A critical report condemns “unfair removal from GP patient lists” and says some practices are failing to deal appropriately with the most basic complaints.
Published today (18 October 2011), the Ombudsman’s annual review of complaint handling by the NHS in England said 21% of all complaints about GPs it investigated last year were about patient removals.
In one case, a terminally ill woman was removed from her GP’s list following a dispute between the practice and her daughter.
In another, a woman was removed from her GP’s list after a “simple disagreement” about unanswered telephone calls.
The Ombudsman, Ann Abraham, said such incidents “suggest GPs are failing to manage relationships with patients properly, resulting in a breakdown of communication and patients being removed from GP patient lists without fair warning or proper explanation.”
The report says some GPs are not following the “clear guidance” that patients must be given a warning before they are removed from lists, except where this would pose a risk to health or safety or where it would be unreasonable or impractical to do so.
“Zero tolerance policies” of some GPs were criticised, with the report slamming “unfair and disproportionate” decisions that “can leave entire families without access to primary healthcare services following an incident with one individual”.
The report acknowledged “it is not easy for frontline staff to deal with challenging behaviour, and aggression or abuse is never acceptable”, and described the importance of the GP-patient relationship.
However, it added: “As GPs prepare for the increased commissioning responsibilities outlined in the government’s health reforms, it is essential that they get the basics of communication right.”
In response, Dr Michael Devlin, the Medical Defence Union’s head of advisory services, said: “To put this report in context, the 48 complaints against GPs investigated and reported on by the Health Service Ombudsman represent a tiny proportion of the 300 million GP consultations estimated to place in England each year.”
“However, it’s important we are all alive to any emerging trends and it is clear from the report that the Ombudsman’s office is investigating more complaints about removals from practice lists which it believes are happening without fair warning or proper explanation.”
The MDU stressed that removing patients from a practice list “should only be considered in exceptional circumstances after other options to resolve the problem have been explored.”
The two most common reasons people gave for being dissatisfied with how the NHS had handled their complaint were poor explanations and no acknowledgement of mistakes.
The Ombudsman report calls for “an increased focus for all NHS staff on understanding and evaluating the totality of a patient’s experience, from the minute they pick up the phone to their GP surgery until the time they no longer need NHS care.”