Responding to a complaint directly

The following guidelines are aimed to assist practitioners in how to deal with complaints made to them or about them and the health service they provided.

Resolving complaints

It is generally recommended to deal with complaints directly when they occur and try to resolve them locally with the patient or the person that complains. The following guidelines provide some tips on how to best manage complaints at an early stage.

Why do people complain?

Many people have high expectations about treatments and about health service providers. People complain because:

  • they want an acknowledgement that something went wrong and an explanation of why
  • they want an apology for the distress they experienced
  • they do not want to see other people facing a similar problem
  • they want to improve the service for themselves or others in the future
  • they want someone to be blamed, punished or held accountable for what happened
  • they want compensation.

It is important to keep in mind that people generally complain because they are dissatisfied. A complaint can be an opportunity to increase understanding of the patient’s perspective. It can also help to improve the service that you offer.

Please remember that the person making the complaint may have found it quite distressing to do so and may have had difficulties in putting their experiences down on paper.

In the vast majority of situations people make a complaint because they genuinely believe that something went wrong. Only very few people complain just to cause trouble.

Tips for responding to a complaint

  • Acknowledge the complaint
  • Try to resolve the complaint directly with the complainant
  • Be aware of differing views of what happened and what was said
  • Reassure the complainant
  • Have a complaint handling mechanism already in place

Every complaint is different, so the approach to resolving it will differ depending on:

  • the nature of the complaint (the seriousness and the complexity)
  • the complainant’s wishes
  • the issues the complaint raises
  • how the complaint came to you.

Acknowledge the complaint

When people get a response to their complaint, they often see this as a sign that their concerns are being taken seriously. Acknowledge their concerns and experiences, and take responsibility for what happened. Often the complaint may well be on the way to being resolved.

It is important to give the person a clear time frame in which the complaint will be addressed and contact details of the person responsible. It can be helpful to outline the plan of action in investigating and responding to the complaint.

Try to resolve the complaint directly with the complainant

Wherever possible, invite the person who made the complaint to talk directly. It is important to clarify the issues and the desired outcomes. The reason for a person’s complaint may not always be clear in the written version. Most complainants greatly value the opportunity to talk about what happened and to tell their point of view and this can be also useful in guiding your response.

If the matter can be resolved immediately, then a written response can follow to confirm the agreed action.

Be aware of differing views of what happened and was said

Many complaints involve issues with communication. Patient and provider can have different perceptions and understandings about what happened and what was said.

Reasons for this may be that:

  • A person with a health problem is in a vulnerable situation.
  • Health service providers assume that their information or explanation has been clear when in fact the patient or the patient’s family may not have understood it.
  • The person has been given conflicting information from other people. This may be from other treatment providers or media reports or general opinions from others.

Who is telling the truth?

Who is telling the truth may not be relevant in cases where communication and perceptions are the main issues. Where there are differing accounts or points of view, it is important to acknowledge this without dismissing the complainant’s point of view.

Perceived cover-up

Many complainants believe that all incidents/conversations are on record, so if there is no record then they may believe there has been a tampering with the records or there is a cover-up.

Many complainants have a concern that their point of view will not be listened to and that the staff will defend each other and stick together.

Reassure the complainant

People who make complaints are often worried that there will be some kind of negative consequences for their ongoing care. It is important to offer reassurance throughout the complaints process that this is not the case. Make sure that the person will not be discriminated against or victimised as a result of making a complaint, and the fact of making a complaint will not affect the person’s treatment.

Also offer reassurance that the complaint will be kept confidential, and that there will not be a reference to the complaint in the complainant’s health record, unless they want that to happen.

Have a complaint handling mechanism already in place

Evidence suggests that effective complaint handling and resolution decreases the risk of the complaint leading to legal action.

Responding to a complaint will be easier if you already have a system in place to deal with complaints. This should include a practical mechanism by which complaints are welcomed, received, investigated and resolved.

Inform the consumers/patients about how you will manage their complaint. Responding appropriately to a complaint can restore trust and prevent a minor grievance escalating.

General complaint response principles

Timeliness

Respond as soon as possible to complaints, even if it is just to explain the process and give a commitment to a certain timeframe.

  • Stick to the timeframe given.
  • Keep the complainant informed.
  • Give the reasons for any delay.

Address all aspects of the complaint

  • Provide a full response so that important issues are answered and the complainant can see that the complaint has been taken seriously.
  • Explain the process of investigation.
  • Acknowledge areas of disagreement or varying accounts without dismissing what the complainant has said.

Remember

  • Try not to be defensive.
  • Acknowledge the distress of the complainant.
  • Apologise if appropriate, but in any event be sympathetic.
  • Acknowledge any errors that did occur.
  • Try to understand the situation from the complainant’s perspective.
  • Find out what will assist the complainant to resolve the matter and their preferred options for resolution, for example, a written response, a phone discussion, changes in policy or procedure, a meeting.
  • Avoid official or technical language, jargon and clichés.
  • Consider cultural background and the possible use of interpreters.

Lessons learned

Outline what happened, how it happened, what is being done to stop it happening again, and that you are sorry that it happened.

If the complaint is about one of your staff

  • Listen to the staff member’s point of view and be aware of conflicts of interest.
  • If you are the manager of the staff you are very likely to want to support the staff member by believing them/taking their side/accepting their point of view.
  • Assist the staff member to acknowledge the complainant’s point of view.
  • If possible, separate the support of the staff member and the complaint handling mechanism.

Guidelines for a written response to a complaint

It is best in a written response to:

  • acknowledge that voicing concerns is appreciated
  • acknowledge the distress and the person’s experience
  • say what has been done to investigate the complaint
  • state what has been done/could be done to address the concerns
  • mention any changes or action taken or that are being considered as a result of the complaint
  • offer an opportunity to discuss further, with choice of options (meeting, telephone, written)
  • reassure the person that they can receive further service, if needed, without any concern about having made a complaint.