Handling Complaints

Complaints, including anonymous ones, may be made to the practice in person, in writing, by telephone, by e-mail or online, either by the individual concerned or by someone complaining on their behalf.

There are two possible internal stages to the NHS Model Complaints Handling Procedure: Early Resolution and Investigation. There is a third stage, external Independent External Review. Further details of each stage can be found in the NHS Scotland Model Complaints Handling Procedure [1]

NB: First consideration must always be given to whether a complaint can be resolved at the Early Resolution stage.  Complaints that should be directed to investigation stage are issues that are complex and require details investigation or the complaint relates to serious, high risk or high profile issues.

Stage 1 – Early Resolution

Early resolution aims to resolve straightforward complaints that require little or no investigation. Any member of staff may deal with complaints at this stage. Always aim to bring about early resolution to complaints within 5 working days*,  preferably on-the-spot. In exceptional circumstances, and only if it is likely the complaint can still be resolved at the early resolution stage, the 5 working days may be extended by an additional 5 working days, in agreement with the person making the complaint. Extensions to early resolutions should not become the norm [1].

When responding to the complaint include: an apology where appropriate, an explanation and an indication of identified improvement.

A complaint that is straightforward and resolved to the person’s satisfaction within 5 working days, and where the outcome has been communicated to the person either face-to-face, by telephone or e-mail, does not need any further written confirmation.

Escalating to Investigation:

Early Resolution complaints must be escalated to an Investigation where the person making the complaint is not satisfied and requests an investigation into the complaint or satisfactory early resolution is not possible as the complainant has insisted on an Investigation.

*Day 1 is the day the complaint is received, or next working day if the date of receipt is a non-working day [1].

Stage 2 – Investigation

Investigation is required where:

  • the complaint is considered serious or complex and clearly cannot be resolved without an investigation;
  • the person is not happy with the practice’s Early Resolution stage response; or
  • the person has insisted on an investigation.

If an investigation is required, the complaint must be acknowledged in writing within 3 working days of the complaint being received using the person’s preferred method of communication. Always aim to respond to the complaint  within 20 working days** of receiving the complaint at investigation stage. This may be extended if there are clear and justifiable reasons to do so and in agreement with the person making the complaint [1].

** Day 20 is the latest day for a decision to be issued to the person making the complaint or an agreement is reached with the person to extend the deadline.

Acknowledgement (within 3 working days)

The acknowledgement should include:

  • Your thanks to the person making the complaint.
  • An expression of empathy and acknowledgement of any distress.
  • Contact details of the practice’s Feedback and Complaints Officer.
  • A copy of the practice’s complaints procedure for patients (see Templates below).
  • The established method of communication with the person, or if not known, ask them if they have a preferred method of communication.
  • A statement that the complaint will normally be investigated within 20 working days or as soon as reasonably practicable (or if this is not possible, provide an explanation as to why there will be a delay, and where possible, a revised timetable).
  • A summary of your understanding of the complaint and what the person wants as an outcome.
  • An outline the course of action or indication of the investigations currently being conducted, stressing the rigour and impartiality.
  • Details of the advice and support for the patient, including the Patient Advice and Support Service (PASS) [2].
  • Information on the role of and contact details for the Scottish Public Services Ombudsman (SPSO) [3].
  • Information on alternative dispute resolutions services (mediation) and other support services, e.g. advocacy.
  • An offer to meet to discuss the issues.
  • A request for evidence of consent if someone is complaining on behalf of a patient [4].

Where possible keep the person informed during the course of the investigation. Meetings should take place within the 20 day limit. Record the meeting and provide a copy to the person.

Contact your defence union if at any point you are in any doubt about how to proceed or wish further advice.

Response (within 20 working days)

Following an investigation of the complaint, respond to the person covering the points below. This should be within the specified timescale in writing as well as their preferred method of communication, if this is different.

  • Ensure the response is clear, easy to understand and written in a person-centred and non-confrontational way.
  • Apologise if things have gone wrong.
  • Reply to all the points made by the patient clearly explaining any technical terms used.
  • For each issue, explain what has been or will be done to prevent the same thing happening again; ensure that the response demonstrates that action has been taken.
  • Highlight any area of disagreement and explain why no further action can be taken.
  • Include information about what the patient can do next if they are not satisfied with the response (see Unresolved Complaints).
  • Offer to talk to the patient if there is anything they do not understand about the response.

Action points for complaints handling:

Ensure the patient’s immediate oral health care needs are being met if this is relevant at the time the complaint is made.

Ensure the person making a complaint feels they are being listened to and understood. Treat them in a courteous and sympathetic manner. Express empathy, and acknowledge and offer an apology for any distress.

  • Feedback, comments or concerns need to be considered as to whether they should be lodged as a complaint, if the person is not satisfied with the initial response.

Aim to resolve the complaint at the time it is made, or if this is not possible, establish whether the person wishes the matter to be dealt with under the practice’s Complaints Procedure (see Templates below).

Establish the person’s preferred method of communication, if the complaint cannot be resolved on-the-spot.

Provide the person with information on the help and support available to them for making a complaint, such as PASS [2], NHS Inform [5], and other communication, interpreting and advocacy services.

Respond to a complaint within the given timelines. (See Early Resolution and Investigation above).

When required, explain the practice’s Complaints Procedure (see Templates below) to the person and give them a copy of this. It may be necessary to refer the complaint to the practice’s nominated Feedback and Complaints officer at this time.

If a person is insistent that they do not want to formally complain, record the complaint as being resolved at the Early Resolution stage.

Offer to apply the complaints procedure even if the person has stated in writing they intend to take legal proceedings.

Follow the complaints handling procedure as far as possible for anonymous complaints to allow for staff learning and completeness of complaints records.

Aim to establish what the person wants to happen as a result of the complaint to help decide whether their expectations can be met. Be open and honest with the patient if their  expectations cannot be met and explain the reasons why.

Ensure that the practice’s response demonstrates that action has been taken.

Record details of the complaint as soon as possible (see Record of Complaint under Templates below) and within 5 working days, and ensure that this is kept up to date at each stage of the resolution process. Keep all written communication sent to and received from the person with the complaints record, not with the patient’s dental records (see Recording and Learning from Complaints).

Consider what support staff may require if they are the subject of a complaint.

Submit complaints information to your local Health Board quarterly, and feedback, comments and concerns information annually (see Recording and learning from Complaints).

Use all complaints received, including anonymous ones, to help identify areas for improvement, e.g. thorough review at practice staff meetings (see Recording and Learning from Complaints).

Sources of Information

  1. Timelines (Appendix 4)The NHS Scotland Complaints Handling Procedure [PDF]
  2. Patient Advice and Support Servicepass-scotland.org.uk
  3. Scottish Public Services Ombudsmanspso.org.uk
  4. Consent form [Appendix 9]The NHS Scotland Complaints Handling Procedure [PDF]
  5. Making a compliant about your NHS care or treatmentNHS Inform