More to do on NHS complaints

21 January 2015

The Health Select Committee concludes that, while patient safety and the treatment of complaints and concerns have become high profile issues in the last few years, this is only the beginning of a process of change with significant scope for further improvement.

The MPs found that:

  • Most of those who complain about NHS services do not seek financial redress. They do so because they wish to have their concerns and experiences understood and for any failings to be acknowledged and put right so that others do not suffer the same avoidable harm. Where such errors occur, patients and their families deserve to be met with a system which is open to complaints, supports them through the process and which delivers a timely apology, explanation and a determination to learn from mistakes.
  • The current system for complaints handling however, remains variable. Too many complaints are mishandled with people encountering poor communication or, at worst, a defensive and complicated system which results in a complete breakdown in trust and a failure to improve patient safety.
  • The Committee welcomes the progress made since its last report and in this final report on complaints and concerns in this Parliament, it sets out an overview of the developments and recommendations to date as well as those expected in 2015. It also makes a number of recommendations where it feels further action is required.
  • In moving to a culture which welcomes complaints as a way of improving NHS services, the number of complaints about a provider, rather than being an indicator of failure, may highlight a service which has developed a positive culture of complaints handling and it will be important for system and professional regulators alike to be able to identify the difference.
  • Complaint handling remains overly complex and the Committee recommends a single gateway for raising complaints and concerns with clearer, adequately resourced arrangements for advocacy and support. 
  • The removal of primary care complaints handling from local areas has resulted in a disconnection from local knowledge and learning and led to unacceptable delays. The Committee recommends that this is rectified.
  • There is also a strong case for integrating complaints about health and social care under the same umbrella and this should start with a single rather than separate ombudsmen. There is now no excuse for any health or care organisations not to implement the recommendations of the 'My Expectations' report on first tier complaints as this has clearly set out a user led guide to best practice.
  • Just as the NHS is expected to respond in a timely, honest and open manner to patients or families raising complaints or concerns, we should expect the same for staff. The treatment of whistleblowers remains a stain on the reputation of the NHS and has led to unwarranted and inexcusable pain for a number of individuals. The treatment of those whistleblowers has not only caused them direct harm but has also undermined the willingness of others to come forward and this has ongoing implications for patient safety. Whilst the committee is clear that professionals have a duty to put patients first and to come forward with their concerns it recommends that those who have suffered harm as a result of doing so and whose actions are proven to have been vindicated, should be identified and receive an apology and practical redress.

The Chair of the Committee, Dr Sarah Wollaston MP, said:

"The Health Committee would like to thank NHS staff for their dedication and hard work on behalf of patients. This report does not seek to undermine their commitment but to make sure that where poor standards do occur, these can be identified and put right at the earliest opportunity for the benefit of patients and staff alike. Concerns and complaints are an important source of information for improving services and it is vital that the NHS continues on the path of changing the way that these are viewed and handled.

There can be no excuse for not implementing a complaints service which is easy to use and responsive to patients and their families but sadly the situation remains variable. We welcome the progress to date but make recommendations for further work in this area. In particular we recommend a single, easily identified gateway for complainants which can then make sure their complaint is handled by the most appropriate organisation. In the case of primary care for example, we do not feel that complaints should be investigated in an entirely different part of the country or plagued by delays.

Patients and staff do not complain for financial redress but because they seek an acknowledgment and explanation, a timely apology if appropriate and for the NHS to reduce the chance of avoidable harm to others. They and the NHS deserve our support to make sure that this can happen."

Further information 

Image: iStockphoto

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