information you have found answer the following questions:

  • how many, if any, of these relate to issues of patient/client safety?
  • why do you think these issues receive such high media attention?
  • what could the impact of this media coverage be on the patient/client involved and the practitioners or healthcare staff involved?
  • do you know what to do if you are approached by the media?

Record your answers to these questions and identify where you have learning or information needs. Discuss how these needs can be met with your mentor. Add this information to your portfolio.

Learning from complaints

Statistics can show the pattern of complaints made in NHSScotland.

Find out more about NHSScotland complaints statistics in the ISD complaints statistics report. Use the contents list of this report to find an area you are interested in, alternatively read pages giving the results.

  • what do you think can be learned from investigating complaints?
  • how does what you have read impact on your practice?

Record what you have learned for your portfolio.

Learning from good outcomes, comments, concerns and complaints

You may want to do this activity in 2 stages of you are short of time

Identify a situation in your work setting where the outcome was better than anticipated and things really worked well, or where you received good feedback from patients/clients or their families.

Also identify a situation where there have been comments, concerns or complaints in your work setting or, comments or concerns have been expressed by patients/clients or their families.

Answer the following questions in relation to each situation:

  • record/map each stage of the situation
  • identify what happened at each stage
  • identify who was involved?
  • what were the responses of everyone involved at each stage
  • identify where different responses could have altered the outcome
  • how does this compare with a similar clinical situation where there was no indication of the potential for comment?

You may want to complete this activity in stages, depending on the time you have available.

Reflect on what you learned from these situations and how you would respond to similar situations in future.

Record your reflections for your portfolio.

The power of apology

'We are all human - we can all make mistakes.'

This quote is taken from a man who complained to the Ombudsman following the death of his son. His motivation for complaining was to ensure that the public body being complained about would listen to him, that they would learn lessons from his complaint, and most importantly, that they would make a meaningful apology to him for what went wrong.'

From the Scottish Public Service ombudsman website page about The Power of Apology.

Go to the Power of Apology page and read about the impact that an apology can have then reflect on what you have read there and your experiences in practice.

Take into account:

  • what you have learned and read in this section so far
  • situations you have encountered in practice where there were comments, concerns or complaints (you may want to look at the situation you used in the previous activity)
  • how you would react differently by taking the power of apology into account

Record your reflections for your portfolio and discuss what you have learned with your mentor.

NHSScotland Complaints/complaints policies

A formal complaint system is one of the ways in which patients/clients can feedback on their experience of healthcare that they feel has not been satisfactory or does not meet their expectations. Anyone making a complaint under the NHS complaints procedure is entitled to:

  • a full and complete explanation of what happened and why, given in terminology that the complainant can understand.
  • an apology, if there was an error or omission on the part of staff
  • if an error or omission has occurred the complainant should be given information about the action that the organisation has taken, or is taking, to prevent it happening again.

You should:

  • review the NHSScotland Complaints Procedure It is important that you are confident in your understanding of Part 2: Learning from Comments and Concerns and Part 3 of this guidance

The Scottish Public Service Ombudsman deals with complaints after they have completed the complaints procedure of the organisation that delivered the service. This means that they deal with complaints that have not been resolved by the organisation.

Find out:

  • more about this work from their website
  • about the type of complaints they deal with and the outcomes by using the search function to find specific clinical conditions, service areas, or Health Board areas
  • what information is available in your Health Board to provide information about complaints and where this can be obtained. How easy was this to find?

Local complaints policy

As a newly qualified practitioner, it is important that you understand the local complaint policies and procedures. You will be able to use the information you review here in other activities in this section.

You should:

  • access this local information, making sure you understand your role in handling complaints
  • also check that the information displayed locally for patients/clients is up to date
  • find out who is your local complaints officer and how to contact them

Information for Patients/clients

As a registered professional working in NHSScotland, you need to know how to respond if a patient/client wants to make a complaint. Several sources of information are given below. Review these so that you know where to advise patients/clients to get further information in a variety of formats.

Health Rights information Scotland

Citizens Advice Bureau: NHS Complaints

The Health Rights Information Scotland leaflet 'Making a complaint about the NHS'. Local versions of this leaflet will be available in your Health Board.

Responding to complaints effectively (1)

As a newly qualified practitioner, it is important that you understand the local complaint policies and procedures. Access these, making sure that you understand your role in handling complaints.

You need to know what to do if a patient/client or other visitor to your work setting raised and issue, comments on something that has happened, or you receive a complaint from a patient/client about the service you work in. Remember that (when handled properly) issues, comments and complaints can lead to very positive outcomes and improvements in the standards of care.

Consider what you would do if a patient/client approached you verbally regarding an aspect of their care that they wished to formally complain about.

You could use a real issue, comment or complaint that has been previously logged in your clinical area or think about a situation that could have resulted in a complaint. Also, use the information you have read or recorded in other activities in this section.

The NHSScotland 'Can I Help You?' Publication provides good practice guidance for handling and learning from feedback, comments, concerns or complaints will be useful to you when completing this activity.

  • Page 6 of the document (7 of the PDF) gives a summary of the NHSScotland complaints procedure
  • Pages 10 to 13 of the document (11-14 of the PDF) discusses learning from comments and complaints

Reflect on:

  • actions you could take and why
  • how informed of the local policy and procedures you feel and where you feel you need to know more
  • the skills could you draw on to try to bring about a resolution and any you need to develop
  • how you would know that you needed to involve others in resolving the patient's/client's complaint

Discuss your reflections with your mentor.

Regulatory bodies and complaints

It is important that you understand the nature of complaints about the conduct or practice of healthcare professionals that have been referred to either the Nursing and Midwifery Council or the Health Professions Council.

Consider how your regulatory body act to protect the public from harm by healthcare professionals by looking at the Fitness for Practice page.

Fitness to practice cases can offer insight into:

  • the issues that these organisations investigate to ensure patient safety
  • the issues that arise for practitioners that can lead to complaints

Look at your regulatory body website and review 2 or 3 cases that are relevant to your role/work setting.

NMC

Fitness to Practise

Hearings and outcomes

HCPC

Fitness to Practise

Hearings and decisions

Care Inspectorate

Additionally, if you work in the social care sector, the Care Inspectorate is independent regulator of social care and social work services across Scotland.

Portfolio activity

Make a portfolio entry which summarises what you have learned about Issues, Concerns and Complaints. Include what you have already recorded in this section, sharing best practice, your learning needs and how what you have learned so far has changed aspects of your practice. Make sure you discuss this with your mentor/supervisor and/or NHS KSF reviewer and that your future learning needs are reflected in your Personal Development Plan.

Add an alert to your Flying Start NHS® portfolio and /or make a date in your diary to revisit Issues, Concerns and Complaints.