Making a complaint about medical care can seem difficult, distressing and intimidating, but there are plenty of people who can help with free advice and information.

Do not hesitate to get help

If you are thinking of making a formal complaint about a GP or GP surgery, do not hesitate to consult a medical negligence legal expert at this early stage. If they are genuine specialists, the solicitor will be happy to help and answer questions on a no fee, no obligation basis. They can help identify who to complain to, give you the right questions to ask, and put you in touch with people and organisation that can help you fill in the forms and write letters.

Why should you complain?

You can and should complain about a GP or other healthcare professional within a practice if they do not provide a good standard of care. It is often perceived as a hassle and time consuming. Patients worry that the complaint will not be taken seriously, it could affect their future care or it could mean the patient is struck-off the GP’s practice list. But in the vast majority of cases these fears are unfounded and highlighting poor care, errors and omissions by medical professions is important for your health and the health of other people.

Each individual healthcare professional must provide a good standard of care. It is a legal duty and it is required by medical regulatory bodies. In the case of a practice nurse at your GP’s surgery it is the Nursing and Midwifery Council and The General Medical Council for GPs.

A duty of candour recently came into effect for GP practices, which means GPs are under a duty to inform patients when things have gone wrong. They have to be transparent if someone suffers severe harm, moderate harm or prolonged psychological harm as a result of a failure in care. They must inform patients, provide reasonable support, provide truthful information and write an apology.

In many cases, a GP or GP surgery will welcome the feedback that a formal complaint provides. A frank and open approach can help them review personnel, services and procedures that will ultimately improve their service and care.

What to do before you complain?

Before deciding to make a complaint it is important to consider what you want to achieve. Do you want an apology, action to be taken against a member of staff, or a change to their medical procedures? You will have to make this clear when you register an official complaint.

A complaint can take a while to resolve, and you might be asked to verify information at a later stage. Even if you intend to make your complaint verbally, it is recommended that you make notes before and during the complaint procedure. It is important to secure the following information:

Ask for your medical records

Write down an account of what happened to you and when

Record dates and times of appointments and treatments

Write down the names of everyone involved in your treatment, GP and practice nurses

Make notes of any verbal conversations you had regarding your diagnosis and treatment

Safe keep and copy any correspondents to and from the GP surgery

Keep a diary of the effects the failure in care has had on your daily life, physical, emotional and financial

When you make a complaint in writing, keep a copy of everything you post, and make a note of when you sent it.

Who do you complaint to?

If you’re unhappy with your GP or GP surgery, you can make a formal complaint to the practice directly, or to the NHS in your region.  If your complaint isn’t resolved at this level, you can contact the Health Service Ombudsman.

Complain directly to your GP surgery

It can be confusing to work out who is responsible and who you can raise your concerns with. Most GPs are not employed directly by the NHS. They have a contract to provide NHS services. Surgeries employ their own staff and therefore if you have concerns about a member of staff at the GP surgery (including a doctor), you can complain to the GP surgery that employs them.

Many problems can be dealt with on the spot if they are raised informally with staff at the GP practice. However, if you would like to make a formal complaint then each GP surgery will have its own complaints procedure. Ask for a copy from the practice manager and make sure you follow it to ensure your complaint is dealt with quickly and appropriately.

Again an experienced medical negligence solicitor will be happy to give you 30 minutes of their time to advise you on how to complete any forms or put you in contact with organisations that will help, such as Healthwatch, The Patient Association or NHS Advocacy.

Under the NHS Constitution you have a right to have your complaint properly investigated. Your complaint should be acknowledged within three working days, and you should also be told about the outcome of the investigation.

Complain to the NHS

If you do not wish to complain directly to your GP surgery then you can contact the NHS within you region.

It is important to ensure that you direct your complaint to the correct NHS organisation so that your concerns can be investigated properly. All GP practices now belong to a Clinical Commissioning Group (CCG) and you can direct your complaint to the local CCG. To find your local CCG click here and enter your post code. The complaint can be made by email, letter or verbally, but make sure you make a note of your complaint and the response you receive by phone or face-to-face.

If you have already complained to your service provider, in this case the GP surgery, then the CCG will not be able to reinvestigate the same concerns. However, if you are unhappy with the response to your complaint or they are being too slow, you can refer the matter to the Parliamentary and Health Service Ombudsman.

Complain to the ombudsman

The Parliamentary and Health Service Ombudsman (PHSO) is independent of the NHS and free to use. It can help resolve your complaint, and tell the relevant NHS service how to put things right if it has got them wrong.

The PHSO only has legal powers to investigate certain complaints and it has very strict criteria to meet before they will investigate. In the first instance you must have received a final response from your GP practice or the appropriate CCG, or at least given them a reasonable time to respond, before the ombudsman can look at your complaint. You must give the care provider an opportunity to put things right first.

