Answering complaints is an important role of the Emergency Department Consultant and it is now part of the RCEM management portfolio.

Remember complaints should be seen as a positive thing – they are able to stimulate us to improve, and sometimes give us the “clout” that we need.

When someone is complaining verbally: –

– Listen to what the complainant is actually saying – not what you think they are saying.

– Stay calm and give them a chance to express their concerns.

– If you can’t solve the problem maybe someone else can – often the senior nurse will be the most experienced person in the department at de-escalating complaints.

– Never say that something has “nothing to do with you” or “not your department”. Say that you will try to help and put the patient in contact with the appropriate person.

– Only when you have done everything possible to resolve the concern, or if the patient is adamant they wish to complain, should you direct the patient to Complaints or PALS.

Responding to a verbal complaint: –

Use the 3R’s or CALM approach to deal with a verbal complaint –

Patient Advice and Liaison Service (PALS): –

* The PALS team manage to resolve many complaints before they get to the formal stages. 

* PALS have a non-biased view on the complaint and the complainant. They will be able to easily link to other departmental resources.

* PALS will “triage” the patient’s complaint and, depending on the nature of the concern and wishes of the patient, may attempt to agree on an informal resolution or register the issue as a formal complaint (which may be through passing the case to a separate Complaints Department, who can also be contacted directly rather than via PALS).

* The content of the complaint will be reviewed and even if the patient agrees on an informal resolution, it may be appropriate to complete an incident form.

* By triaging the complaint, PALS are able to identify the key issues and the preferred action of the patient. Patients who persistently complain may need a specific “code of conduct” plan.

* PALS or the Complaints Department will also liaise if more than one department has to answer the complaint. 

* They will help form an agreement as to who should lead the response and will review the final response letter to check the language is appropriate. They will also help co-ordinate a meeting to discuss the complaint should it be agreed that this will aid resolution of the concern.

Who can write a complaint: –

• The patient himself (the affected person).
• If the person writing the complaint is not the person affected (e.g. daughter of a mother with dementia who was the patient), the Complaints or PALS department will make sure appropriate consent from the patient has been sought.
• If the patient is deceased and the complainant has “sufficient interest” the complaint will proceed.
• Children can complain, although they are encouraged to involve an adult in their complaint. Complaints should be accepted in any language.
• Sometimes MPs (member of parliament) complain on behalf of their constituents – it is assumed by most trusts that the MP has gained consent to do so.

Timing of making a complaint: –

• A complaint should be made within 12 months of the incident that is the subject of the complaint or 12 months from the date the complainant became aware of the matter that is the subject of the complaint.

• If it would have been unreasonable for the complaint to be made earlier and where it is still possible to investigate the facts of the case effectively, then discretion may be used.

Responding to a complaint: –

• All complaints should be triaged and acknowledged within three working days.
• The regulations require that an appropriate timescale to receive a written response is agreed with the patient and the patient should be kept informed of any delays.
• Some Trusts have general timescales by which they aim to achieve all responses – often this is within 25 working days but check your local complaints procedures.

Concluding Complaints: –

Once a response has been sent, if the patient is still not satisfied, they can approach the Trust for further resolution. If the patient is still not satisfied or if the Trust is not able to offer any further resolution the complainant has the right to approach the Parliamentary and Health Service Ombudsman (PHSO).