More Information

Key Points

• The aim of this report is to inform the development of guidance on good professional practice for doctors. 
• The complaints handling process goes through three stages;
  • Preliminary Proceedings Committee (PPC)
  • Fitness to practice Committee (FTPC)
  • and the Medical Council.

• Good complaints handling should include measures to ensure there is feedback and lessons learnt from complaints that can contribute to improvement.
• Almost 2,000 complaints were reviewed in the quantitative study and 100 complaints files were selected for deeper analysis through the qualitative study.

Quantitative Review

• A Quantitative Analysis of Complaints
• There were 1,723 complaints made to the Medical Council between 2008 -2012.
• 211 of these complaints involved more than one doctor, so in total, there were 2056 doctors involved in complaints throughout this period.
• The number of complaints received by the Medical Council each year rose from 335 in 2008 to 488 in 2012.
• 3% of complaints were from the HSE and other employers.
• For doctors subject to one complaint in the review period, the likelihood of being subject to at least one further complaint was 21%.
• Certain groups of doctors were more likely to be the subject of a complaint to the Medical Council: males, older doctors, doctors who qualified in Ireland and specialists.
• Doctors who qualified in the EU and doctors without legal representation were more likely to be subject to a high impact sanction by the Council.

Qualitative Review

• A Qualitative Review of Complaints Received by the Medical Council and Doctors' Responses
• The analysis of complaints looked at the underlying causes of complaint, the motivation for making complaints, and the effect of the incidents that initiated the complaint on the complainants and their families.
• A key theme that emerged included the importance of acknowledging and managing different components of competency of medical practitioners.
• Another key theme to emerge was the challenges that may arise for doctors in dealing with the families of patients. In many ways a patient’s family can be of critical importance and value to the doctor in describing symptoms, explaining concerns, acting as a carer and advocate for the patient. 
• Good communication emerged as a key factor in the causes of complaints against doctors. From the perspective of many complainants, assessment of the medical needs of patients also requires recognition and valuing of patients’ “experiential and embodied knowledge” and “lay expertise” of their health.

Conclusion

• The rising tide of complaints observed at the Medical Council in the period of the review is common to other bodies that handle complaints and relates to a wide range of social, political and cultural factors. 
• The overall system for handling complaints from the public needs to be easier to understand, more supportive to patients, streamlined and joined up. 
• Compared to similar bodies, the Medical Council receives a greater proportion of complaints about doctors directly from members of the public and less commonly receives complaints from employers and other healthcare professionals. While public complaints are an important source of information and contribute to the majority of fitness to practise inquiries, complaints from employers and other healthcare professionals are more likely to contain serious fitness to practise concerns requiring regulatory action.
• Our findings about doctor related factors that are associated with an increased likelihood of complaint or disciplinary action are similar to international findings. We use this information to implement initiatives that can help address risk and causes of concern. 
• Failings in communication skills and compassionate attitude, point to a need to maintain a strong and consistent focus on professionalism from medical school through specialist training and to continuing practice.