The ombudsman will generally not look into your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.

It is advised to make your complaint in writing using a designated form but you can also email or phone the PHSO about your concerns. Again, do not hesitate to approach a specialist solicitor for advice about the PHSO process.

Act quickly

When making a standard complaint about your care to a service provider (GP surgery or CCG) or the PHSO you have 12 months from the date of the incident, or from when you were made aware of the incident, to start a complaint. If they are still able to investigate a complaint after a year they may still consider it, but they are under no obligation to do so.

They may consider investigating a complaint if there are exceptional extenuating circumstances. For example, a patient has experienced major trauma and it took a long time to recover.

But it is always better to make a complaint as soon as possible, to avoid any facts being disputed and the process taking longer to resolve.

Write to your MP

GP services are there for us when we need them. GPs and practice nurses do an extraordinary job in high-pressured, often life or death situations, in busy, underfunded and short staffed surgeries. They have just 10 minutes with each patient to make a diagnosis from often complicated symptoms and also help us with our lives in general.

With government cuts taking hold, GPs are working longer hours for more patients, with less support staff, and less time to make a diagnosis, which means during even routine medical consultations and procedures, an error or omission, can happen.

So, it is not always in the power of the GP or the GP surgery to improve their standard of care. Certain concerns and complaints that you may have about a GP service could ultimately be about wider policies and funding. Highlighting those concerns and complaints with your local Member of Parliament is an important and constructive way of voicing issues regarding the standard of care that your local GP and GP practice are able to provide.

This week is the annual World Sepsis Day (13th September) with the hope that the event would raise awareness of this serious infection, which is said to be responsible for thousands of deaths in the UK annually.

Sepsis is a potentially life-threatening condition triggered by an infection. It is the most common cause of death from infection despite advances in medicine. Sepsis is normally caused by an infection such as pneumonia or flu. Notably, some people are more susceptible to developing sepsis than others, for instance the elderly, young or individuals who have undergone surgical procedures.

In sepsis, the body’s immune system goes into overdrive following an infection, which can lead to damage of tissue and organs. It can cause inflammation, swelling and blood clotting. This can lead to a significant drop in blood pressure, which means the blood supply to vital organs such as the brain, heart and kidneys is reduced. If sepsis is not treated in a timely manner, it can lead to organ failure and even death. It is estimated that, in the UK, more than 100,000 people are admitted to hospital with sepsis and around 37,000 will be fatal cases.

Symptoms of sepsis

There are a number of common symptoms that are visible during the early stages of sepsis and these include:

• High temperature
• Shivering
• Rapid heartbeat
• Rapid breathing

In cases of more severe sepsis symptoms may include:

• Feeling dizzy or faint
• Confusion or disorientation
• Nausea and vomiting
• Diarrhoea
• Cold, clammy and pale or mottled skin

Treatment

An early diagnosis of sepsis is essential in order to obtain the correct treatment. It is claimed that around 13,000 lives could be saved each year by better treatment methods. Treatment of sepsis varies depending on the site and cause of the initial infection, the organs affected and the extent of any damage.

If your sepsis is detected at an early stage and has not affected your vital organs then it is possible to receive treatment at home by way of antibiotics. Most people will make a full recovery from sepsis following this.

If the sepsis is severe or you develop septic shock (when your blood pressure drops to a dangerously low level), you will need emergency hospital treatment and may require admission to an intensive care unit (ICU). ICUs are able to support any affected body functions, such as breathing or blood circulation, while the medical staff focus on treating the infection.

As a result of problems with vital organs, people with severe sepsis are likely to be very ill and up to four in every 10 people with the condition will die. Septic shock is even more serious, with an estimated six in every 10 cases proving fatal.

However, if identified and treated quickly, sepsis is treatable and in most cases leads to full recovery with no lasting problems.

Management of sepsis

Management of sepsis after admission to hospital is popularly known as the ‘sepsis six’. This involves six elements, three treatments and three tests, which should be initiated by the medical team within an hour of diagnosis.

Treatments:

• Giving antibiotics
• Giving fluids intravenously
• Giving oxygen if levels are low

Tests:

• Taking blood cultures to identify the type of bacteria causing sepsis
• Taking a blood sample to assess the severity of sepsis
• Monitoring your urine output to assess severity and kidney function

How we can help

At the Serious Injury Helpline, we understand the impact a sepsis diagnosis can have on patients and their families. We also know how important obtaining compensation can be to help with rehabilitation of those who survive and the financial worries of those that are bereaved as a result of sepsis.

If you believe that you or a loved one has had a late diagnosis of sepsis or was poorly treated, you may be eligible to pursue a claim for clinical negligence.

Please feel at ease to contact us on 0800 230 0573 to see whether you have a viable claim for medical negligence.

