Even the best dental teams are not immune from patient complaints. With this in mind, Donna Hickey offers advice on how to make the most of such an eventuality and help turn complaints from a negative into a positive.
The General Dental Council (GDC) has indicated that in 2013-14, the total number of complaints relating to just dentists in England alone was more than 12,000, an increase over previous years.
This figure includes 3,099 fitness to practise complaints made to the GDC, 6,973 made to NHS England, 1,043 to the Care Quality Commission and 1,068 to the Dental Complaints Service (www.gdc-uk.org, 2016).
In terms of the fitness to practise upsurge, the GDC’s annual report for 2014 states: ‘Further research is underway to understand the drivers behind increases in complaints in recent years, but possible factors may include: patients are complaining to the GDC rather than to their local primary care organisations; greater awareness of how to complain due to increased internet usage; and the effect of changes to “no win, no fee” rules which has prompted more referral of cases to the GDC’ (www.gdc-uk.org, 2014).
The outcome of such research would, of course, be of interest. However, whatever the reason for the increase, it does not change the fact that more dental professionals than ever are being reported to various overseers.
There is no doubt, sadly, that some cases do need to reach this stage. However, for other team members, having a good system in place to handle grievances from the outset may allow many more patient complaints to be handled in-practice to everyone’s satisfaction.
Clearly, a significant proportion of your working day is spent communicating with patients. Sometimes the nature of the conversations may not be pleasant and, despite best efforts, it is inevitable that complaints will be made.
It is, of course, natural to feel upset when a patient makes a complaint. However, there can be a positive aspect to this. Analysis of patient complaints can identify shortcomings that could affect your risk management procedures, patient safety, staff performance or the business.
While you are initially unlikely to perceive a patient’s complaint as a positive, you may find further down the line that listening to their comments is ultimately beneficial. For instance, analysis may show a pattern of complaints made when:
- A particular dental laboratory was involved
- When staffing deficiencies were experienced
- A named team member interacted with patients
- Treatment costs were higher than expected.
The culture of learning from patient complaint occurrences should be nurtured, and appropriate safeguards put in place to prevent such incidents happening again.
Your complaints policy
A policy to handle complaints fairly and efficiently requires all members of the dental team to be committed to delivering high quality care and service to all patients, irrespective of whether they are NHS or private, a regular attendee or an infrequent visitor.
Should a situation arise where a patient claims that this has not been their experience, the practice needs to know about the patient’s experience and learn how to improve the service.
The practice is most likely to receive complaints by letter, telephone or email, or made directly to reception staff.
The complaint should be passed on to the complaints manager (often the practice owner or practice manager) immediately, and acknowledged by this person within 48 hours. Any delays experienced during the preliminary investigation should be communicated to the patient. If the patient is unhappy with the choice of appointed person, an alternative member of the dental team must take on the role of complaints manager.
The patient should be invited to discuss the complaint via a telephone call or during a meeting at the practice, to which the patient may bring a representative. A face-to-face meeting is often a better choice, since it is easier to gauge how discussions are faring through observation of facial expressions and body language. Whichever format the patient chooses, a record of the discussion must be made and the patient given a copy in a language or format that they can easily understand.
If no resolution is reached as a result of the initial meeting, a further investigation needs to be carried out. During this investigation, the patient must be kept informed of progress. If a non-clinical person has been appointed to deal with a clinical complaint, they may require advice from a person who has clinical knowledge.
Dental suppliers and manufacturers, as well as dental technicians, may also need to be contacted to complete the investigation satisfactorily. Should any contact need to be made with third parties, written consent must be obtained from the patient in advance.
Following completion of the investigation, a second meeting will need to be arranged and the findings discussed with the patient. Prior to the meeting, the patient needs to be informed of who will be in attendance. The patient, meanwhile, again has the right to bring a representative with them. If the patient is unwilling to attend a meeting, discussions may be held over the telephone.
Comprehensive notes must be taken throughout the conversation – whether in person or over the phone – and verified as a true record by everyone involved. The patient must then be sent a written copy of the meeting or telephone conversation notes in a language or format that they can easily understand, which will conclude with whatever decision has been made about the complaint.
If, following the complaint investigation, the practice is found at fault then it must also offer an apology.
Failure to settle
If the patient feels the response has not adequately addressed their initial complaint or feels dissatisfied with any part of the procedure, and if they are not willing to continue a discussion within the practice, they should be directed to:
- NHS Choices
- Your local Independent Complaints Advocacy Service (ICAS)
- The Dental Complaints Service (in the case of private patients)
- The General Dental Council
- Care Quality Commission (England only).
It would be wise to seek advice from your legal representatives at this stage, if you have not done so already.
Donna Hickey has worked at the DBG for more than 20 years, introducing compliance services and products to the UK dental market. As a qualified dental nurse, practice manager, trainer and assessor, Donna has inspected more than 1,200 dental and GP practices to UK legislation and guidance standards. She also works as a healthcare consultant for many dental suppliers and dental corporates, and often lectures at various conferences and events.
*This article was originally published in Oral Health magazine.
Len D’Cruz will be tackling how to handle complaints at CPD Dentistry UK – a one-day seminar in London on Friday 20th January 2017.