GP Practices In England Remain Unaware Of The Changes To The NHS Complaints Procedure


The Medical Protection Society is receiving an increasing number of calls from GP practices in England who require assistance with the complaints procedure, two years after the introduction of the new complaints system.

Last year MPS opened 2,101 files on handling complaints and of those 61 escalated to the Ombudsman. We envisage the trend will continue this year as we have already opened a further 771 files with 15 cases being referred to the Ombudsman, in the first four months of this year.

In our experience, many English GP practices remain unaware of the changes to the NHS Complaints Procedure introduced in April 2009 and are failing to comply with the requirements:

- To produce a written plan (to be agreed with the complainant) outlining how the complaint will be investigated, managed and followed up.

- To appoint a "responsible person" and "complaints manager".

- To inform a complainant at the outset of their right to approach the Parliamentary & Health Service Ombudsman if they are unhappy at the conclusion of local resolution and to provide details of the local Independent Complaints Advisory Services.

- To undertake a structured and proportionate investigation process.

- To co-ordinate cross agency complaints.

Commenting on this lack of awareness, Director of Policy and Communications, Dr Stephanie Bown said: "Since the introduction of the new complaints system we have been working with practices to help them update their complaints policies in order that they comply with the new requirements.

"We would advise GP practices to liaise closely with the complainant from the outset as this presents the best opportunity for an efficient and effective resolution of that complaint. MPS has produced a wide range of publications, including booklets and factsheets which give comprehensive guidance about how best to resolve complaints. We would strongly encourage practices to familiarise themselves with the new procedure so they feel confident in dealing with complaints in the proper manner and do not attract additional criticism from the Ombudsman for procedural deficiencies."

MPS's advice on resolving complaints includes:

- Acknowledge complaints within three working days and agree a plan with the complainant as to how the complaint will be investigated and what form the response will take (including timescales).

- Appoint a practice partner to act as a responsible person to ensure compliance with procedures and that action is taken as a result of the complaint.

- Appoint a complaints manager to manage the handling of complaints. The responsible person and complaints manager can be the same person.

- Have in place a complaints procedure which meets the requirements of the regulations and is underpinned by the principles.

-Co-operate with any multi-agency complaints.

- Try to resolve concerns informally, outside of the regulations, with the agreement of the patient.

- Co-operate in multi-agency complaints.

- Work closely with the PCT when they are involved in individual complaints.

- Make provision for an oral complaint to be committed to writing.

- Use a risk assessment tool to determine the seriousness of the complaint, and investigatory tools, eg. conciliation, internal or external investigation.

Source:
Medical Protection Society

Clandestine Abortions Generate Up To $95 Million A Year For Polish Doctors As Women Use Illegal Private Sector

New analysis published by the UK journal Reproductive Health Matters shows that the criminalisation of abortion in Poland has led to the development of a vast illegal private sector with no controls on price, quality of care or accountability. Since abortion became illegal in the late 1980s the number of abortions carried out in hospitals has fallen by 99%. The private trade in abortions is, however, flourishing, with abortion providers advertising openly in newspapers.

Women have been the biggest losers during this push of abortion provision into the clandestine private sector. The least privileged have been hardest hit: in 2009 the cost of a surgical abortion in Poland was greater than the average monthly income of a Polish citizen. Low-income groups are less able to protest against discrimination due to lack of political influence. Better-off women can pay for abortions generating millions in unregistered, tax-free income for doctors. Some women seek safe, legal abortions abroad in countries such as the UK and Germany.

"In the private sector, illegal abortion must be cautiously arranged and paid for out of pocket," says Agata Chełstowska, the author of the research and a PhD student at the University of Warsaw. "When a woman enters that sphere, her sin turns into gold. Her private worries become somebody else's private gain". The Catholic Church, highly influential in predominantly Catholic Poland, leads the opposition to legal abortion.

Since illegality has monetised abortion, doctors have incentives to keep it clandestine: "Doctors do not want to perform abortions in public hospitals," says Wanda Nowicka, Executive Director of the Federation for Women and Family Planning. "They are ready, however, to take that risk when a woman comes to their private practice. We are talking about a vast, untaxed source of income. That is why the medical profession is not interested in changing the abortion law."

