Recent NHS statistics show a near 40% increase in written complaints about general practice in 2021/22 in comparison to the previous year. Alongside, we hear from MDU members worried about the increasing number of complaints that aren't easily resolved.
Local resolution meetings can play an important part in resolving complaints successfully. There are, of course, several things to consider before holding a resolution meeting.
Members can also get further advice on responding to complaints at the MDU complaints hub.
Do I have to hold a resolution meeting?
There's no requirement to hold a resolution meeting. However, it can be a helpful method in resolving the complaint and avoiding escalation. If it does escalate, it also demonstrates to the Ombudsman that every effort was made to resolve the complaint locally.
There will be circumstances where holding a meeting would not be productive, including when there are concerns that the complainant will be aggressive.
When should I hold the resolution meeting?
You can hold a meeting at any point during the complaints process. It does not need to take place after the final written response has been sent and may even be more appropriate much earlier on in the process. If a meeting is successful in settling the complaint, the final written response can sometimes be much shorter.
What issues should be on the agenda?
Agree the areas for discussion in advance. It is often helpful to set an agenda or to ask the complainant for a list of questions they would like addressed.
We sometimes find that complainants are unwilling to provide this information for fear they will be prevented from asking other questions during the meeting. So, explain in advance that you're asking for these documents only to ensure the meeting runs efficiently and to maximise the likelihood the complainant leaves the meeting satisfied that all issues have been covered.
Who can attend the meeting?
This needs to be established in advance. The complainant might benefit from bringing a friend or someone from an advisory/advocacy service. In return, you'll need to let the complainant know in advance who else might attend from your side, such as a practice manager or a senior partner who was not involved in the issues that led to the complaint.
Explain the roles of those attending, such as the chairperson, a note taker and the clinician(s) involved in the complaint. Try not to have too many people at the meeting in case the complainant feels outnumbered and intimidated.
Very occasionally, complainants will opt to bring a solicitor with them. If this happens, make it clear beforehand that the purpose of the meeting is to discuss the complaint under the NHS complaints procedure, rather than to discuss compensation or litigation. For a resolution meeting where a solicitor will be present, please liaise with us for specific advice.
Where should the meeting take place and for how long?
Holding the meeting in your practice may be suitable in most circumstances, but there may be rare occasions when it would be better to find a neutral venue.
Ensure enough time is allowed for a full discussion, outside surgery time, and make sure you're not interrupted during the meeting The duration will depend on the complexity of the complaint and people involved. It is appropriate to stipulate the start and end time for the meeting in advance and to stick to these. A follow-up meeting can be planned if the allotted time isn't enough.
Who leads the discussion?
Whoever is chairing the meeting should make sure introductions are done first and cover any preliminaries - such as reminding the complainant of the agenda and reassuring them that they can ask any other questions.
When discussing each item on the agenda, it can be helpful to let the complainant explain their concerns and ask their questions first. Aim to avoid interrupting; actively listen. You might need to take a minute before answering a question. Aim to respond with a clear explanation and response. Stay calm and measured, even if the complainant is not.
Should I offer an apology?
Members often ask us whether saying sorry will lead to problems. On the contrary, saying sorry is ethically important when something has gone wrong and is not an admission of liability in clinical negligence cases.
In our experience, what can lead to criticism is the 'hollow' apology: "sorry you feel that way…" or using 'if' or 'but'. A genuine apology for something that should have happened differently can often help settle a complaint, but if you have any concerns about a particular case, please come to us for advice.
What should I do about documentation?
It's a good idea to have all the relevant documentation to hand during your meeting, such as the relevant notes, the complaint letter, any replies sent and significant event audit minutes.
Take full minutes and make sure all parties agree on them afterwards. Outcomes should be fed into the response and any learning points from investigating the complaint.
The complainant should still receive a formal written response even if the meeting resolved the complaint. But this can often be much shorter than if the meeting had not happened, because much of the ground will be covered in the minutes of the meeting.
Can patients record the meeting?
Some patients may wish to record the meeting, which can be unnerving. However, having a record of the meeting can be helpful in drafting the minutes afterwards and ensuring there is an accurate, comprehensive account of what was said. So if a patient asks to record a meeting, you may wish to do the same. If so, you should let the patient know if you are planning to record the meeting. It's probably safe to assume that the meeting is being recorded, whether or not the patient asks you.
What can I do to manage the stress around complaints?
Attending a complaint resolution meeting can be stressful - especially for clinicians who may be the focus of the complaint. It's important not to let any feelings of defensiveness overcome your calm and professional manner.
Seek support from trusted colleagues within the practice beforehand, and if the meeting needs to be paused for attendees to take a break, this can be incorporated. It can also help to hold a debrief session after the meeting, particularly if it involved any tense exchanges.
At a time when GP practices are already stretched, the prospect of finding time to meet with complainants can feel burdensome. But often a meeting like this will avoid the need for protracted correspondence back and forth about a complaint, and may even speed up progress.
If the complainant still isn't satisfied after you've responded to the complaint, speak to your medical defence organisation for advice on what to do next.
The original version of this article appeared in GP Business.
This page was correct at publication on 24/05/2023. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.