Writing a complaint response

MOST doctors or dentists, at some point in their career, will find themselves either subject to a complaint or assisting in the investigation of a complaint. It is important to recognise a complaint as an opportunity for reflection and development, even if you feel you did everything right.

Complaints most often arise due to a breakdown in communication. It may be that the complainant misunderstood what they were told or felt they were not given enough information. Responding to a complaint is an opportunity for you to provide a further explanation of your actions and hopefully put the complainant’s mind at ease. Our experience at MDDUS is that providing a comprehensive response to a complaint is much more likely to lead the complainant to feel that they have been heard and their concerns have been taken seriously. A detailed and carefully worded response is more likely to satisfy the complainant and dissuade them from referring their concerns to other bodies such as the GMC or GDC.

Here are some general tips on writing a good response. In addition you should contact an MDDUS adviser directly for advice on wording and content before sending your response.

1. Keep it conciliatory. A complainant may be upset and angry. It is important not to antagonise them further by appearing dismissive or offended by their complaint. Adopting a more polite and conciliatory tone is more likely to make the complainant feel you have understood their concerns and are taking them seriously.
2. Keep it factual. Try to provide a factual chronology of events that relate to the concerns raised. You may be assisted by the relevant medical or dental records in writing a timeline of events.
3. Apologise where appropriate. Often acknowledging when things have gone wrong and saying sorry is enough to resolve a complaint. In Good Medical Practice, the GMC recommends that doctors should apologise when things have gone wrong. The law (Compensation Act 2006) also makes it clear that providing an apology in such circumstances will not be considered an admission of liability if there is a subsequent legal claim.
4. Address every area of concern. A complaint may raise queries about several events. It is important to review the letter of complaint carefully to ensure you have responded to each concern. If there are numerous concerns, or they are very similar in nature, you can group them together and provide a more general response.
5. Don’t forget the detail. Remember to include all your positive and negative findings that led to your clinical management. Including what you looked for and failed to find is just as important in explaining why you reached a particular clinical decision.
6. Highlight the source of your comments. When writing your response state whether each significant comment you make is based on your personal recollection of events, reading of the contemporaneous records, or usual practice. You may find it helpful to use phrases such as “I can remember...” or “From the medical records I note that...”
7. Write in the first person. This will provide a more personal style and show the complainant that you are responding to their concerns. For example, instead of writing “It was noted during the consultation that...” try re-phrasing to something along the lines of “I noted during our consultation...”
8. Write in the first person. This will provide a more personal style and show the complainant that you are responding to their concerns. For example, instead of writing “It was noted during the consultation that...” try re-phrasing to something along the lines of “I noted during our consultation...”
9. Avoid speculating. It is important to restrict your comments to matters of fact within your own scope of knowledge. Try and avoid speculating or criticising the actions of other healthcare professionals in your response.
10. Offer to meet. Some complainants may have further queries arising out of your response or feel you have not addressed a particular matter fully. Consider ending your letter with an invitation to meet with the complainant should they have any outstanding concerns once they have read your response. You may also want to provide the contact details, for example of your practice manager or secretary, with whom they can arrange an appointment to meet with you.
11. The ombudsman. Complainants are entitled under the NHS complaints procedure to refer their concerns to the relevant health service ombudsman if they remain dissatisfied at the conclusion of local resolution. The NHS complaints procedure recommends that complainants are advised of this right. You might therefore consider including a final paragraph in your letter providing the contact details of the relevant ombudsman.

Dr Naeem Nazem is medical adviser at MDDUS