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Hello, everyone. And welcome to the weekly mindedly webinars on preparing how to be an F one. Um, today we're going to be joined by as Stephanie, uh, Lausanne from mg. Um, he's going to tell us all about complaints. Um, we're going to have Q and a session afterwards, So please make sure you send all the questions in the chat. If they just pop to your mind or you can save them all till the end, we'll make sure to answer them all, and the session will be recorded. Will send you the link, um, which you can access any time and the materials will be available for you later. Make sure you're registered at the mind a bleep dot com for the weekly webinars. I'm going to post the link for the webinars registration so you can access it later. Um, before we start, I would like to also give a shout out to our sponsors. The mg. Don't forget to to, um, sign up for the MG Foundation membership before you start shadowing, because unless you failed in the foundation, application for your student membership will see you in the summer. So it's essential they have your endemic recovery. So check out the M D u M D U website and the sign up link. I'm going to post again in the chat so you can access it anytime. Um, and Lausanne, um, is representing mg so she can answer all of your questions. Um, if you have any questions, as I did say, just let us know, and I hope you do enjoy the session, and I'm just going to hand over to lasagne. Thank you so much. Okay. Thank you. Right. Good evening, everybody. So Okay, she has asked me to come and talk to you about dealing with complaints. Now, I don't want you to think that you are definitely going to get complaints, you know, like serious complaint with an F one. You know, not everybody does. Okay, but it is important to kind of know how to deal with them, because dealing with it as a professional and in the right way is the most important way that you can actually protect yourself. Okay, so I'm going to take you through this. We're going to talk about a few examples, and, um, like, yeah, they'll be plenty of time for questions. as well. Okay, right, There we go. So we're going to start with what is a complaint? What actually constitutes and qualifies as a complaint as such. Now it is important to note that in the English in a chest complaints legislation, uh, you know, there's absolutely no legal definition of this, um, which is very, very difficult sometimes. But what we adopted the M d U and we think you should adopt to is that a complaint is any expression of dissatisfaction that you can't ignore something you have to respond to. Okay, Now, um, generally, that is quite straightforward. And generally our advice is always to respond to complaints because things can really escalate. And I'm going to give you a brief example of that later as well. So moving on the aims and objectives of tonight's session is we're going to talk about the NHS complaints process that is really important to know about because you guys as f one's working for the N h s. Um, you have a responsibility to make sure that that process happens, okay? And if you don't or if you get in the way of it, you could potentially you find yourself in trouble. All right, so we're going to tell you about that. We're going to talk about the types of complaints that come from patients. So you know which areas to just potentially be a little bit more careful with or give a little bit more attention to. We're going to talk about what a good quality response looks like. Okay. And I will say very much, Remember, we're looking at things from in a perfect world. This is what we would like you to do. All right? We can't tell you what to do, and we can't make you do it. So it is very important to remember we look at it from that point of view. And then lastly, we're going to talk about this reason why it's so important to deal with complaints. Very, very good from the start of possible. Okay, So the energy is complaints procedure? First of all, um, so this is where patients have the right to have the right enshrined in law to complain about the service that they get from the NHS. Okay, Now, the law, of course, differs in the different jurisdictions of the UK, So if you are you know, moving to Wales, Scotland and Northern Ireland. That could be slight differences. Tonight I'm going to concentrate on England. Okay, because that's where I live, and that's what I know. But, uh, most of the things are relevant to all the jurisdictions, they might be slightly different, Uh, like headings. Two things. What they're called. My main advice would be that if you ever kind of worry about it, do get the proper kind of documentation. Have a look at it. You will probably be very surprised if you don't get a copy or some training on this when you go to your F one induction. Okay, so talking about the complaints process in England, it's very much a two stage process. So the idea is that you know any organization that provides NHS care in England or adults social care in England, they have to adhere to this. And the idea is that, um, this complaints process concentration tries to resolve things locally, but it gives the patient the right to escalate things further if they're not happy with the local response. Okay, this complaints process, as I said, any any organization that provides NHS healthcare so It's your GPS, your pharmacist opticians. Ambulance service is and of course, hospital. Anybody really who can call themselves a responsible body? All right, now, in the case where you perhaps have a complicated or joint complaints, so two different, Uh, you know, companies are involved in it. Let's say a GP and the hospital, they're part of the complaint. Then the usually the organization