Conflict with patients and family

Question 1

You are an FY2 on a Geriatric ward. You have been asked to see Mrs Smith on the medical take who has been admitted with a hospital acquired pneumonia. She had been on your ward three days ago following a fall at home but was discharged after the physiotherapists had declared her safe to go home. Her daughter is with her and is very upset as she feels her mother was discharged inappropriately. She told the consultant looking after her mother that she didn’t think she was safe to be discharged because no one was at home looking after her. She recognises you from the previous admission and wants to know why her mother’s pneumonia wasn’t picked up before her discharge. She would like to make a formal complaint.

What are the stakeholders in this situation?

Answer 1

• The Patient - comes first
• The patient’s daughter -
• The consultant who looked after the pt previously - will need to be informed
• Myself
• The discharging physio team

Question 2

How would you deal with Mrs Smith’s daughter?

Answer 2

First - attend to Mrs Smith - patient safety comes first, if she has HAP, she is unwell and needs to be treated.

Once Mrs Smith is safe - I would invite Mrs Smith’s daughter to a quiet room where I won’t be disturbed, give someone to hold my bleep and give her space to explain her concerns.She’s angry and it may be that there is a good reason for their anger

I would also apologise for the situation and try offer some explanations why this may have happened - e.g. HAP can happen up to 5-7 days after discharge, so may have not been evident on discharge.

I would then try to identify the daughter’s concerns and expectations. What does she want and whom does she want it from? I would also explain that I will feedback to the team looking after her.

I would give her info about what options she has for making a formal complaint and what departments can give her advice.

Question 3

What do you understand by the term PALS?

Answer 3

PALS stands for Patient Advice and Liaison Service. They offer confidential advice, support and information on health-related matters.

They provide a point of contact for patients, families and carers. PALS can also give information on the NHS complaints procedure, including how to seek independent help if they want to make a complaint

Question 4

Do you know how complaints are handled in the NHS?

Answer 4

Two step procedure

1. First step involves trying to reach a local resolution - so organisations should respond and deal with complaints internally
2. If this fails to reach an acceptable outcome, then the second stage allows pts (or their reps) to refer the matter to the Parliamentary and Health Service Ombudsman

Question 5

What is the Parliamentary and Health Service Ombudsman?

Answer 5

The PSHO is reponsible for considering and handling complaints that have not been resolved by the NHS in England. It is an independent and free service financed by the UK Government. If they decide that the organisation has got things wrong, they make recommendatations for it to put them right.

Question 6

Who is available for support, if a complaint is made against your practice?

Answer 6

• Clinical and educational supervisor
• Training programme director
• Medical defence union
• Medical union such as the BMA
• Trust legal team