Blog: Complaints Framework Model

The Medical Council is the independent statutory body which regulates medical practitioners in Ireland. Its primary purpose is to protect the public by promoting high standards of professional conduct, education, training, and competence among doctors.

In keeping with our strategic objective to “Ensure medical regulation protects the public and supports registered medical practitioners” the Medical Council has commenced a project to review and realign our approach to dealing with complaints against doctors within our regulatory processes. Additionally, we have also listened to our stakeholders, during recent consultations on our new Statement of Strategy who have told us they feel there is too much emphasis on the complaint process for doctors. The general view was that the process was very stressful, lengthy, and often leaves all parties unsatisfied with the outcomes.

"Our aim with this project is to develop a more compassionate and efficient process that not only takes swift action in the cases where there is the highest risk to patient safety but also considers the well-being of our doctors. By learning from global best practices and actively involving our stakeholders, we are committed to creating a system that is agile,  fair, transparent, and effective." Project Lead, Fiona McVeigh, Head of Regulatory Policy.

Regulatory Reform

The reform of our complaints model is occurring at a time when medical regulators worldwide are increasingly focusing on the experience of complainants and doctors. The project objective is to establish a comprehensive Complaints Model Framework for realigning our approach to dealing with complaints within our regulatory processes. This will be achieved by researching how complaints against medical professionals are handled in different countries and recent changes made that have improved their systems, particularly in relation to embedding compassion within the process. We want to understand the experiences of both doctors and people who make complaints. We will look at both numbers and stories to get a full picture. By doing this, we hope to find out what works well and what doesn't in different systems. Then, we'll use this knowledge to make recommendations for change and a plan on how to make our own complaints process better.

Risk Based Profiling

The Medical Council is committed to enhancing a risk-based approach to dealing with concerns raised, tailoring the response to the risk posed by each individual case. We want to be sure that we are taking swift action in the cases where there is the highest risk to patient safety. The changes will avoid unnecessary investigations where the doctor does not pose a risk to public or to the public’s confidence in the profession.

Embedding Compassion into Regulation

The path toward adopting a more compassionate approach to regulation begins with the Medical Council as a regulator acknowledging how our interactions may be interpreted and their potential influence on the psychological health and well-being of registrants and the public. The compassionate approach does not require compromising professional standards. Instead, it depends on clear and timely communication. Patients can still have confidence that public safety is central to all our work.

We know doctors find being under complaints investigation very stressful, and that regulatory investigations can have very serious implications on a doctor’s wellbeing, and it is important to us to do all we can to minimise that.

Complainants can also find the process difficult and the aim of adopting a more compassionate approach will focus on clear and more timely communication, enhancing transparency. We believe patient input is essential to the work of the Council. We know that the input of people who use health services can help us inform and design policy and services that work better and meet the needs of people who use them. The Medical Council is actively facilitating patient input throughout the project to provide input on how we can improve our handling of complaints.

The Medical Council designed a 3-year framework programme in Q4 2023 and commenced its implementation in Q1, 2024. Over the last four months, this programme has been based on several principles: looking at compassion, kindness, and empathy in all correspondence and language across the organisation; well-being supports that can be integrated throughout the entire lifecycle of a doctor; and a dedicated contact centre to reduce response times for stakeholders. These initiatives represent the initial steps toward embedding compassion within the regulations of the Medical Council.

Swifter Resolution

One of the key outputs being sought from undertaking this project is the ability to resolve concerns more quickly, providing early resolution for patients, families and doctors, and ensuring that where there is a risk to patient safety the steps necessary to deal with this public are put in place sooner. This, combined with data driven approaches, will give the Medical Council more capacity to invest more resources in supporting the professionalism of all registrants.

Project Commencement

During the project we are committed to engaging with key stakeholders, and we are actively seeking input from doctors and patients to capture input as to how the Council should reform it complaints process. We have established a Working Group to support the project which has include doctor and patient representative groups and indemnifiers.

"Involving our stakeholders is crucial to the success of this project. Their insights and experiences are invaluable in shaping a complaints process that truly meets the needs of both patients and doctors. We are dedicated to ensuring that their voices are heard and integrated into our approach to medical regulation." Dr. Mary Davoren, Medical Council Vice President and Chair of Working Group.

The project aligns with the Medical Council's commitment to right touch regulation, emphasising a nuanced and proportionate approach to complaints handling. It aims to reinforce public trust, uphold the standards expected of doctors, enhance patient safety, and prioritise the well-being of medical practitioners throughout the complaint’s continuum. This will provide the Medical Council with the roadmap for an agile complaints model that is responsive to the evolving context of healthcare regulation, ensuring high standards of medical practice and patient safety.