with the most to answer for will take charge of handling the complaint. Unless, of course, you have potentially a single practice GP. Sorry. A single GP practice where, you know, it wouldn't be appropriate for him to investigate themselves. Okay, So that kind of thing, and very important it is about how quickly the response is required. Those kind of things. I've got a bit of a graph here. If you bear with me. Sorry. The main thing you guys need to remember is number one. If somebody makes a complaint to you, remember that any kind of expression of dissatisfaction that you will be ignored, and basically we don't want anything ignored. If the complaint is made to you verbally or orally, then you have to ask the question. Can I resolve this person's complaint within 24 hours. Okay, so is it a really simple complaint? Somebody telling you they want a glass of water and nobody's brought them one. Can you fix that by taking them a glass of water? Or, you know, somebody's rude to them and and or let's say they complain that you're rude, and then you go and you apologize, and they're happening with that. They don't want to escalate things. That's all settled within 24 hours. So that does not have to go to the proper complaints procedure. Okay, everything else does. If they complain to you and it can't resolve it within 24 hours or if they take the time to actually write their complaint down, it has to legally go through the proper complaints process. Okay, Now, what that involves is number one, and your Your involvement in that is, if you're the person they're complaining to, you have to number one. Tell them that there's an energy complaints procedure and help them get access to that. Number two, If you can't do that, make sure you escalate the matter A s a p. All right. And that is because, um, the NHS, the organization that you work for, has three days to formally acknowledge the fact that they've received the complaint. And those three days start the moment you become aware of it. Okay, so if you're the person that is the first in line to get this complaint, you've got to make sure that it gets action. And and that's really, really important. If the NHS doesn't, uh, don't respond to a complaint within those three days and it's three days, it's not three weekdays or anything like that. Okay, it includes the weekends. If they don't acknowledge it within three days, then they can get into a lot of trouble. And they can potentially get fines from the ombudsman as well. So you can imagine that if you're the reason. Either you forgot to tell anybody about the complaints or you just didn't treat it as urgent or anything like that. Then you know, you can imagine that they will have to look into why this has happened as well. All right, so that's the most important thing. Somebody complains to you. If you can't resolve it, make sure somebody else knows about it. Make sure you take it up the the management chain. All right. Now they once the the organization knows about this. They're all right to the complaining, saying that they know about this complaint and they will be investigating it. And then they have to do that in what is called a timely fashion. Another place Hospitals have gotten into trouble because, you know, a timely fashion does not excuse for holidays or staff shortages or anything like that. The hospital has. It is absolute best to investigate and respond to the complainant as soon as possible. All right, that they will put out that will create an investigation team. And you know they'll interview people. Find out what was going on, and we'll talk about more about how that works later. Once they've done the response, they have to reply to the patient and the patient. Will complainant well, then decide whether they're happy with the response. Sometimes and most often, you will also kind of include a meeting right before to kind of make sure everything's answered. Two. If you're happy with the response, great, the case is resolved and they can close that if they're not happy with it. I'm sorry. Wrong way. Then they have the right to take the complaint to the ombudsman. The ombudsman may use the information gathered by the hospital team to make their decision about whether or not the complaint has been answered fully or they can. And they do sometimes do brand new investigations and get external body is involved. All right, so it can obviously escalate into something much more serious. So, to recap, your involvement is mostly if you become aware of it, try and resolve the complaint straight away. If it's oral, if it's, you know, if it's been written and it can't be resolved to make sure that you tell somebody about it straight away, okay? And I would in this case, they don't tell a colleague. Tell somebody more senior. All right. Don't just pass on the job, all right? I'm really sorry. Lausanne and I have to interrupt very, very quickly. Because of the technical issue, I think you might have to click to the display the display settings and change it to the presentation view. I'm really sorry. Well, can you see my slides? Yes. I'm not going to bother with that. So you guys can see what's coming up next. It's not a Okay, all right? Okay. All right. Thank you. It's fine. It's been a while since you soon, so who knows? Okay, so that is the complaints procedure. So we're going to move on to our first case. Just go hide this bit. There. Now, we have written this. As you know, we want you to kind of imagine yourself in the shoes, but I do kind of promise you we're not, uh we're not that creative. Most of these cases are based on real things. So imagine yourself now working on a general medical ward and you're asked to review a patient in a side room. When you're into the room, the daughter of the