What is the impact of COVID-19 on complaints against doctors?

Editor – The COVID-19 pandemic is causing unprecedented demand upon healthcare services across the world. This had led to a multitude of changes such as the cancellation of hospital visiting, suspending elective work, redeployment, shielding, working from home etc. Many patients died alone in hospitals, causing tremendous distress and anguish to families. In addition, a significant number of patients died due to nosocomial COVID-19 infection.^1,2 So, what impact did these changes have on concerns against healthcare services? To explore this, we analysed the data available in the public domain on complaints against medical practitioners in the UK.

The number of complaints recorded by NHS England in the first quarter of 2020 (April–June) that coincided with the first peak of the pandemic was significantly fewer than compared with the previous year (14,142 vs 28, 849).³ However, the numbers gradually increased in the next three quarters, but was still lower than the previous years (Table 1). In Scotland, the number of complaints fell from 32,438 in 2019–2020 to 24,905 in 2020–2021 (Table 2).⁴ Also, the number of doctors referred to the General Medical Council (GMC) in 2020 was the lowest reported since 2014.⁵ Unfortunately, we were unable to get data for Wales and Northern Ireland despite an extensive search and contacting the relevant bodies.

In view of the terse data available, we could only speculate the reasons behind this pattern. Firstly, at the beginning of the pandemic there was a great sense of appreciation and empathy towards keyworkers, especially for healthcare workers. One example of this was when the nation cohesively stood out once a week to demonstrate their appreciation. Secondly, a reduction in the number of elective activities and fewer interventions meant that fewer complications resulted in fewer complaints. Lastly, when healthcare professionals were redeployed to take on roles that were outside their expertise, the GMC issued guidance on when one should be referred regarding concerns on their fitness to practice.⁶

The initial dip in complaints was followed by a gradual increase due to poor communication; suspended visiting; nosocomial COVID-19 infections; inadequate care due to staff shortages caused by sickness and isolation; frequent last-minute cancellations of procedures; and waning sympathy. The latest report from the GMC revealed that two-thirds (65%) of doctors have struggled to provide a sufficient level of care to patients due to high workload and burnout.⁷

A survey involving primary care clinicians revealed that two-thirds feared facing a complaint and more than a third had already received a complaint related to the pandemic.⁸ The commonest reasons quoted were increased waiting times, delays in accessing tests, poor communication and online consultation. It is likely that complaints would continue to increase unless we find an effective way of dealing with the effects of the pandemic.