Patient complaints and angry relatives are a reality of NHS practice, and the panel wants to see that you can handle these situations with empathy, professionalism, and a clear understanding of the formal processes involved.
De-Escalation Principles
When facing an angry or upset patient or relative, your immediate priorities are: ensure safety (for yourself, the patient, and others), remain calm and composed, use a low, steady voice, acknowledge the person’s feelings (“I can see you are very upset, and I understand why”), actively listen without interrupting, and avoid being defensive. The SAGE & THYME model (developed by Manchester University NHS Foundation Trust) provides a useful communication framework: Setting — find a private, appropriate space. Ask — “Would you like to tell me what has happened?” Gather — listen and gather information. Empathise — “I can understand why you feel that way.” Then: Talk — ask what would help. Help — offer practical solutions or next steps. You — bring it back to the patient’s needs. Me — offer appropriate follow-up. End — summarise and close.
The NHS Complaints Process
Every NHS trust has a formal complaints procedure, and you should be aware of the key stages. Stage 1: Informal resolution — many complaints can be resolved at ward level through explanation, apology, and direct communication. The Patient Advice and Liaison Service (PALS) exists in every trust to help resolve concerns informally. Stage 2: Formal complaint — if the patient or relative is not satisfied with the informal resolution, they can submit a formal written complaint. The trust has a duty to investigate and respond within a specified timeframe (usually 25–40 working days, depending on the trust). Stage 3: If the complainant remains dissatisfied, they can escalate to the Parliamentary and Health Service Ombudsman (PHSO), which is the independent body that investigates complaints about NHS services in England.
Duty of Candour in Practice
The Duty of Candour is both a professional obligation (GMC Good Medical Practice 2024, Domain 4) and a statutory requirement (CQC Regulation 20, Health and Social Care Act 2008). It applies when a “notifiable safety incident” has occurred — defined as an unintended or unexpected event that resulted in, or could have resulted in, harm to the patient. The statutory Duty of Candour requires healthcare organisations to: notify the patient (or their family) as soon as reasonably practicable after the incident, provide a truthful account of what happened, apologise (an apology is not an admission of liability — this is protected under Section 2 of the Compensation Act 2006), provide a written explanation of the incident, and document the conversation and the notification. In your interview answer, being able to reference the Duty of Candour by name and explain its practical application is a significant scoring point.
Worked example: “A relative is angry because their mother’s diagnosis was delayed by 24 hours. I would find a quiet, private room, introduce myself, sit down at the same level as the relative, and listen to their concerns without interrupting. I would acknowledge their distress and apologise sincerely for their experience. I would explain what happened honestly, in line with the Duty of Candour, and outline what steps are being taken to investigate and prevent a recurrence. I would offer to involve PALS if they wished to make a formal complaint, and ensure they know how to contact me or the department for follow-up.”