patient is there Before you can say anything, the daughter makes it really clear that she's unhappy with because she's had to wait for a long time to speak to the doctor. And now she's going to be late getting back to work. Okay, so you can imagine. Not really not that unheard of. You'll get these patients Okay. Uh, these complaints you suggest to the daughter that you, of course, first examine her mom because the patient has to be your first priority, and then you're going to speak to her afterwards. Okay, so think a little bit about what you potentially are going to have to, you know, think about when it comes to this. It is a complaint. Okay, so is it a complaint? Yes, it is. You know, it's but in this case, this is a very, very minor issue. It was made to you verbally. So if you can resolve it, then it doesn't have to go through the full complaints procedure and use up all those resources. Okay, So what would you consider before speaking to the daughter? Now, again, we look at it from a medical legal point of view. So there's a few things we want you to kind of think about, and most importantly, here is consent. Okay, So you need to make sure that when you go and examine the patient's mother Sorry. The complainants mother. Okay. Get permission right then and there about what you can and can't discuss about the patient's clinical issues with the daughter. And the reason we say this is you want this, uh, interaction to go smoothly and you want to come out as a confident doctor And have the complainant, uh, you know, re establish the report and everything. Okay, so that's the ideal thing that you want to try and do here. If you make sure that you find out all these things beforehand, then the conversation that you're going to go have with the daughter is going to go much more smoothly. So make sure that you have the consent. If you don't have the concern, that's fine, too. But then you have that answer already. So when you go and speak to the daughter, you know, once you've apologised about the fact that they've had to wait because you always apologize is the polite thing to do, you know? But once you apologized to them, the next question they're going to ask you is Okay, Well, how's my mom? So you need to ideally know whether or not you can discuss things. And if you can't, you can then confidently say, Oh, you know, I did ask your mom. She didn't want me to talk about it. Okay, so that is for good. It shows a conscientious to show you as forward thinking. Now when you speak to the daughter. There is a almost a magic way, you know, a magic way for things that you should always include in any kind of whether it's a verbal response to a complaint or any kind of interaction with patients as well. But there's four main things I want you to think about, and I will reiterate it a little bit. As we go through things. Number one is an apology. You must apologize. Okay? You're not admitting guilt or anything like that. You're apologizing for the fact that they've been through something or that they're unhappy. And that was purely the polite thing to do. Okay, then you have to try and give an explanation. But be very, very careful not to kind of go into the realm of giving excuses. Okay? An explanation is fine. Were extremely busy on the ward today. You know, things like that. That's absolutely fine. But don't get an excuse as in Oh, I don't know why it has nothing to do with me. Okay? That's not actually useful empathy, Of course. Always make sure that you do empathize them. That you show it to the people you're talking with. It's not just good enough to really have it. They have to experience it from you as well. And then, lastly, come up with a remedy. Give them a solution. Okay, so apology, explanation, empathy and remedy. If those four things will be in every good patient complaint response, or even breaking bad news sometimes as well. Okay. And then, lastly, the thing again from our kind of medical legal heart, what we want you to do is document very clearly clearly in the records what this patient and complainant have said, Okay. Have they accepted the fact that you know, do they say to you that Yeah, they don't want to take this complaint any further, Can you know? So then you put it in the notes. The fact that you believe that this, uh, complainant was satisfied with the response and that this thing is settled. Okay. Okay. If not, then you say you don't believe the patient complaint was satisfied with the response. You've given them the details of how to make a formal complaint, things like that. Okay, but I always put it in the records. Okay, Right. Just a couple of comments and concerns just from our kind of experience and things. Issues where the hospital is generally have is that front line stuff very rarely get all the right training in how to respond to complaints in a positive way. Okay, they're scared of it. They tend to kind of push things up the ladder. You know, sometimes any kind of training that you can go to or that you can provide. If you're being charged one day to get your front line staff to deal with the small complaints there and then is going to save your organization, your team, so much hassle. Okay? And it's so much better for the patients and to keep them trusting you as well. Okay, so whatever you can do, that's really, really important. Of course, it may seem very, very uncomfortable, especially if it's something that's just completely not in your control. You know, it's just like waiting times again. It is something people complain about, you know, again, if you deal with it up front and you have the right training and the confidence, then you know they're not going to go home and take that with them and then bring it back next time, okay? And that's very very important