Rising complaints against doctors

The number of complaints to the GMC, which oversees doctors practising medicine in the UK, increased by 23% from 7,153 in 2010 to 8,781 in 2011 – continuing a pattern which has been rising since 2007. While the rise in complaints does not mean that medical standards are falling, the likelihood that the GMC will investigate a doctor increased from one in 68 in 2010 to one in 64 in 2011. The findings come in the GMC’s second annual report on The state of medical education and practice in the UK, which presents a profile of the medical profession over the last year and outlines challenges for the future. The report looks at the changes in the medical profession, the challenges facing doctors at different times in their career and the influence of where they work. As in the past, most complaints in the last year have come from members of the public – and although many are not about matters which call into question the doctor’s fitness to practise, some are serious and require a full investigation. Among these complaints there was a significant rise in concerns about how doctors interacted with their patients – allegations about communication increased by 69% and lack of respect rose by 45%. There has also been a rise, albeit a smaller one, in the number of complaints from medical directors and others holding official positions. The GMC trends are in keeping with rising complaints across the NHS, and, in particular, complaints about doctors. However, there is no evidence that this points to falling standards of practice and initial analysis suggests that greater expectations, an increased willingness to complain, less tolerance of poor practice within the profession, as well media attention for high profile cases, may be behind the increase. The number of doctors falling seriously below the standards expected of them remains relatively small – the GMC took action in more than 500 cases and gave advice in a further 700 – the names of 65 doctors were erased last year from the medical register, in effect permanently removing their right to practise medicine in the UK, while a further 93 were suspended. For the first time, the report also provided detail on how doctors are more likely to face different types of complaints depending on where they work and the stage of their career. GPs, psychiatrists and surgeons attracted the highest rates of complaints. Men, and in particular older male doctors, were also far more likely to be the subject of complaints than women. Doctors trained outside the UK and Europe were less likely to be complained about in middle age but more likely to face allegations when they were older. The GMC said it was working to better understand what was driving the increase in complaints and the nature of the complaints themselves as well as how to provide greater support for doctors over the course of their career. The GMC is introducing a series of measures to deal with the rise in complaints – this includes:

• Establishing a 15-strong team of Employer Liaison Advisors who cover the whole of the UK and support medical directors and Responsible Officers in managing concerns about doctors as well as providing advice on issues such as revalidation.
• Launching a confidential helpline for doctors later this year so they can raise any patient safety concerns they may have with the GMC in confidence.
• Launching a pilot for a national induction programme for doctors new to the register.
• Major reforms of its fitness to practise procedures – this includes setting up the Medical Practitioners Tribunal Service (MPTS), piloting initiatives such as meeting with doctors and complainants to speed up investigations and reduce the trauma involved.
• Launching a new version of its core guidance Good Medical Practice later this year which sets out the standards that are expected from doctors. The GMC will also publish for the first time Good Medical Practice for patients to make clear what patients should in turn expect from their doctor.

Niall Dickson, chief executive, of the General Medical Council, said: “We are committed to enhancing patient safety and improving the quality of medical care across the UK. Critical to this is the new system of regular checks for all doctors – known as revalidation – which we plan to introduce from the end of this year. “We also need to respond to the rising number of complaints about doctors – a pattern seen across healthcare. We are investing more in this area and we are rolling out a package of measures both to protect patients and provide greater support for doctors during the course of their careers. “While we do need to develop a better understanding of why complaints to us are rising, we do not believe it reflects falling standards of medical practice. Every day there are millions of interactions between doctors and patients and all the evidence suggests that public trust and confidence in the UK’s doctors remains extremely high. We hope this report will shed further light on the issues and challenges facing the medical profession in promoting high quality healthcare across the UK.” Commenting on the publication of the data, Mike Farrar, chief executive of the NHS Confederation, highlighted the importance of patient feedback and said doctors play a major role in ensuring patients are treated with dignity and compassion. He commented: “It is essential doctors listen to their patients’ experiences – good and bad – to improve professionally. It is also crucial that the right systems are in place to learn from occasions where things go wrong. “We must keep a careful eye on these complaints. A rise may partly be a result of patients, rightly, being more assertive in voicing dissatisfaction about their care, or it may be something more substantial.” He added that employers and individual doctors need to analyse the data and look carefully at the cases where doctors have not met the standards that patients expect, and what action they need to take when they fall short. “Every patient should be given the necessary time to discuss healthcare concerns which can often be complex and upsetting. Worryingly, these figures suggest that this is not always the case,” Mike Farrar continued: “Doctors play a major role in making sure patients and their families are treated with dignity and compassion when they access NHS services. The NHS Confederation will continue to engage with the GMC as part of the Commission on Improving Dignity in Care for Older People to see how we can tackle this complex issue. “The introduction of revalidation will be another important step in raising the standards of care among doctors. It will introduce regular assessments for doctors and will help reassure the public that their medical care is up to date, safe and effective.”