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Ombudsman warns GPs over patient removal

GPs and CCGs must follow correct procedure in complaint handling

Louise Prime

Friday, 09 November 2012

GPs need to make sure they are complying fully with official guidance before they remove patients from their list, the Parliamentary and Health Service Ombudsman has warned today in its annual review. It received 16% more complaints this year than last, from patients who said they had been unfairly removed from their GP’s list.

The report said that GPs must comply with BMA guidance on removal of patients from their list, as well as with their contractual obligations. In all but the most exceptional circumstances:

  • GPs must warn the patient that their behaviour is putting them at risk of being removed
  • the warning must clearly set out what is inappropriate about the patient’s behaviour (for example, frequently not attending appointments without cancelling) – and what they must do in order to avoid removal.

The review also found that there had been no improvement in the number of GPs’ “failing to handle even the most basic complaints correctly”. It warned that this failure to improve caused wider concerns about clinical commissioning groups effectively delivering their responsibilities for dealing with complaints about their commissioning decisions, ensuring that providers with whom they contract deal with complaints well, and using complaints data from providers to inform future commissioning decisions.

The Ombudsman said it is working with the NHS Commissioning Board to ensure that GP providers and CCGs handle complaints well and “to help embed good complaint handling across the NHS”.

The report showed that right across the NHS, poor communication with patients was a huge factor in many complaints. Health Service Ombudsman Dame Julie Mellor said: “Time and again, poor communication with patients and their families is at the core of what goes wrong. Last year, we received 50% more complaints from people who felt that the NHS had not acknowledged mistakes in care. We received more complaints from people who felt they had not received a clear or adequate explanation in response to their complaints, and more complaints about inadequate remedies, including apologies.”

Overall complaints made to the Ombudsman about the NHS, or NHS-funded services, were 8% higher this year than last. This included a 61% rise in complaints about care from independent providers, a 50% rise in complaints about the NHS not acknowledging mistakes in care, and a 42% rise in complaints that the NHS had not offered an adequate remedy to a complaint.

NHS Confederation Mike Farrar said: “Of the 16,337 complaints the Health Ombudsman received, over two-thirds were sent back to local organisations because they had not completed the NHS complaints procedure. This suggests that we are not doing enough to resolve things at an early stage and communicate with people about how they can raise their concerns."

He added: “Listening to patients and their families is an essential part of providing dignified and compassionate care. It provides invaluable information about what’s working and where organisations need to do better …

“We should encourage feedback from patients and families. Only by having a two way dialogue and seeing complaints as positive, can we change patient experience.”

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