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One in five complaints against GPs relate to removal from lists

BMJ 2006; 333 doi: (Published 20 July 2006) Cite this as: BMJ 2006;333:170
  1. Adrian O'Dowd
  1. London

    More than one in five complaints to the parliamentary and health service ombudsman Ann Abraham in England last year related to the removal of patients from GP lists. Many of the people complaining said that they had not had a warning of removal or been given the opportunity to put their side of the story.

    The figures from the ombudsman published last week show that less than half the complaints made against GPs in 2005-6 were upheld (59 out of 139). But overall complaint figures are rising.

    Cases relating to health made up more than half of all the cases completed by Ms Abraham in 2005-6 (1891 out of 3782 cases). Just over 1000 complaints related to continuing care. The ombudsman fully or partly upheld 67% of all the complaints she investigated.

    The report describes how the ombudsman worked with the Department of Health and NHS quality standards watchdog the Healthcare Commission during the year to develop a standard for NHS complaints.

    Some NHS bodies remain “defensive” when it comes to handling complaints, the report also warns.

    “The quality of complaints handled by local NHS bodies is still very variable and is often dogged by defensiveness and a lack of corporate commitment to taking complaints seriously,” writes Ms Abraham in the report.

    “Furthermore, the demand for independent review—the second stage of the NHS complaints system, which passed to the Healthcare Commission in July 2004—proved much higher than forecast. This caused a significant backlog of complaints at the Healthcare Commission, which they have found difficult to address.”

    Complaints relating to health services (not including continuing care) ranged across 475 different types of body including acute trusts, primary care trusts, strategic health authorities, and ambulance trusts.

    There were some recurring themes such as complaint handling; communication with patients and their relatives and carers; care planning; and record keeping, which showed a lack of patient focus and failures in management and leadership.

    Ms Abraham welcomed the Department of Health's intention to integrate the handling of complaints about both health and social care—announced in the white paper Our Health, Our Care, Our Say in January 2006—as this was one of the recommendations she made in her March 2005 report on the NHS complaints procedure, Making Things Better.

    Annual Report 2005-06: Making a Difference is available at

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