NHS needs complaints handling revolution
An independent report commissioned by the Prime Minister and Secretary of State for Health, Jeremy Hunt calls for a revolution in the way in which the NHS handles complaints.
The report follows the highlighting of failings at Mid Staffordshire NHS Trust earlier this year and in particular the comments made by Robert Francis QC that complaints are a warning sign of problems in a hospital.
The report is based on a review which received 2,500 responses describing poor care and a lack of compassion and deep dissatisfaction with the way in which their complaints had been handled. The review panel also heard from people who had not complained because they felt the process was too confusing or they feared for their future care. Many were also concerned about the lack of independence in the current system.
The recommendations aim to improve the quality of care, address the causes of complaints, improve access and responsiveness of the complaints system, and ensure that hospitals adopt an entirely new attitude to complaints – as well as whistleblowing.
The review reflects on a “decade of failure” to reform the way in which complaints are handled, and demands urgent action in the next 12 months. To ensure there is real change as a result of the review, the review has taken the unusual step of securing undertakings from key health organisations to ensure that action will be taken within the next year.
The three main drivers for change will be:
- Consumer power – Consumer and patient bodies have agreed to work together locally and nationally to oversee and monitor implementation of the recommendations;
- Championing complaints reform – Mike Richards, the Chief Inspector of Hospitals, is making complaints a central part of CQC inspections of hospitals. He will develop standards for the handling of complaints by NHS organisations, ensure inspectors’ judgements are fully informed by what people say about the quality of care in a hospital, and publish his findings on complaints across hospitals in a year’s time;
- Concrete commitments from major NHS players – 12 organisations including the Royal College of Nursing, Health Education England, the General Medical Council, Monitor, CQC and NHS England have together signed up to nearly 30 actions to help improve the complaints culture across the NHS. For example, new guidance for nurses and reviewing training and education on complaints handling.
Tricia Hart, Chief Executive of South Tees Hospitals NHS Foundation Trust said:
We need a fundamental change in culture and we need transparency so that when things go wrong improvements are made to make sure it doesn’t happen again. But most of all we need action – and that is what sets today’s report apart. Leaders from across the NHS have signed up to concrete actions to start to do better on complaints.
The end goal has to be that the NHS provides better, safer, kinder care so that fewer patients feel like they want to complain. Listening to and acting on complaints now is essential to making that a reality.
Key recommendations include:
- Board level responsibility – Chief Executives need to take responsibility forsigning off complaints. The Trust Board should also scrutinise all complaints and evaluate what action has been taken. A board member with responsibility for whistleblowing should also be accessible to staff on a regular basis.
- Transparency – Trusts must publish an annual complaints report in plain English which should state complaints made and changes that have taken place.
- More information on the wards – Trusts should ensure that there is a range of basic information and support on the ward for patients, such as a description of who is who on the ward and what time visiting and meals take place.
- Trust complaints scrutiny– Patients and communities should be involved in designing and monitoring the complaints system in hospitals.
- Easier ways to communicate – Trusts should provide patients with a way of feeding back comments and concerns about their care on a ward, including by putting a pen and paper by the bedside and making sure patients know who they can speak to, to raise a concern.
- Patient services and independent advice – the Patient Advice and Liaison Service should be rebranded and reviewed so its offer to patients is clearer and it should be adequately resourced in every hospital. The Independent Advocacy Services should also be rebranded and reorganised.
The Government will now consider this report and respond in full later this autumn.