Enquiries made by the general public to the General Medical Council about doctors’ fitness to practise rose from 5,168 in 2007 to 10,347 in 2012.In a bid to understand this increase, the GMC commissioned a research team from the Collaboration for the Advancement of Medical Education, Research and Assessment (CAMERA) at Plymouth University Peninsula Schools of Medicine and Dentistry to investigate the issues and produce a report.
The report –
Understanding the rise in fitness to practise complaints from members of the public – is published today, 21 July 2014.
An increase in complaints has been seen across the UK, which suggests wider social trends rather than localised issues. A large number of complaints did not progress because the issues raised could not be identified, which suggests that the GMC is receiving complaints outside its remit. According to the report, this points towards problems with the wider complaint-handling system and culture.
While the report does not point to any specific causes for the increase in complaints, it does clearly identify a number of trends which have contributed to an environment in which the public are more prone to making complaints about their doctors.
Clinical care remains the largest source of complaints, but there has been a significant increase in complaints about doctor-patient communication: this highlights the importance of the doctor-patient relationship.
The report identified that the media has a role to play in the increase in complaints. While there was no direct link between media coverage of high profile medical cases and spikes in complaint traffic, the authors of the report suggest that media portrayals of both the GMC and the medical profession may influence how and why complaints are made.
This may be due to the GMC’s own success in raising its profile, but the report shows that name recognition and having a basic understanding that the GMC ‘has something to do with doctors’ does not result in a wider understanding of the GMC’s remit – which may in turn have resulted in the number of complaints that could not be pursued because it was not the GMC’s job to do so.
While the reputation of the medical profession remains positive overall, the report identifies that negative press coverage may be ‘chipping away’ at this reputation and resulting in an increased number of people making ‘me too’ complaints to the GMC.
The authors of the report also acknowledge the role of social media in the increase in complaints. Social media encourages people to discuss their experiences in public forums, and it allows information to be more easily accessed and exchanged.
The report also identifies that patients have greater ownership of their health, are becoming better informed, are developing higher expectations and are treating doctors with less deference than they might have done in the past.
Dr Julian Archer, lead author of the report of Director of CAMERA, said: “The process of compiling this report has produced some fascinating findings. They show that the forces behind a rise in complaints against doctors are hugely complex and reflect a combination of increased public awareness, media influence, the role of social media technology and wider changes in society.
“We found that while a better awareness of the GMC has a role to play in the increase in complaints, it did not necessarily result in an increase in complaints the GMC were in a position to deal with.”
He added: “The report also indicated that there is much to do to improve the wider complaint-handling system, so that complaints made by the general public about their doctors are directed to the appropriate authorities.”
Commenting on the research Niall Dickson, Chief of Executive of the GMC, said: “We have no evidence that the rise in complaints against doctors reflects falling standards – what this research underlines is that patients are more willing to complain and find it easier to do so. Doctors too are more willing to raise concerns about their colleagues. The challenge for the GMC and other organisations is to make sure that anyone who has a concern or complaint can find their way to the right organisation to deal with it. For the vast majority of patients and relatives, that will mean local resolution. The large number of complaints we receive that are not for us, suggests that the current system is not working as well as it should.”