Unhappy patients?
Independent practitioners need to work together with private hospitals to manage patient complaints. Disa Young shows how.
Care Quality Commission (CQC) regulations specify that independent hospitals have an independent review stage for complaints.
Ninety-eight per cent of independent hospitals in England choose the Independent Sector Complaints Adjudication Service (ISCAS) to provide this independent review.
Following the Francis Report, hospitals are facing even greater scrutiny around complaints handling and this will, in turn, have an impact on your hospital-based private practice.
As part of your practising privileges at an ISCAS-member hospital, you agree to co-operate with the hospital’s complaints policy.
For ISCAS-member hospitals, this is a three-stage process:
- The registered manager is responsible for Stage 1;
- Stage 2 is conducted by the corporate head office – in the case of group hospitals – or by the chairman of the board or appointed non-executive director in the case of individual hospitals;
- ISCAS independent adjudication is the third and final stage for complaints that the provider has not been able to resolve.
As such, a framework exists for the management of complaints and if a complaint is made about you, you are the start of the
process.
Having this structure in place is particularly beneficial for those complaints that you are unable to personally resolve.
What type of complaints does the ISCAS code cover?
The code covers complaints made about clinical issues, but it does not deal with matters of clinical negligence. It also addresses non-clinical issues such as administration, fees and complaints handling itself.
Complaints are sometimes solely about consultant care, but they often involve more than one professional and it is important to fully co-operate with the process if the care you provided is part of a broader complaint.
What are your responsibilities?
It is vital to share information in a timely fashion with the registered manager about any complaints made against you and to involve them if you are finding the complaint difficult to resolve.
Co-operate with any requests to meet with the patient. ISCAS encourages registered managers to offer to meet with patients to discuss their complaint and the vast majority of complaints are resolved through this means.
It is also important that you make your consultant notes available to ISCAS if requested, with the appropriate consents, without delay.
Ensure you have a copy of the hospital’s complaints policy and are familiar with its contents, particularly around time-scales within which to respond to complaints and how to signpost complainants on if you are not able to resolve their complaint.
Learning lessons from complaints against consultants
The ISCAS code places an emphasis on hospitals learning from complaints and it is important that consultants take this on board too.
In 2014, 17% of all complaints that reached ISCAS independent adjudication (Stage 3) concerned consultants.
The main issues complained about were:
Lack of informed consent around risk;
Consultant attitude and behaviour;
Lack of transparency around consultant fees – and linked to this, hospital fees. In fact, complaints concerning fees is a growing area and will be covered in a future Independent Practitioner Today article.
Making goodwill payments
ISCAS adjudicators have developed a useful document setting out a decision-making structure for the awarding of goodwill payments to complainants.
These payments are not intended to be compensation or an admission of liability but rather a recognition of the inconvenience and distress caused to a patient.
The Goodwill Payments Guide is available to download on the ISCAS website at www.iscas.org.uk and is a structure you might choose to consider when making your own judgements.
In summary, patient complaints are an inevitable aspect of a consultant’s professional career and the ISCAS Code of Practice provides an invaluable framework for you to manage them.
Consultants and hospitals should not be responding to complaints independently of each other; instead they need to work in partnership and respond in a joined-up fashion.
Disa Young (right) is senior adviser at ISCAS