Complaints on the rise

By Robin Stride

The private healthcare complaints watchdog has issued a wake-up call to consultants and healthcare organisations following rising concern at patient grievance levels.

In its annual report published this month, it reveals: ‘How complaints are handled by providers continues to be one of the most frequent concerns raised by patients, in 77% of cases. Com­plaints about consultant care continue to rise year on year, with 60% of complaints including this element in 2019-20.’

Sally Taber

But according to Sally Taber, director of the Independent Sector Complaints Adjudication Service (ISCAS), complaints about consultants have become the top area of dissatisfaction since April.

She said  reasons why complaints to ISCAS were upheld include: 

 Lack of fee transparency by organisations and consultants. Specialists not making patients aware of the requirement to inform them about the costs of procedures and treatments before doing them. 

 Consultants not providing patients with an outline of the risks and complications with their treatment.

 Specialists failing to ensure they include all post-operative instructions in their notes. 

 Consultants not clearly documenting findings of all examinations and treatments plus failing to clearly record when consent has been obtained. 

 Organisations and consultants not having guidelines for specialists regarding continuity of care during their absences. 

ISCAS said organisations should consider reviewing internal processes to ensure consultants are aware of the GMC and Royal College of Surgeons’ requirements to take account of patients’ vulnerabilities and psychological needs. 

Remind doctors

It told Independent Practitioner Today it would like to ‘remind’ doctors and independent healthcare organisations of their responsibilities to ensure better complaint handling. ISCAS advice is:

Obtain written statements from all staff involved in complaints at Stage 1, including consultants with practising privileges.

Consultants should not respond to a patient’s complaint directly. One cohesive response should be sent from organisations, incorporating comments from consultants.

Seek an independent clinical opinion at Stage 1 rather than relying on the treating consultant’s perspective. 

Ensure complaint-handling staff know that complaints can proceed in tandem with a legal claim. 

See that consultants know the complaints process so they can direct complainants appropriately.

Mrs Taber said: ‘The specific issues have been communicated to all ISCAS subscribers, which includes the Independent Doctors Federation.’ 

A total of 509 people complained to ISCAS in the year ending March – up from 314 the year before. But one in five were outside its scope, as their treatment organisation was not among the watchdog’s fast-rising membership of 135 hospitals, clinics and private GP services. They were signposted to other organisations, where possible. 

Of 111 complaints adjudicated on in the year, there were 348 individual elements of complaint, a rise from 2.6 to 3.1 per application from 2018-19. 62% of ‘complaint heads’ were either ‘upheld’ or ‘partially upheld’.

Baroness Fiona Hodgson, chairwoman of the ISCAS advisory board, said more private patients now had the assurance of access to an independent review of their complaint by an appropriate body. 

But it was ‘disappointing’ that a large proportion of NHS private patient units – around 90% – did not yet provide access to an appropriate scheme for escalating complaints. 

Now ISCAS will redouble efforts to engage them and will publish a position statement soon.

It said nursing and discharge are recurring themes in complaints: ‘A change seen in this year has been a large increase in the frequency that ‘accommodation’ was an element of the complaint.