Bridging the Gap Between Regulation and Reality

Understanding complaint-handling expectations from the CQC, GMC, and Parliamentary Ombudsman can protect your clinic and your patients. Here’s how HSCAMP helps bridge the gap between compliance and real-world practice.

Healthcare regulation in the UK is built on clear principles — safety, transparency, accountability, and learning. Yet many providers still struggle to interpret what regulators actually expect when it comes to complaint handling.

Between the Care Quality Commission (CQC), the General Medical Council (GMC), and the Parliamentary and Health Service Ombudsman (PHSO), the standards are robust but often complex.

HSCAMP (Health & Social Care Complaints Adjudication Management Partners) bridges this gap — turning regulatory frameworks into practical systems that protect both patients and professionals.

Why Regulation Matters in Complaint Handling

Complaint management isn’t just about customer service — it’s a statutory requirement tied to governance and professional conduct.

Failing to meet regulatory expectations can have serious consequences:

• Negative CQC inspection outcomes.
• GMC referrals or Fitness to Practise investigations.
• Escalation to the PHSO or even legal action.

By contrast, strong complaint systems demonstrate a “Well-Led” organisation that values safety and transparency — key CQC indicators.

1. The CQC: Complaint Handling as a Marker of Quality

The Care Quality Commission evaluates complaint handling under its “Well-Led” and “Responsive” domains.
Inspectors expect providers to:

• Have a clear and accessible complaints policy.
• Show timely, transparent, and empathetic responses.
• Provide evidence of learning and improvement.
• Involve patients and families in complaint resolution.

How HSCAMP Helps:
Our external adjudication pathway and certification system (Bronze, Silver, Gold) align directly with these domains.
By integrating HSCAMP processes, clinics can demonstrate:

• Independent review capability.
• Evidence of action plans and quality improvement following complaints.
• Compliance documentation ready for inspection.

2. The GMC: Professional Duty of Candour

The General Medical Council’s Good Medical Practice (2024 update) sets clear expectations for doctors:

• Be honest and open when things go wrong.
• Offer a meaningful apology and explanation.
• Use complaints and adverse events to improve systems and communication.

How HSCAMP Helps:
HSCAMP’s complaint management training modules include communication and duty of candour workshops.
By embedding these principles, clinicians reduce the risk of escalation and reinforce professional integrity.
Our adjudication process also provides structured, fair analysis — avoiding adversarial blame and ensuring GMC-aligned transparency.

3. The PHSO: Principles of Good Complaint Handling

The Parliamentary and Health Service Ombudsman outlines six fundamental principles:

1. Getting it right
2. Being customer-focused
3. Being open and accountable
4. Acting fairly and proportionately
5. Putting things right
6. Seeking continuous improvement

How HSCAMP Helps:
Our adjudication model mirrors these six principles.
Each case is assessed independently, outcomes are proportionate, and systemic learning is shared anonymously across the sector.
This not only meets Ombudsman expectations — it often prevents cases from needing escalation to them at all.

Bridging Regulation and Reality

While the frameworks are clear, implementation can be difficult in real-world clinical settings.
Common barriers include:

• Limited administrative capacity in smaller practices.
• Uncertainty over what constitutes a “formal complaint.”
• Lack of documentation or evidence trails.
• Staff anxiety about admitting fault.

HSCAMP provides a bridge:

• Standardised templates and tracking systems.
• External adjudication to manage complex or high-risk complaints.
• Training in communication, documentation, and resolution.
• Quarterly governance summaries for compliance review.

This transforms abstract regulation into practical compliance — ready for audit, inspection, or defence.

Case Example: Turning CQC Feedback into Strength

A cosmetic clinic received CQC feedback that its complaint records were incomplete and lacked evidence of learning.
After enrolling with HSCAMP:

• The clinic adopted our standardised complaint documentation and review template.
• Quarterly reports were used as part of CQC inspection evidence.
• HSCAMP adjudicated one unresolved case, producing an outcome letter that the CQC later cited as an example of good practice.

The result: a “Good” rating in “Well-Led” and “Responsive” domains during reinspection.

Conclusion

Regulatory compliance isn’t about bureaucracy — it’s about protecting patients, professionals, and the integrity of healthcare itself.

By aligning with CQC, GMC, and PHSO expectations, providers show that they are accountable, transparent, and committed to learning.

HSCAMP bridges the gap between regulation and reality — transforming complaint handling from a reactive task into a proactive governance strength.

Because good complaint management isn’t just compliance — it’s leadership.