December 2024 - Dealing with complaints

Whilst clinical professionals are committed to providing excellent care, complaints can and do arise. The General Optical Council's requirements for Approved Qualifications in Optometry or Dispensing Optics Outcome O5.2 places an obligation on optometrists and dispensing opticians to know how to manage a complaint, incident or error in an effective manner. 

Common complaints often relate to incorrect prescriptions, fees, eye examination concerns, prescriptions dispensed by a different practice or the diagnosis or management of a clinical condition.[1]  Complaints may also arise between colleagues, learners and supervisors so it is essential to be equipped with skills to deal with these different situations. The General Optical Council also advises that education and training should form a safe space for students to develop and learn and they would expect complaints that may give rise to concerns about a student’s fitness to train to be considered in the first instance under the provider’s local disciplinary process. Effective learning will include mistakes being made by students. The General Optical Council do not consider it necessary to treat all mistakes as constituting a potential impairment of fitness to undertake training in accordance with section 13D(2) of the Act.

Why handling complaints matters

In many instances, it is not always the initial complaint that raises issues, moreover the way in which it was handled. Handling complaints is a vital skill for students to master as they transition into professional practice. Complaints are often opportunities for improvement and addressing concerns effectively can:

  • Reinforce trust between practitioner and patient and increase patient satisfaction
  • Highlight areas for personal or clinic-wide improvement and ensure that students enter the workforce with the confidence to handle difficult situations effectively
  • Prevent escalation of minor issues into formal disputes and reduce the risk of legal issues

Teaching optometry and ophthalmic dispensing learners how to approach complaints requires a structured curriculum, practical exercises, and mentorship. In addition to lectures and workshops, further ways to incorporate this into the curriculum include:

  • Simulation - using videos to record students or virtual reality simulations to create scenarios and allow learners to review their performance and identify strengths and weaknesses in a controlled, supportive environment. Provide constructive feedback, highlighting areas for improvement whilst also commending effective strategies.
  • Case studies - present students with real-life case studies and discuss how the complaint was resolved and its effectiveness. Consider alternative approaches that might have improved the outcome. Highlight circumstances in which poorly handled complaints can escalate to legal disputes.
  • Real-time feedback - within clinical placements, provide immediate feedback on how a student has handled a particular situation and ensure that they reflect and self-evaluate. Allow them to observe other colleagues managing complaints.
  • Guest speakers - such as practicing optometrists or experts in the field of patient relations.
  • Written exercises - ask students to write a response to a patient complaint, practising professional tone and empathy.
It is rarely poor clinical performance. Escalation to the OCCS is often driven by the expression, ‘It’s not the fact it’s how you react.’

No one should be discriminated against for raising a complaint, and handling complaints sensitively, professionally and in accordance with good practice is a key responsibility of optometrists and dispensing opticians. 

Failure to respond to peoples' expectations when they complain brings with it the risk of continuing dissatisfaction.[2]

Facing a complaint can be a distressing and sometimes intimidating experience that can consume a great deal of time and emotion. 

These tips can help the process:

  • Active listening - encourage learners to allow the patient to explain their concerns fully without interruption and listen. If possible and appropriate students should also make notes. Also advise students on the effective use of  empathetic language to show they understand their feelings.
  • Learners should acknowledge the issue - validate their patient's feelings and let them know their concerns are taken seriously. Where possible, learners must avoid taking anything personally or be defensive; instead, they should try to understand that the patient is frustrated or upset at the situation and express a willingness to help. Developing skills in resilience, as discussed in December 2023's topic is important for this.
  • Encourage students to use use clarifying questions to establish the facts as well as helping them understand the nature of the complaint. Questions can can also help redirect the patient's attention from their emotions to the facts. Learners must always document the complaint accurately, noting any specifics.
  • Encourage students to express empathy and honesty. They must be realistic about what they are able to do and how long it will take.
  • Work with students to investigate - look into the issue to determine if it’s a misunderstanding, a mistake, or a legitimate concern. During this process, students should review patient records and consult with relevant staff if necessary. It is also important to keep patients (and carers or family where appropriate) informed of the process. Providing updates to let them know the next steps of the complaint process and progress ensures the patient knows what is happening and when to expect further communication.
  • Respond - once the student has all the information, they must explain their findings to the patient clearly and respectfully.
  • What do do if there is an error - students should be encouraged to be transparent, take responsibility and explain how it will be addressed. June's topic feature looks at Duty of Candour and advises how to teach students what to do when things go wrong.
  • Provide students with skills to propose possible resolutions but also to be flexible and open to suggestions from the patient as well.
  • Follow up - this is sometimes forgotten but is almost as important as dealing with the complaint. After resolving the issue, students must check back with the patient to ensure they are satisfied with the solution. This not only provides closure but shows they value the patient's experience.
  • Students must be reminded to document the complaint - this is a valuable learning exercise and can also help with clinical audits.
  • Encourage student reflection - they should make use of feedback to identify future areas for development. Reflective practice can turn complaints into opportunities for improvement and build stronger relationships with patients.
  • Remind students to remain professional - whilst it may sometimes be hard to regulate emotions when faced with a tense situation, learners must be encouraged to maintain a calm demeanour throughout the process, regardless of the patient’s attitude. Where possible, deal with the complaint within a practice and de-escalate where possible. This might not always be possible and there may be situations where complaints need referring to the Optical Consumer Complaints Service.
  • Ensure students are familiar with the NHS regulations, understand consent and confidentiality. Know when to ask for help.
  • Use available resources such as the Optical Consumer Complaints Service (OCCS) to help resolve complaints that cannot be resolved inhouse.

As AOP’s head of clinical and regulatory, Henry Leonard summarises: Listen, communicate clearly and seek advice from your indemnity provider or professional body if a complaint is made formal.

Whilst most concerns can usually be resolved informally, it is important that learners are informed of the Optical Consumer Complaints Service (OCCS) who can help and offer mediation if a consumer and the optical practice cannot resolve the complaint within the practice. Learners should be made aware that this free service, funded by the GOC, is completely impartial and can ensure that each complaint is considered fairly so that it can be resolved allowing everyone to move on.

Effective complaint management is the basis of patient-centred optometric care. By encouraging empathy, teaching structured responses, and providing opportunities for learners to practice these skills, educators can prepare students to handle complaints with confidence and professionalism. With these skills, future optometrists and dispensing opticians can build stronger patient relationships, contribute to clinic success, and continuously grow as compassionate healthcare providers.

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References and bibliography

[1] Powell. Selina, 16 June 2021, Managing complaints, Optometry Today

[2] Allsop.J and Mulcahy.L, Quality in Health Care 1995, Dealing with Clinical Complaints

Allsop.J and Mulcahy.L, Quality in Health Care 1995, Dealing with clinical complaints 

Association of Optometrists, Dealing with complaints

ABDO, Professional complaints handling

ABDO, OC Guidance on Managing Non-Tolerance Issues

College of Optometrists, Dealing with complaints

The NHS Scotland Complaints Handling Procedure, Scottish Government NHS Model Complaints Handling Procedure

Optical Consumer Complaints Service Optical Professionals - Optical Complaints