Mr H was a senior consultant general and breast surgeon who worked in a district general hospital. He was recognised by his colleagues as an expert in breast surgery and an informal arrangement was put in place to transfer all patients with breast problems to Mr H. This arrangement was endorsed by the hospital clinical director but was not formally agreed...

Dr J is a specialist plastic surgeon working in the private sector in the UK. He prides himself on giving patients a full and frank explanation of the likely outcome, potential complications and expected cosmetic appearance of surgery.

Complaints in health and social care: standards and guidelines for resolution and learning (2009) aims to provide a simple, consistent approach for staff who handle complaints, and for patients who raise complaints across all health and social care services.

Miss B was a 20-year-old university student who had suffered marked breast asymmetry since puberty. As she got older the problem started to cause her real embarrassment in social relationships. She made an appointment to see Mr M, a local consultant plastic surgeon, and took her sister along for moral support.

Twenty-year-old Miss D was referred to orthopaedic consultant Mr A for assessment of an old clavicle fracture. Two years previously, Miss D had sustained a clavicle fracture after falling off her bike. This injury was treated in a different hospital in a conservative way, using a collar and cuff sling. In the early follow-up period, she moved to her current address and she was lost to further review.

Ms C, a 30-year-old hotel receptionist, went privately to see Mr T, a plastic surgeon to discuss surgery to change the appearance of her nose. She had been unhappy with its appearance for a number of years, and finally decided to have a rhinoplasty. Mr T explained the risks and benefits of the operation as well as the limitations of surgery.

Mrs J, a 42-year-old mother of two children aged 14 and 12, attended a private cosmetic surgery clinic for a consultation after seeing the clinic’s advertisement in the back pages of a lifestyle magazine.

Dr H, an orthopaedic specialist, was operating to remove metalwork from the leg of Miss P, a dancer in her twenties.