as well. And it's also very important to note any kind of potential errors, near misses and that kind of thing. All right, now, a lot of people often ask us, like, should I really apologize? You know, it doesn't an apology, uh, in itself amount me accepting. I don't know, admission of negligence or breach of duty of some sort. And the answer to that is absolutely no. Okay, if you make an apology that you're sorry for something that you did or not either did or didn't do, then it's not an admission that you're responsible for any damages that maybe suffered because of it. That's a mouthful. I understand that. Okay, you just need to remember an apology is not admission of liability. So don't worry about apologizing and the legal things about okay. However, a good apology is a lot better than a bad apology, but a bad apology is still better than no apology. Okay? Ideally, we want you to give a good apology. Now again, with apologies, you know, empathy, honesty and openness, you know, they're much, much more likely to actually prevent complaints and claims that they are actually to cause them. Okay, right. So what do people complain about very quickly just starts for you. They haven't had the latest figures in for the co video just quite yet. We expect there will be some complaints, but in most cases, there's around 208,000 complaints every year. And I just think in this graph, what's interesting is the things that people complain about. Okay, so they complain about communication. Large chunk of complaints has to do with communication, and you will hear us talk about communication all the time. The most important thing you can do is communicate well, but that is also the first thing that goes out the window. At the moment, people stress the moment there are overworked, you know, it's hard to consistently communicate. Well, okay, so that is something you should always try and keep in the back of your mind. Then the next one, They're the orange one. Patient care, hydration, food, that kind of thing. And then, lastly, values of, uh, behaviors of staff and again, values and the behaviors of staff is something that you can kind of think about. So when you have to kind of always remember that when your patients are lying on the warts and stuff, they're watching you guys all the time. So if they see you know, one doctor treating another badly, they will complain about it if they see, um, you know, if they feel that they're not being treated well, of course they're going to complain about it as well. They very often complain about behavior of doctors when doctors think they're not being watched. All right, it's part of life, and you can't be perfect all the time. We're not saying you can. It is worth just kind of remembering this. You know, there's always eyes somewhere in the world. Okay, right. So responding to complaints and move on to this, we're going to come up with our second case again. You I think this is quite a simple one, and you will probably imagine that this might happen to you. All right. It happened to this guy, so f y two or night. He was working very, very hard. And, um, they had a very busy night, and all the minor cases were backing up. And, you know, it was just absolutely mad house in the knee that night. pardon? This doctor hadn't eaten. We've been to the toilet since his shift started, and he really was working as hard as you can to try and clear the backlog. And a 90 year old lady came in who had had a fall at home. Okay? The family was already upset about the fact that they had been waiting in a any for quite a while. And finally, when the doctor go to going to go see them, they said to him as he entered the room and said, Oh, you know, it's about time to. Okay, so there's two responses. The first is what we would have liked to see. And I want to kind of point out to you again the empathy, apology, explanation and remedy. Okay, so I'm really sorry I kept waiting. The department has been unusually busy, which means there's delays and other patients being seen. I understand. I was upsetting. It must be to have you on waiting, and I'll do my best to get things moving along. Okay. Very nice. Simple response. Unfortunately, what the doctor said that night was can't you see that we're busy? I've not had a break or drinking nine hours. I'm working as fast as I can. They were genuine emergencies that needed to be seen. Now, why have you brought your mom into the any in the middle of the night? Okay, now, this was not a bad doctor. This was a doctor on a bad day. And unfortunately, yes, this did turn into a complaint, and, uh, it escalated to an internal disciplinary investigation, and the doctor received a verbal warning from the hospital for this one. Okay, that is, unfortunately, the reality of things to you can't talk to people like that. Okay, Case three. And this one is more in depth. So again, if you bear with me, I'm just gonna talk you through it. Okay? So I am writing to say how disappointed I am at the care that I've had from your department. As you know, I've been admitted with a P and sepsis, both of which I know can be life threatening conditions. When I started my chemo, I was given an information pamphlet about sex is I kept a check of my temperature. And when I went home and I called the ward when my temperature fell below 35 degrees. I explained that I wasn't feeling well, but I was told that only a high temperature was important until not to worry. The next day, my partner had to bring me to any. After I collapsed at home, I told the nurse on the board that I had a DVT in my in my leg years ago. They told me not to worry about it and that I wouldn't need any preventative treatment because I would soon be on my feet. I was in the hospital for a week and I complained