In several high profile cases, women and girls have been denied legal abortions following rape or because of serious health conditions and have been hounded by the media for seeking them. The 2004 case of a young pregnant woman who died after being denied medical treatment is currently under consideration at the European Court of Human Rights.

Other articles in this issue of Reproductive Health Matters focus on many aspects of health privatisation worldwide and include studies from Bangladesh, Turkey, Malawi, India, Madacascar and South Africa.

Source:
Reproductive Health Matters

Award-winning Free CPD Tool Now Updated To Help GPs Get Up To Speed With New NICE Guidance On Diagnosing And Treating Ovarian Cancer

GPs are urged to complete the latest version of Target Ovarian Cancer's award-winning[i] free CPD tool, which has just been updated to include the latest NICE guidance[ii] on new symptoms and best practice for diagnosing ovarian cancer.

The online tool, produced and recently updated by BMJ Learning, is a step-by-step professional guide which tests existing knowledge and helps GPs detect ovarian cancer earlier in more women. New features include audio from a woman diagnosed with ovarian cancer describing her experience of diagnosis.

"It's a challenging disease to diagnose for GPs - but this will help them understand how to distinguish between ovarian cancer and other less serious conditions and what first steps to take. We hope it will mean many more women get a quick diagnosis.

"The earlier that ovarian cancer is diagnosed, the better a woman's chances of survival. The UK presently has one of the poorest survival rates compared to other developed countries[iii]. This has been linked to late diagnosis," said Frances Reid, director of public affairs, Target Ovarian Cancer.

Target Ovarian Cancer says official figures show the swift diagnosis of the fourth most common cancer killer of women could help save up to 500 lives per year[iv] in the UK.

The online tool was originally launched a year ago, since then more than 3,000 GPs have completed the tool. Last autumn the tool was highly commended in an Excellence in Oncology Award in part due to the overwhelmingly positive feedback.

NICE issued its first clinical guidance on ovarian cancer in April. It states, for the first time, that urinary symptoms can be an indicator of the disease. This is in addition to the recognised symptoms of persistent bloating, early satiety and pelvic pain.

It also says that ovarian cancer symptoms are likely to occur more than 12 times per month and be new to the patient within the last 12 months.

The guidance states GPs should always test a woman, if she is over 50, for ovarian cancer if she presents with symptoms that might suggest Irritable Bowel Syndrome. Target Ovarian Cancer's research showed that IBS was the most common misdiagnosis given to women who were later found to have ovarian cancer.

The guidance is the first to be produced in the disease area by NICE, which Target Ovarian Cancer regards as an important step forward to ensuring improvements in detection and survivorship.

Professor Willie Hamilton, a GP and a professor of primary care diagnostics at the Peninsula College of Medicine and Dentistry, presents the module and gives his top tips.

[i] The module was highly commended by the 2010 Excellence in Oncology Awards in the 'best professional education initiative category'. The judges recognised it showed great potential to influence the diagnosis of ovarian cancer.

[ii] CG122 'Ovarian Cancer: the recognition and initial management of ovarian cancer' National Institute for Health and Clinical Excellence, April 2011.

[iii] Coleman M, Foreman D, Bryant H, et al; Cancer survival in Australia, Canada, Denmark, Norway, Sweden and the UK, 1995-2007 (the International Cancer Benchmarking Partnership) : an analysis of population-based cancer registry data. The Lancet 2011; 377(9760): 127-138

[iv] Eurocare-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R, the EUROCARE Working Group. European Journal of Cancer 2009, 45:931-991

NICE guidance, April 2011, gives the following symptom information.

Symptoms

-- Frequent - more than 12 times a month

-- Persistent

-- New - they are not normal for the woman and may have started in the last year

- Persistent pelvic or abdominal pain
- Increased abdominal size/persistent bloating
- Difficulty eating or feeling full quickly
- Urinary symptoms

-- Occasionally there are other symptoms:

- Changes in bowel habit
- Extreme fatigue (feeling very tired)
- Unexplained weight loss
- Back pain

Source:
Target Ovarian Cancer