Complaints and significant events: Support for GPs

Understanding the terms

It is helpful to know the difference between a complaint and a significant event.

What is a complaint?

A complaint is when a patient, or someone acting on their behalf, expresses dissatisfaction with the care they received. Practices have a formal procedure to handle and respond to complaints.

What is a significant event?

Your first steps after an incident

If you are involved in a complaint or significant event, it is important to get support quickly.

Take these immediate steps:

1. Acknowledge what has happened—Try to stay calm. Do not attempt to manage the situation by yourself.
2. Speak to a colleague—Talk to a trusted partner in your practice, your appraiser, or a peer.
3. Contact your defence organisation—This is essential. They will provide expert medico-legal advice.
4. Inform your practice manager—Your practice needs to be aware so they can follow the correct procedures.

Taking these steps will help you get the right support from the start.

Where to find support

Different organisations provide different types of help. It is important to know who to contact.

Medico-legal and indemnity support

Your medical defence organisation (such as MDDUS, MDU, or MPS) is your first point of contact for legal advice. They will represent you and guide you through any formal processes.

State-backed indemnity (CNORIS) 

If you are a board-employed GP or you hold a direct contract with an Out of Hours (OOH) service, you are also covered by the CNORIS indemnity scheme.

However, CNORIS does not cover all OOH work. Coverage depends on your employment status:

• Contracted GPs—If you hold a contract with a health board, you are covered by CNORIS.
• Locum GPs—If you are doing a locum shift, you are not covered by CNORIS. You must ensure you have your own full medical indemnity in place.

Peer and emotional support

Dealing with an incident can be emotionally challenging. You may experience the 'Second Victim' phenomenon.

What is the 'second victim' phenomenon?

This term describes healthcare workers who are involved in an unanticipated adverse patient event or medical error and become traumatised by the experience. Feeling this way is a common reaction to a stressful event, but it is vital to recognise it and seek help.

Confidential support is available from:

• Second victim support—A website dedicated to supporting healthcare professionals involved in patient safety incidents.
• BMA counselling—A free 24/7 counselling service, open to all doctors.
• Doctors in Distress—Join a facilitated peer support group to share your experiences safely. 
• Your Local Medical Committee (LMC)—Can provide support and connect you with a peer. View a list of Scottish LMCs on the BMA website.

These services understand the pressures that doctors face.

Support from your employer

Your practice or NHS Scotland employer has a duty of care to support you through this process. They should have clear, supportive procedures in place for managing complaints and significant events.

Learning from events to improve care

The goal of a Significant Event Analysis (SEA) is to learn, not to blame. The process involves a structured review with your team. This is to understand what happened and what could be changed to improve patient safety in the future.

Discussing SEAs and complaints at your annual appraisal is a key part of your professional development. You’ll find SEA guidance and tools on Turas Learn.