that I was a bit short of breath, was again told not to worry this time by a doctor who didn't even examine me. The day after I was discharged, my partner had to call an ambulance and the doctor and they and he told me I could have died. I'm disgusted by this treatment, and I want to know what you will do to stop this happening again. Okay, All right. So what do patients want when they complain? And it's very much the things that we told you should be in the In the answer to that complaint, they want an explanation. They want to feel heard. They want an apology, Okay, They want improvements to the service, and I think that is very, very important. The vast majority of people who complain will say to you that the reason that they complained is not just for themselves is because they don't want this to happen to somebody else. The vast majority, okay. And of course, they want the institution. They're complaining about to accept that they've done something wrong and to be willing to fix things, what they definitely don't want. Is there issues to be trivialized or being told that it's not important or that their unreasonable? They don't want to be made to feel that they are to blame for what has gone wrong. If only they had spoken up, this would never have happened. They don't want to be given excuses. They don't want to hear that. Oh, it's not my job or it's not my responsibility. They don't know the inner workings for them. You are part of the institution, okay? And they also definitely don't want to have to jump through multiple procedural stages. They don't want to have to go to one and then not get any justice and go to another and not get any justice. Okay, so with that in mind, the with this case, the complaints department set up investigatory team and they had a look and they started gathering evidence, uh, to kind of see, you know, they needed to know the facts of what is right and wrong and what has happened. So amongst other things that they look for, they went and found a copy of the leaflet about sepsis that they had to look at the medical notes to see who the patient spoke to you over the phone. They had to look at the department SVT risk assessment to kind of see, you know, what should have been done. What is the rules? That kind of thing. And they went and had a look at the medical notes to see who was the last doctor to see this patient just before discharge. Okay, so the information leaflet made it very clear that the temperature below 35 degrees Celsius could indicate infection. So the patient was right. He did the right thing in calling in. There was at the time, unfortunately, no evidence of who spoke to the patient on the phone, and there's no no to record. And conversations weren't being taped or, you know, for the records or anything like that. Um, so, since then, the hospital made a change here. And, um, every phone call now have two forms to be filled in for every phone call. Um, had a look at the V t a risk assessment. And it appears that the nurses didn't really take all the rules into account. You know, they needed to think about the previous DVT and again to put yourself into this doctor's shoes. I want you to imagine that you were the last doctor, uh, the one who kind of didn't examine the patient. Okay, imagine yourself in that situation. So the complaints team will then come to you and ask you, um, you know, we would like a statement of your involvement. This is a bit where we know you were involved. Okay, so it's very important you got to think about who can you turn to for help? There is plenty of help available, and it's really important that you get some feedback and advice. Okay? Of course you can come to us. That's a given. Okay, But also you can, of course, very much go to your supervising consultant. You know, your educational supervisor, Even the doctor is just got a little bit more experience of you will have valuable input to how you You know what you could potentially need to do next and so forth. Okay. What would you consider? Well, you will probably need to, uh, add this complaint to your your portfolio. You'll have to reflect on it, learn from it, identify areas where you could have done better and potentially come up with a way to include those areas as well. Okay. And if it's a serious case, you will also have to probably review the case as well. Okay, Um, what should you include? You in your response? Well, I think the first thing to really understand and appreciate is that any complaint you get is going to be a stressful event Nobody likes being complained about. And you definitely don't want to be complained about when you've already had a rough week. Okay, So acknowledge the fact that if you receive a complaint, it's not going to be a nice thing. Alright. It often feels really, really unfair. So It's very, very important that you take the time to compose yourself. Focus. You know, you need to kind of look through everything. Think about what had happened, all of that. And you can't do that when you're running around doing 50 different chores. Okay? Start your first draft. You know, considered, of course, that you are not just answering. Even though the people asking you for the statement is the complaints department. You need to write your response to the patient. Okay to the complainant, So address their experience. Don't think about the fact that they've got it wrong and they're being unfair. Think about if I was them. What do I want to hear? All right. So it's not just about the facts and figures and the medical talk. You really need to make sure that that complaint is addressed to the patient. Okay, then, once you've done that, get some feedback from people again. We would be happy to look over it for you as well, you know, See if they