Risk adviser Alan Frame looks at how a considered apology to a patient when things go wrong can oſten defuse a fraught face-to-face encounter


For want of an apology S


ORRY does indeed seem to be the hardest word – or so the Parliamentary and Health Service


Ombudsman (PHSO) has said in a recent report on how well GP practices in England deal with patient complaints. Based on an analysis of 137 closed


complaint cases involving general practices, PHSO investigators found that the quality of complaint handling was rated as “Needs improvement” in 36 per cent and “Inadequate” in 10 per cent. In particular the review concluded that in a third of cases staff did not provide an adequate apology where appropriate, and the apologies offered were not always sincere. Tis is all the more surprising given the


host of recent legislative and professional measures requiring professionals to be open


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and honest with patients and to offer an apology when care or treatment goes wrong. In 2014 a statutory duty of candour was introduced applying to all healthcare providers in England and last year the GMC released new guidance on the professional obligation of all doctors to be open and honest with patients when mistakes are made that have compromised – or could have compromised – patient safety. Te Scottish Parliament has also recently passed a bill with the aim of ensuring that an apology does not amount to an admission of liability and is inadmissible as evidence in certain legal proceedings. Medical and dental defence


organisations have also continually stated that saying sorry is not an admission of legal liability. Indeed, in our experience, a


sincere apology can and does prevent a patient complaint from escalating further, and saying sorry should not be viewed as a sign of weakness. In fact, most times it is the right thing to do and a genuine apology may be all that a patient wants.


No caveats So what does the PHSO consider to be a sincere apology? In the report it found that practices responding to complaints oſten used the phrases: “I’m sorry but” or “I’m sorry if”. While these convey an apology of sorts, it is oſten a very qualified one. An example cited in the report is where a practice manager apologises that she might have been “perceived” as being rude or dismissive but goes on to defend her poor attitude as a “human frailty” which


SUMMONS


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