To be used as a learning exercise.

•  Identify gaps in your knowledge or your practice system and rectify this.
• Just dealing with a complaint does not by itself qualify; it is how you use this to learn. You may, for example, discuss as a team how to handle requests for urgent visits following a complaint from a patient. This may lead on to you auditing your telephone and appointment systems or providing training in telephone skills.
• A missed diagnosis may point you in the direction of improving your consultation skills and show up a gap in your clinical knowledge.

• Review the RCGP paper from 1996

• Review the extract below from Good Medical Practice

GMC Good Medical Practice, paragraphs 16–21

Sometimes GPs make mistakes despite trying to do their very best. When this happens, your patients have a right to expect a prompt, appropriate, honest and constructive response to their complaints. You must not allow the patient’s complaint to prejudice your care of them. The NHS requires you to have a practice-based complaints procedure to help when things go wrong. You should make sure that it operates effectively.

Doctors do not always handle mistakes well. Patients often find that doctors and their staff are extremely defensive when things go wrong. Often matters proceed to a formal complaint simply because a doctor will not admit that something went wrong. Patients do expect you to do your best to avoid mistakes; however they do not like cover- ups when things have gone wrong.

When you are deciding how to handle a mistake, you should think about how serious it was, whether it could have been avoided, whether it could be put right for this patient, how it could be prevented in future, and whether you or the practice need to change to prevent it happening again. Discussing mistakes frankly within the practice team is always helpful. You should support colleagues who have made mistakes; this includes acknowledging that a mistake has occurred and helping the person to find the best way forward both for the patient and your colleague.

The excellent GP
• Contacts the patient soon after it is apparent that a mistake has occurred
• Apologises for himself or herself or for the practice staff
• Tells the patient what has happened and how it can be put right
• Co-operates with any investigation arising from the complaint
• Tries to maintain a relationship with the patient or family when a mistake has occurred

The unacceptable GP
• Does not acknowledge or attempt to rectify any mistakes that occur
• Does not make appropriate apologies
• Has no procedure for dealing with complaints
• Hinders or obstructs a complaint or investigation
• Allows a complaint to influence his or her care of the patient adversely
• Strikes a patient off the practice list solely because a complaint has been made or is likely