read it the way that your intend Okay. Make sure that when you do answer that you have the most up to date clinical records You need to know if you know anything at the time. Maybe the information wasn't available. You need to know that it wasn't available, That there's something new. Now, all of those things give a full chronological account of your involvement. Okay? Don't stray into speculating about what other people did or what other people say. Stick to what you did. All right, again. I apologize if it's appropriate. And again, we pretty much say, Always apologize. It does not cost you a thing. And people appreciate apologies. Okay, if nothing else, if you can imagine, um, going to a restaurant and the food isn't quite up to the standards that you wanted. You know, the moment the waitress says to you, I'm sorry. I didn't like it. She didn't cook it, you know? But you do want them to just acknowledge the fact that you're unhappy, and I apologize the quickest way to do that. All right. Um, things could have been better say so clearly. And it's really important in your response to say what you've learned and what you would potentially do. Different. Okay, So, coming onto why it is so extremely important to respond Well, it's something called multiple jeopardy. Okay, but it's also very much your ethical responsibility, as with your GMC guidance. Okay, so GMC says you must. And if you guys haven't heard me say this before when you read GMC guidance, you always look for the must and the shirts. It really helps you decide, like what you absolutely must do. Don't let anybody else tell you different, especially consultant sometimes and what you should do. Okay, And that's what you must try to do, so you must respond promptly, fully and honestly. Two complaints and apologize when it's appropriate. You must not allow patients complain to adversely affect the care or treatment you provide or arrange. Okay, so it's always about stay professional, but you have to deal with it. You cannot ignore it. All right now for you guys. Why it's so important to deal with complaints really well is something called multiple jeopardy. And you may very well have heard me talk about this. We we go on about this quite a bit. Okay, Multiple jeopardy is where you can have a single incident and out of that single incident a whole range of different interested parties, different investigations, different outcomes of investigations. Just because you're innocent of a crime revolving that incident doesn't mean that you're not going to be potentially found on 50 practice. Okay? They're independent of each other, and that's very, very important. It means that these things can become quite complicated. And that's all I really want to say about it. Okay, get advice. Make sure you follow all the right rules right from the beginning. That's the best advice I can give you right now. Okay? All right. But it's not all gonna happen to you. It's just in case. Rather safe than sorry. So we've done for you to responses again. This is based on our experience. So, please, you know, we do know what you're talking about. The first response is what we do see. Sometimes it is not something we would advise, but we've made it here for you, so you can kind of see what's likely to happen. Okay, so there's some speculation going on here, of course, but it is based on experience. So first response I've been asked to reduce the statement in response to Mr X is complaint. I was asked to see him by the nursing staff to confirm some details on his discharge prescription. The nursing staff did not report to me that he was short of breath. I've written in the I've written that The patient told me he felt short of breath. But I recall that his observation was normal and that had been cleared for discharge on the ward around earlier the same day. I do not consider that it was anything else that I needed to do. Okay, So very straightforward, very plain. But it doesn't It doesn't do those four things. It doesn't show empathy. There's no apology. It doesn't really get an explanation of what was going on more. Oh, they didn't tell me or I assume things okay. And also, you know, there's no real remedy. The doctor here doesn't say that he thinks he should have done anything any differently, so that, unfortunately, is not going to sit well with the patient to get that. So what the hospital will do if that's the statement that you provide is they could very well include the statement as it is in the response to the patient, which means the patient is going to read that they're not going to be happy with that, okay? They're just not so. If they're not happy with that, either they're going to lose faith in the investigation process itself, escalate things to the ombudsman. Or they could potentially, of course, refer that particular doctor to the GMC as well. This patient has suffered harm. So it is possible that they could to the hospital as well just to kind of demonstrate the multiple jeopardy of how things can escalate. And, of course, you know that kind of response. You may very well have, uh, you know, your employer investigate you as well as part of the disciplinary proceedings. Okay, So to show you outcome one, lots of different things can happen. Okay, So our job and what we try to do is make sure that if there's going to be a complaint, we try our best to make sure that it doesn't escalate into anything else. And one of the best ways you can do that is by providing a proper response. Okay, Because again, imagine the patient now reading this one, and I've highlighted for you all the important words that are in there. And I want you to think about those four things again. Think about apology. Think about explanation. Think about remedy and all of the and empathy