Further reading: World Sepsis Day

Each year, around 20 million people attend Accident and Emergency and half of them need an X-ray to check for a broken bone. As the strain on the NHS increases, more and more fractures are being missed.

Partner at Birchall Blackburn Law Susan Liver, who specialises in Clinical Negligence, has noticed an increase in missed fractures. She said: “We are seeing more clients from all over the country whose fracture was missed when they first attended hospital. This can lead to the correct diagnosis being weeks after the original incident happened.

“Clients are ending up having to have complicated surgery. Long term complications can also arise as a result of the clinical negligence.”

Finding a fracture on an X-Ray is a difficult process. Sometimes, the fracture will not show up at all on a standard X-ray. Both skill and experience are crucial if certain types of breaks are to be spotted.

Patients in Accident and Emergency are frequently seen by junior doctors

This may lead to more fractures being missed. To combat the problem, some hospitals are getting all their X-rays reviewed by specialist radiographers. Even where a review does take place, it can take up to a month. This is often too long and the patient may still suffer complications as a result of the misdiagnosis.

Certain types of fracture are more difficult to detect

A hairline fracture occurs when the bone breaks but the fragments do not move. This can appear as a very light line on an X-ray. The most common place to break the wrist is in a tiny bone called the scaphoid.  This bone may not be seen at all on an X-ray.

Susan Liver said: “We are seeing a number of clients with scaphoid wrist fractures that were initially missed on the X‑ray. This can cause life changing problems for the client. Some have sadly lost manual jobs because they are no longer able to lift things.”

The National Institute for Health and Care Excellence will soon be issuing further guidance on the treatment of scaphoid fractures.  The recommendations are likely to be in line with those of the College of Emergency Medicine.  Anyone with a suspected scaphoid fracture should undergo an MRI scan even if the X-ray is clear.

Misdiagnosis can lead to on-going pain and discomfort. In the worst situations, an initially simple injury could lead to life-altering complications.

If you have suffered a delay in the diagnosis of a fracture, you may be entitled to compensation.  Our compassionate team of Clinical Negligence experts understand the worry and pain caused by medical mishaps.  Please get in touch with us on 0800 230 0573.

Closures, budget and training cuts, and reduced services will continue to put mothers and babies at risk in maternity units across the UK in 2016.

Towards the end of last year the Royal College of Midwives (RCM) highlighted the intense pressure on maternity services following the insight provided by a survey of UK senior midwives (Heads of Midwifery).

The RCM said that maternity units face unprecedented challenges as a high birth-rate, increasingly complex births, and an acute shortage of midwives threatens the quality of NHS services.

With staff pushed to their limits in busy maternity wards and no relief in sight through extra funding, training and staff, mistakes are inevitable. The Times reported in June 2015 that the annual bill for NHS negligence in pregnancy had reached £1 billion after more than 1,300 babies died 2014.

The results of the RCM survey, published at the beginning of the winter, suggest that the situation is not going to get any better in 2016. According to the survey over two-fifths of England’s maternity units had to close temporarily during the last year because they could not cope with demand (32.8% in 2014 and 41.5% in 2015). Units closed their doors on average on 6.6 occasions in 2014 and 4.8 times in 2015.

More than a quarter of senior midwives (29.5% in 2014 and 29.6% in 2015) said that they did not have enough midwives to cope with the amount of work. It is estimated that the country is short of 2,600 full-time midwives. A tenth of the senior midwives surveyed (10.9% in 2014 and 11.0% 2015) reported that they had to cut services as funding and staffing shortages bite. This included cutting specialist midwives, parent classes, bereavement support and breast feeding help.

Senior midwives said that the most common type of staff redeployment was from the community and postnatal service to the labour and delivery suites.  This restricts choice and impacts on the quality of care women and their new-borns receive. Worryingly the lack of adequate postnatal services makes spotting infection in the mother or baby, or maternal mental health issues, less likely. This can have potentially devastating consequences.

Many senior midwives responding to the 2015 survey were worried about how well they were able to do their job given the demands of the role. Nearly a third (31.2%) disagreed or strongly disagreed with the statement ‘I am able to do my job to a standard I am personally happy with’ and nearly two-thirds (62.3%) disagreed or strongly disagreed with the statement ‘I am able to meet all the conflicting demands on my time at work’.

It is also a concern that two-fifths (21.9% in 2014 and 20.3% in 2015) of senior midwives had to reduce staff training.  Training and continuing professional development are critical to the delivery of safe and high quality care.

Cathy Warwick, RCM Chief Executive, said: “All of this shows a system that is creaking at the seams and only able to deliver high quality care through the efforts and dedication of its staff.

“When services are operating at or beyond their capacity, safety is compromised and mistakes can, and almost certainly will be made, through no fault of the dedicated staff delivering the service.”