Dangerous GP surgeries are named and shamed… Why is the patient’s voice unheard?

12 Dec

by Jill Stocks, GM PSTRC Research Fellow for Core theme Jill Stocks blog 1 image 2_cropped Most patients receive safe quality care from their general practice. However headlines such as these will not be surprising to many of us. Prof Steve Field, the CQC’s new chief inspector of GPs, commenting on the Care Quality Commission’s preliminary report, said the problems highlighted in the checks had sometimes been known about locally for years. “We are hearing about problems that people are very worried about but no-one has tackled in the past.” If our concerns about our GP practices are not being acted on then should we be complaining louder and more often? Most of us are probably unaware of how to raise our concerns with our GP practices. If we look at the information provided by the NHS we are encouraged to complain to our GP first (NHS complaints). Naturally we feel intimidated and uncomfortable about complaining directly to the GP yet the means to raise our concerns with an independent body is not readily accessible. We can go to the Parliamentary and Health Service Ombudsman, although we are supposed to complain to our GP practice in the first instance, or we can read the NHS constitution to discover the formal procedures. However a recent survey by the Patients Association shows that even those who are aware of the NHS constitution do not know how to enforce these rights. The National Reporting and Learning System collects reports of patient safety incidents. Only NHS staff can report to this and only about 0.5% of reports come from GP practices. Does this mean the complaints are not being reported or are they not being made by the patients to the NHS staff? I have made a complaint on behalf of my mother who was prescribed a dose of a drug large enough to kill her. I felt that the investigation by the Primary Care Trust did not deal with the problem adequately yet I never had the opportunity to comment formally on the investigation. This is why we just grumble to anybody who will listen when we have a problem with our GP practice, even when that might seriously affect our own or someone else’s safety. We need an accessible, fast-acting, responsive route to raise our safety concerns about primary care now. Not until we ask the patients about safety in GP practices will we have the true picture.



8 Responses to “Dangerous GP surgeries are named and shamed… Why is the patient’s voice unheard?”

  1. DB December 12, 2013 at 4:10 pm #

    Are GPs ready to accept feedback from their patients? Or do they prefer to stick with the paternalistic and authoritarian type of relationship practised by past generations?
    We hear talk about how patients must view themselves as partners in pursuing good health, but the GPs need to adjust their way of thinking as well – to welcome feedback rather than be defensive.

  2. Ros Holmes December 12, 2013 at 5:59 pm #

    As a nation, we find it difficult to complain. We like to moan and grumble between ourselves but very few instances of bad practice get reported officially.
    We need an easy, accessible way to complain, raise concerns and leave feedback. Our voices need to be heard and listened to, and concerns/complaints need to be properly investigated. Patients or their representatives should have the opportunity to put their side of the case during the official enquiry process.

  3. Lynda Mather December 12, 2013 at 7:14 pm #

    Thank goodness there are others disillusioned about their GP’s advice and high-handed manner in which they dole out apparent medical advice; believing they are always right and that the patient is a hypochondriac. A few years ago, I started with aches and stiffness in my hands, followed by my feet, knees, hips and shoulders. The stiffness became quickly worse over several weeks and with a history of Rheumatoid Arthritis in the family, i requested a Rheumatoid Factor test from the senior GP at my local surgery. The result was positive and yet despite this, also showing clinical signs and with family history, my GP advised i had Fibromyalgia. Further, I was told to be more ergonomic when mucking my horses out, to perhaps cut down on fell running and to remember i was now “37 years old and not 27”, clearly suggesting i was just overdoing things. Of course, the shock of being seropositive hit me with such force that i merely accepted his advice and asked no further questions. Luckily, i have friends with experience in medical science and after quickly realising i had been misdiagnosed i returned to the GP demanding to see a rheumatologist. After a long haul and 2 further private consultant referrals i was finally diagnosed with aggressive RA and immediately started treatment which resulted in remission, although supported by drug therapy. The rheumatologist estimated that had i not commenced treatment, i would have likely incurred joint disability within less than 6 months. Experiences like mine are not uncommon at our GP practice and yet we all shy away from making official complaints, because we are the layperson and unable to enter into a medical debate. Even after my referrals i was still treated by the GP as an ‘awkward’ patient and the correspondence to consultants deemed me to be ‘anxious’ about my symptoms. GP practices like this need bringing into the limelight and patients need the right forum to complain, without feeling intimidated.

  4. Rob Finnigan December 13, 2013 at 11:54 am #

    I sat on a Patient Participation Group (PPG) a few years ago and expected to be able to engage with the Practice when patients alerted the group to problems and complaints. The Practice doctors were reluctant to engage on any matter that, in their opinion, questioned their administration thereby rendering the PPG impotent and little more than a box-ticking exercise under the Quality Outcomes Framework.

  5. Andrew Perks December 13, 2013 at 11:58 pm #

    I’m a bit nervous about joining anything criticising the NHS at the moment when the suggestion that 1 surgery had maggots in it gets more media coverage than the privatisation of the NHS by this neoliberal government. We can ‘join’ ‘consultative’ groups like PPGs and CCGs but what happens to our carefully constructed criticisms? Many common procedures (particularly screening – sounds sensible but clinically/statistically dubious and lucrative for providers playing on patients’ fears) are widely contested but continue to follow the money. It is good to draw attention to individual errors but wrong to conclude that such errors are commonplace. There should be an easily accessed method for criticising medical practices which does NOT lead to safeguarding/disciplinary processes and merely adds to the data around medical interventions; this worked, that didn’t. Evidence based practice is the way forward and we should be gathering evidence at every point of intervention. Weighting the relevance of every flaw will be a challenge, of course!

  6. Lynda Mather December 18, 2013 at 2:33 pm #

    Why can’t GP surgeries just operate a simple ‘patient satisfaction’ questionnaire on the level of medical advice provided, even if it’s on an anonymous basis? Probably because they are afraid of the answers. We don’t need extensive and complex ‘gripe’ procedures. Our local surgery operates an annual patient questionnaire – the farce being that it’s all about waiting times, ease of booking an appointment and which radio station should be played in the waiting room! Our surgery is a rural practice and we don’t have much choice on where we can go and so the GPs don’t even have to raise the bar to be competitive. Frankly they need a kick up the backside to keep them on their toes. As a professional in the private sector i have to say, most GPs wouldn’t last five minutes.

    • CH December 18, 2013 at 9:31 pm #

      I agree with Lynda on the last comment regarding that “as a professional in the private sector i have to say, most GP’s wouldn’t last five minutes”


  7. CH December 18, 2013 at 9:30 pm #

    When do you know when to complain about a GP or a Healthcare service, you assume they know best, we don’t always no any better, only sometime a feeling that it is not quite right… But of we do complain, maybe it would be nice to be acknowledged by the head of the surgery, at least we would know. Ok, I might be a little biased, but I think GP’s in the UK have lost their touch a little. GP’s are only allocated 10 minutes per patient, what can they hear in that time, just basic symptoms not what is surrounding the patient, their life. In France the consultation last as long as it needs to , meaning that they could be a lot of delays afterwards for other patients, but they ask about how YOU are, what is going on in your life, it feels like they are listening to you, that you are not just a number but a person. Your life can affect your symptoms, Of course we do still have some GP’s like this, but not very often, it feels like they want you out of door as soon as possible, and if you come along with more than one ailment, well, that is too much and they might get confused (I have been told this not so long ago) and we should make another appointment, why making another appointment when you already have one, we are busy with work and life and don’t want to spend hours on end at the surgery. Please listen to your patients and get the whole picture before making a diagnosis …

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