This article reflects the conversations in the breakout group on this topic at the Recently Appointed Consultants symposium on Friday 13 March 2015.


It can be difficult to deal with negative feedback. Complaints are just a small part of a larger feedback process, but a disappointed, disaffected and angry relative can be difficult and time consuming to deal with.

Be proactive with patients and relations and defuse tension through early engagement and communication. Have an open discussion and listen carefully. Communication, behaviour and attitudes feature prominently in complaints and the emotional aspects of complaints, including the emotions of the staff involved, need to be taken in consideration.

In practice it is valuable to remember the 3 R’s. The 3 R’s are regret, reason and remedy. Express regret through an early, meaningful, genuine apology. An apology will help all concerned. Be candid, show empathy and attempt to connect on an emotional level. Apology can be an expression of empathy as well as regret and it should be heartfelt. It’s hard to apologise, but it doesn’t mean you are opening yourself up to later criticism or acceptance of guilt or responsibility. Forget about liability when explaining or apologising to patients and families. If you apologise this does not increase the risk of legal action. It is possible to use ‘I’ even if you are not directly involved and this is a good thing to do. For example ‘I feel sad/sorry. How do you feel?’ Recognise how negative feedback makes you feel and explain this to the complainant.

Offer an explanation or reason. Assess your own performance and the situation objectively rather than subjectively. It is important to be able to accept criticism and be able to be self-critical, but with an accurate self-awareness of any limitations and strengths. Look at all the other underlying causes that may have led to the complaint.

When discussing a remedy, manage expectations and be accountable. Complaints are rarely about taking legal action, rather ensuring lessons are learned. Ask the patients involved what they would like to happen next. Focus on what people hope to achieve by complaining.

Similar to the advice offered in “Human Factors and Critical Incidents” it is very important to separate any emotional processes you may need to go through surrounding the event and its aftermath. Seek help from a trusted friend, a mentor or your own GP. This does not mean you shouldn’t acknowledge these emotions, or that you cannot admit to experiencing them, however, any necessary learning is less likely to happen while raw emotions simmer beneath the surface unaddressed.

Breakout group leader: Dr Dorothy Armstrong, Professional Adviser to the Scottish Public Services Ombudsman & Director, DAPROFESSIONAL

Reviewed January 2018, final paragraph added September 2021.