PHSO

Listening and Learning:

The Ombudsman’s review of complaint handling by the NHS in England 2011-12

Complaints to us about unfair removal from GP patient lists have continued to rise. We saw more in 2011-12 — 94 in total — than we did last year, when we saw 81. We concluded 10 formal investigations about unfair removal this year, the same number as the year before.

We warned last year that as GPs prepare to take on greater responsibility for commissioning patient services, some were failing to handle even the most basic complaints correctly. The failure to improve in this area gives us wider concerns about GP‑led Clinical Commissioning Groups effectively delivering their responsibilities for dealing with complaints.

Guidance on removing a patient from a GP patient list

GPs need to follow the British Medical Association’s guidance on removing patients from practice lists, as well as their obligations under their contracts with commissioners.

In all but the most exceptional cases, a GP must:

  • warn the patient that their behaviour is putting them at risk of being removed from the GP’s patient list;
  • ensure the warning clearly sets out what is inappropriate about the patient’s behaviour (for example, frequently not attending appointments without cancelling); and
  • ensure the warning clearly sets out what the patient must do in order to avoid being removed from the GP’s patient list.

Getting it right in the new NHS

The NHS Commissioning Board will  need to make sure that both GP practices (as providers) and Clinical  Commissioning Groups (as GP-led commissioners of other health services) handle  complaints well.
Clinical Commissioning Groups will  be responsible for:

  • Dealing with complaints about  their commissioning decisions
  • Ensuring providers they  contract with deal with complaints well
  • Using complaints data from  providers to inform future commissioning decisions.

We are working with the NHS  Commissioning Board to help embed good complaint handling across the NHS.