Educational Supervision & ARCP
Complaints are becoming more frequent in the NHS. As TPDs, we often get asked whether a complaint should be detailed on a Form R or not. This web page will outline some important considerations if you are involved in a complaint (even as a third party) and where to document it in your ePortfolio.
Why reflecting on a complaint is important
Although going through a complaint is a distressing time for most of us, a lot can usually be learnt from reflecting on it properly. It’s far to easy (and often wrong) to automatically blame someone else or even the patient. But actually, when a significant event happens where something big has gone wrong, it’s usually the result of a number of smaller things going wrong at the same time. Some of you may have heard of the Swiss Cheese analogy – which says that with most things in life there will always be holes here and there but things go massively wrong if these holes end up in alignment. So, the idea is to reflect on the event in order to identify and understand these other ‘holes’ to see what we can learn from them and what additional measures can be put in place to reduce the chances of the negative event from happening again.
Should I detail a complaint on a Form R?
The Form R is really for big significant complaints – the sort of things that may need GMC/Deanery/Hospital Senior Management consideration or input. You should always inform your Clinical and Educational Supervisor about these. You should also seek guidance from your TPD advisor. In addition to detailing them on the Form R, there should be a reflective learning log entry about them – providing background information, your reflections and learning points. Your Supervisors should write an Educator’s Note about them as well as ticking the box about the presence of a complain in both the ESR and CSR. ARCP panels will mainly be looking to see (i) if these complaints have been resolved, (ii) what the event says about your performance in terms of the professional competencies and (iii) whether you have satisfactorily reflected on them in a meaningful way. Remember to keep names and people out – keep things anonymous. People should not be identifiable.
If you have any concerns about documenting a complaint and the legal consequences of doing so – please speak to your TPD first.
How to deal with a significant complaint...
- The trainee should inform both his Clinical and Educational Supervisor
- The trainee should write a reflective learning log entry to it e.g. what have they learnt from it (note: even if the doctor in question is not at major fault, there is always some learning about oneself or the organisation that can be gained from these type of events). In the title of your learning log entry, prefix with ‘Complaint: blah blah blah’ – so it can be easily identifiable by others in the future.
- On both the CSR and the ESR there is a box to say whether the supervisor is aware of any complaints. The supervisors need to tick this box. They should also read the reflective learning log entry (in point 2) and signpost the learning log entry in the free text box by way of a date. They should consider writing a comment or two about it in the free text box (if not already done so as a comment to the log entry itself).
- It might be worthwhile putting a note in the Educator’s Note (there is no harm in duplication).
- Make sure you keep the ePortfolio updated in terms of what is happening about the complaint until it is resolved.
- If the complaint escalates to a higher level, inform the TPD advisor for the trainee and review whether it needs to be declared on the Form R.