as well. Okay, so think about those things. I was sorry to hear if Mr. X complaint, I have reflected on my interaction with him, and I recognized that it could have dealt with this differently. I was asked to see him about his discharge prescription. During our conversation, he mentioned that he fell short of breath. I recall that I checked his most recent labs. Um, and all of them, including his oxygen saturations, were normal. I was really sure that he'd seen been seen shortly before the war ground and cleared for discharge. I cannot be certain that I examined his chest and I've not recorded that I did so So therefore I think that he must be correct. And then I didn't do it. Okay, that's a big thing. I reflected at length on this consultation and discussed it with my educational supervisor and recorded it in my portfolio. I recognized that I was falsely reassured by the discharge decision made on the ward ground. And I didn't assess Mr X as I normally would. I accept that an examination of his chest would have been indicated and further assessment of his current oxygen saturations. I wish to offer my sincere apologies to the patient that I did not do this at the time. As a result of this complaint, I reviewed the hospital guidance on VT. Everybody had to do that and completed an online CPD module on the assessment of pulmonary embolism. I have reviewed my record keeping and asked my educational supervisor for help to audit. My records was very sorry to hear that he was readmitted and I wish him a full and speedy recovery. Okay, an absolute mouthful. You may very well feel that that's overkill, but imagine you're the patient. I think you'll agree that that's a much better response and that you'll probably have a lot more empathy with Doctor who wrote that. Okay, so, ideally, a good response will mean that the hospital can include that As part of the statement, the patient will be happy without not escalate things. Okay, of course, whether or not they sue because they need the money in order for future treatments, that that's not up to you and that's not against you personally, anyway. Okay, You've done everything you can hear to contain this, to stop it escalating into other areas. And as I said before, I think that's the most important way you can actually look after yourself. Okay, then we're going to talk about reflection just to kind of finish things off. Because reflection, just like dealing with a complaint well again is one of the most important things that you can do to show your professionalism. As a doctor, the GMC is really, really clear. You must reflect on all aspects of your professional work. This should be informed by a discussion with others specific specific evidence data from audits, complaints, compliments. Okay. And you should get the feedback and things not just from your colleagues, but also from your patients. Okay. And I think that's really, really important to kind of think about. This is the reflective practitioner, which is the guidance that you guys should adhere to when it comes to your reflective notes and everything. And I think it's really important that you if you don't have a copy, make sure you do. It's a good one to read through, and I think we've taken a few quotes out for you just because of kind of the stuff that's been in the news and all of that. But it's very, very important to see that the GMC very, very much says quite clearly that they will not ask you to produce reflective statements. Reflective notes. Um, as you know, they won't use those against you as such. Okay, on the flip side of that, I think it's really important as well for you guys to realize that your reflective notes can actually be used to prove that you have learned lessons and done things and fix things. Okay, so make sure you give your reflective notes the right the right attention and focus that you should. It's an important part of your training. And as I said before, if something does go wrong and you find out about ages later, if you have a reflective note and evidence to show that you learned your lesson back then, and you've been doing things differently since then, in that case isn't going to go anywhere. Okay, all right. So how to approach reflective notes again? It's really important to think about you know what is the issues? What have you reflected on, you know? What are you doing? As a result of your reflection, it does not have to be really in depth things. You know, You put as much as you want into it as you want to show. Okay? But it's really important also to think about, you know, what are you going to do? Different in the future? How are you going to make sure you do it? And do you have any learning tips for your colleagues? Okay, it's important that you share your information because you don't really want to have to have patients go through exactly the same issue for your colleague to to learn the lessons as well. Okay, so make sure you do share the knowledge and then very last thing. I'm just going to say how to avoid complaints. Um, we call it the Seven Seas. Right? So bear with me. Number one competence, it's extremely important that you know the limits of your competence and that you stick to it. Okay, This year in particular, you know, a lot of doctors, you know, if one's are very, very worried that they're gonna potentially show different competence levels because of you know, the lack of clinical experience over the last year and things like that. So if you're missing something, if you're not confident, speak up straight away. Okay? Don't pretend to know things that you don't. It's the worst thing. You can do communication. Work on it all the time, come up with things that work. Okay, So the communication with your colleagues with your patients, you