Given the vast majority of patients leave their optometric examinations satisfied with their experience, practitioners may sometimes forget that there’s still a proportion for whom this isn’t the case – 12%, according to the General Optical Council (GOC)’s latest research.1
The most severe of these unsatisfactory experiences, those requiring external mediation, were reported in the Optical Consumer Complaints Service (OCCS)’s latest annual report,2 providing insights on both what can go wrong alongside how such problems can be resolved effectively.
Throughout the latest reporting period, the OCCS received 1,757 enquiries, with 1,675 falling within the service’s remit. Although up 3% from the previous 12 months, Sue Clark, consultant at Nockolds Solicitors, which delivers the OCCS, explains that this isn’t necessarily cause for concern. ‘The numbers aren’t up significantly year-on-year,’ she says. ‘The key moves are a reduction in concerns relating to misdiagnosis over the last two years, from over 60 to 33. Conversely, complaints relating to domiciliary provision have doubled in the last year, a growing concern given the vulnerable nature of many domiciliary consumers.’
Another area highlighted is prescription error complaints, which rose from 183 to 230. Although a large increase, more of these concerns were resolved at an earlier point than before, highlighting the importance of effective communication with patients. ‘Prescription non-tolerance is unsurprisingly a significant proportion of our workload,’ Clark explains. ‘Beesley, Davey, and Elliott at Bradford University published a study highlighting some common prescribing errors and causes of non-tolerance. It’s a great place to start for avoiding such problems from the outset.
‘However, many OCCS cases occur due to breakdowns in communication and trust. Of course, this must be underpinned by a robust, well-understood complaint handling policy.’
Complaint mitigation
The GOC echoes the value of effective and accessible communication in not only enabling patients to understand and safely engage with their optical health, but also preventing potential issues from being amplified.4
‘Optical professionals and businesses have a duty to communicate clearly to patients so that they know what they can expect from their care and have a realistic understanding of what can be provided, and manage their expectations,’ Pauline Whitelaw, GOC policy manager of standards, says.
‘It’s also important to show care and compassion to patients, to treat others with dignity, and show empathy and respect. Respond with humanity and kindness to circumstances where patients, their family, or carers may experience pain, distress, or anxiety. Often, this goes a long way to diffusing a tricky situation,’ she continues.
However, communication isn’t a one-way street. ‘When patients struggle with finding a resolution, it’s usually because they don’t feel their concerns are understood and taken seriously,’ explains Denise Voon, clinical adviser at the College of Optometrists.
‘What may appear to be a problematic patient may actually be one who is struggling to be heard. Empathetic listening, and listening to understand can make a big difference. Sometimes repeating back what you understand to be the concern can demonstrate you are taking patients’ issues seriously.’
When it comes to prescription non-tolerance, it’s also crucial to take note of signals indicative of problems. ‘On collection, look out for any spoken and non-spoken signs that may indicate that a patient may be struggling, such as having to move their head a lot to see clearly, or frowning when trying to focus,’ Voon says.
‘Additionally, a patient needing to adjust their working distance from their usual distance could further indicate their varifocals aren’t quite working for them. It’s important to listen carefully to patient concerns to differentiate lens adaptation issues with systems, which could be due to pathology or intolerance to a change in prescription.’
Towards resolution
What should you do if a complaint is raised? ‘The first thing is not to panic and become defensive,’ Voon advises. ‘If a patient complains about the treatment they received, they have a right for their complaint to be heard and dealt with in a sensitive and timely manner. Doing so can avoid the complaint escalating.’
Complaints should be investigated thoroughly and, where possible, a solution offered – this may include apologising. ‘Always consider the Duty of Candour,5 and whether you should offer an apology to the patient for the distress and inconvenience that they may have suffered,’ she says. ‘Remember, an apology doesn’t mean you are admitting responsibility, it’s a way of showing your concern and understanding.’
If a mutually agreeable resolution can’t be reached informally, then your formal complaints procedure should be adhered to – and should be made available to patients. ‘If you exhaust your internal complaints procedure, you could refer the patient to an independent arbiter such as the OCCS,’ explains Voon.
Although nobody aims to have patients raise complaints, she emphasises that it’s important to view them not as an attack, but instead as learning opportunities. ‘Even if you conclude that your clinical management was adequate, lessons on communication can always be learnt.’
References
- https://optical.org/media/f2uhi05d/goc_9485_public-perceptions-research_report.pdf
- https://www.vetmediation.co.uk/app/uploads/sites/2/2024/06/OCCS-Annual-Report-2023-24-v3.pdf
- https://onlinelibrary.wiley.com/doi/10.1111/opo.12961
- https://optical.org/media/201flx0e/standards_of_practice_for_optoms_dos.pdf
- https://optical.org/media/e0xduxzt/supplementary_guidance_on_the_professional_duty_of_candour.pdf
