BMA launches complaints survey
12 November 2012
With complaints made against doctors up by a quarter in 2011, the BMA is launching a survey to increase understanding of the process and how it affects clinicians and the care they provide.
Have you ever had a complaint made against you or been in dispute with colleagues or management? How did it make you feel? Has it affected your medical practice or personal life ever since?
The latest statistics from the GMC suggest doctors are increasingly likely to face complaints. In 2011, 8,781 complaints about doctors were made to the GMC — a 23 per cent rise from the 7,153 made in 2010.
And that’s just the number of complaints made to the regulator. Many more are likely to have been made and resolved through local or national processes.
The GMC has pointed out that the rise in complaints does not mean that medical standards are falling. Few of the complaints it received resulted in doctors being erased from the medical register.
But the impact on a doctor against whom even a minor complaint is made can be huge and is not well understood. It is for this reason that the BMA will email the majority of its members next week, inviting them to take part in a confidential survey about the healthcare complaints processes.
Doctors will be asked about any complaints made against them from whatever source, their views on the fairness or otherwise of the process they went through as a result, and the impact the experience had on them.
Even doctors who have never been subject to complaints are urged to respond, as there is evidence that fear of complaints can affect doctors’ well-being and attitude to work.
BMA Doctors for Doctors Unit head Michael Peters says: ‘Doctors are often terrified about complaints. If a doctor has a complaint made against them, it goes into their psyche. It is not like being an accountant who slips up; it can mean the destruction of a whole person. That is how the doctor perceives it.
‘Complaints affect all doctors in one way or another, even if they have never had one made against them.’
The study is being organised by the Doctors for Doctors Unit, King’s College London and Imperial College Healthcare NHS Trust.
Imperial’s Professor Tom Bourne says: ‘The feeling is that people are usually exceptionally worried about complaints and how they might impact on their careers, and this may or may not be justified.
‘This survey is the best chance doctors have had to give their views on this system — how it functions, and the impact it has had on them, their colleagues and patients.
‘The complaints system is supposed to protect patients. Yet, if it is resulting in changes to practice, and more defensive medicine, the impact may be counterproductive and lead to a deterioration in the quality of care.’
The team is hoping for a minimum of a 50 per cent response from the 119,000 doctors who will receive the survey invitation.
The survey should take 15 to 20 minutes to complete. It is fully anonymous and the answers cannot be linked back to doctors in any way.
Lead researcher Maria Jalmbrant adds that as far as the team is aware, the survey is one of the first of its kind.
The researchers have an open mind about what the data will show, but they hope the findings will be used to steer future policy. They believe there could be far-reaching consequences.
Dr Peters thinks the results could be used to reshape the complaints processes. He says: ‘We can inform authorities about the impact on doctors in order to make processes more sensitive. It’s not all about the GMC. Some NHS HR departments are not necessarily handling doctors and complaints well. We could sensitise them to the nuances and the potential vulnerabilities of doctors going through complaints.’
Professor Bourne suggests the work could reveal the type of doctor or specialty in which doctors are at particular risk of complaints or conflict. Structures could be put in place in these areas to prevent problems arising and to provide support.
Doctors are notoriously bad at admitting to problems as it is, and Dr Peters says complaints can trigger stress, anxiety, depression and worse.
A 2004 study, Suicide in Doctors: a Psychological Autopsy Study, published in the Journal of Psychosomatic Research details the factors behind the suicides of 38 working doctors in England and Wales. It says 25 doctors had significant problems related to work, although multiple and interrelated problems were often present.
Professor Bourne says: ‘People are worried about putting their hand up [and admitting a problem] if they feel they are depressed, or not coping. It’s not seen as acceptable.
‘But serious depression, anxiety and suicide are not acceptable outcomes of a disciplinary process. Nor is it a good outcome for patients if well trained doctors say “I am not doing that procedure any more” if one minor, isolated problem occurs.
‘That is why we need to understand these issues much better.’
Not about silencing patients
He adds that he has spoken to junior doctors who have received their first complaints. ‘They said it felt like the bottom had dropped out of their world,’ he says.
‘It impacts on their practice, on their time, how they go about their business as a doctor.’
The team emphasise that the work is not about changing the right of patients to complain about their care, or about stopping whistleblowers speaking up appropriately.
However, they say the impact of such process must be proportionate, and if problems with the existing system emerge, the BMA could take the lead on the issue.
Dr Peters says: ‘If we have a sufficient number of responses, we will be in a far stronger position to understand and support doctors, better inform health policy, and improve care for patients.’
The BMA offers the following help and support to all doctors:
- BMA Counselling is staffed by professional telephone counsellors 24 hours a day, seven days a week. Call 08459 200 169
- The Doctor Advisor Service runs alongside BMA Counselling, giving doctors and medical students in distress or difficulty the choice of speaking in confidence to other doctors. Call 08459 200 169, and ask to speak to a doctor adviser
- The Doctor Support Service is for doctors going through GMC fitness-to-practise cases. It offers emotional help from doctor supporters, who can also accompany individuals to GMC hearings. Call (020) 7383 6707 or email firstname.lastname@example.org.
BMA members can also access employment advice via 0300 123 1233.