know, handovers record keeping all of those different elements find a way that works. Well, communication has to be effective. Otherwise, what's the point? Okay. Consent. Explain things really, really clearly to your patients. Risks and benefits. Check their understanding and check their consent and understanding all the way through. Okay, Um, it's not just a one off. Right at the beginning. Chaperones, You know, offer a chaperone for every intimate examination, if you can. It is the gold standard. Make sure that your chaperone is qualified. Person. Okay. Document any discussion about it? Especially if patients tell you that they don't want a chaperone. Okay, just make sure you keep a kind of note on it. It's one of the areas where complaints come from. Okay. Uh, confidentiality again. One of The easiest things to accidentally do is to breach confidentiality. Make sure you know you're speaking to make sure that you look after data. Okay? All these lists you guys are walking around with all the time, treat them with respect. Make sure you shred things. If something goes missing, own up to it straight away. Okay? The hospital. I can deal with damage. Much better if they know it's happened. Okay, Don't. It will always come back to you eventually. So please don't try and hide if you've lost something, okay? And don't think take information off site unless you have permission to do so. Clinical records again. I can speak to you for an hour and clinical records, but it is the most important tool that you have. Not just your patients, but for you to protect yourself with as well. You will get better at it. You will get obviously practice makes perfect. Okay, But remember, clinical records. You need to kind of come up again, come up with a good thing, a good way of doing things and rather safe than Sorry. Definitely. Okay. Lastly, customer service, You know, just remember that you have to treat your patients the way you would like to be treated. And you have to allow for the fact that some days you're not going to be 100% on your game. So if that's the case, then make sure you, uh do you deal with it, okay, Or at least acknowledge it. Because if you know it's happening, then you can deal with it, okay? And that's me. I'm going to stop sharing. And I'm happy to take any questions at this point. Thank you very much. Lose on that was such an interesting and informative presentation, which I'm sure is going to be useful for, uh, doctors and computer doctors. Um, I found it very, very interesting myself. Um, we don't really have any questions in the chat. Anyone can think of any questions, it would be amazing if you can put the questions in the chat now. And in the meantime, I'm going to share my screen with the feedback form. So give everyone a couple of minutes, um, to think about any questions they might have Let me just share an ice cream, so you should always see the feedback for him. Now, I'm also going to print the I'm going to post the feedback link in the chat and, well, let me just have a look at the chat. And so I think somebody is asking about what the remedy remedy would be. Would you mind just letting us know which case you're referring to? I think it was a med who asked the question. Mhm. So, um, it is asking, Um, he said that one of the cases, the response that you quoted the language use was very apologetic, and he acknowledges that apology is not a mission or blame. But he's asking whether there is any limit on how apologetic one should signed when replying. I think as long as it's honest and from the heart, you know, you don't want to kind of overdue it to a point, the patient feels that you're potentially not being truthful. Okay, um, I think there there's there's no limit to how apologetic you should be. You know, I think apologizing once is absolutely fine. But if you feel you want to apologize twice, that's good. Maybe three times will be seen as harassment, so I would very much just kind of say, you know, it depends on the very, very specific thing. Okay, but generally I would say, Say sorry once. Just make sure you do it in a way that the patient can appreciate it. Okay. And if it's heartfelt and you've really thought it through and you've told him why you're sorry, then that's absolutely fine. Okay? But yeah, it's very hard to say, once or twice. Okay, number, anything like that. I think I completely agree. I feel like if the person he's apologizing is being honest, and there shouldn't be any limit to how there is no quantifiable way or I don't think that the thing is as well you might, you might even, you know, if you're very unlucky, you might find yourself in a very kind of contentious or serious case where the consultant where you don't get to apologize, you know, they may take the apology to only be done by the consultant because it has to be that high up. And you may not get to apologize yourself. You know, this is more thinking about, you know, don't be scared to apologize. There's no reason in the world that I can't You just can't just say it You know, it comes quite naturally if you feel it. Mhm. Thank you so much. Does anyone have any other questions? Please feel free to put them in the chart. And if they come to your mind at any point, just please messages on Facebook. Thank you so much, Roseanne. And very, very useful. Just a reminder for everyone to please please fit in the feedback for, um and just be as specific as you can, because that will help us improve the future. Webinars. Um and that's it from us today. Um, we would like to just remind you to join us for the session next week and please join the Tuesday sessions on the Finance Medic. And that's it for me. Is there anything like you'd like to add those on? That sounds good to me. Thank you. Thank you very much.