Practice

The Competent Novice

Dealing with complaints

BMJ 2008; 336 doi: 10.1136/bmj.39455.639340.AD (Published 7 February 2008)
Cite this as: BMJ 2008;336:326

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  1. Judith Cave, specialist registrar in medical oncology1,
  2. Jane Dacre, professor of medical education2
  1. 1Department of Oncology, University College London Hospital NHS Foundation Trust, NW1 2PG
  2. 2Academic Centre for Medical Education, Division of Medical Education, Royal Free and University College Medical School Archway Campus, London N19 5LW
  1. Correspondence to: J Cave j.cave{at}medsch.ucl.ac.uk

    This article explores why patients complain and outlines some strategies for reducing the rising number of complaints and for dealing appropriately with any that do occur

    Key points

    • Try to give patients as much information as they want or need to allow them to navigate through the complexities of their illness and the healthcare system

    • If things go wrong, offer an explanation and a compassionate apology and explain how you will prevent similar incidents in the future

    • If a patient or relative expresses concerns about the patient’s treatment, then listen to them and answer any questions you can. If the complainant decides to make a formal complaint ask them to contact the complaints manager as soon as possible

    One in 10 patients admitted to hospital in the United Kingdom experience an adverse event,1 and around half of these events are preventable. The number of complaints from National Health Service (NHS) patients is rising in the UK: the Department of Health’s Independent Complaints Advocacy Service dealt with 10 422 complaints in 2003-4 but almost 13 000 complaints in 2004-5.2

    It is essential that healthcare professionals work together with patients and deal constructively with feedback to reduce adverse events. Evidence shows, however, that doctors find complaints extremely upsetting, feel unsupported in dealing with them, and are fearful of the consequences, including litigation.3 4 5 Here we describe how and why patients complain and then suggest some evidence based strategies for reducing complaints and for dealing appropriately and helpfully with any that do occur.

    Why do patients complain?

    Complaints often follow adverse clinical events, but they can occur even when nothing has “gone wrong.” Similarly, not all adverse events result in complaints. Focus group studies show that patients want to be told about events occurring in hospital that have caused them harm. Patients want to receive an apology, …

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