Patient safety


NHS complaints handling needs ‘fundamental change’

Hospitals must set out a new attitude to complaints and whistleblowing, an independent review has stated.

‘Putting patients back in the picture’ identified common standards to be applied to complaints handling across the NHS, with 12 healthcare organisations signing up to almost 30 specific actions to ensure change within the next year.

Led by Labour MP Ann Clwyd and Professor Tricia Hart, chief executive of South Tees Hospitals NHS FT, the review was commissioned by health secretary Jeremy Hunt in March following the publication of the Francis report into failings at Mid Staffordshire.

Consumer and patient bodies will be working together to monitor the implementation of the review’s recommendations, and the chief inspector of hospitals is to make complaints a central part of CQC inspections.

The review calls for board level responsibility for complaints, for trusts to publish an annual complaints report, more information provided on wards, involve patients in designing trust’ complaints systems, and rebrand and review the Patient Advice and Liaison Service (PALS).

Clwyd said: “We have given patients and their families a voice in this report, and their message to the NHS on complaints is clear. The days of delay, deny, and defend must end, and hospitals must become open, learning organisations. Our proposals put patients firmly into the driving seat at every level as never before, and we now expect to see progress within 12 months’ time.”

Prof Hart 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.”

Hunt said: “I want to see a complete transformation in hospitals’ approach to complaints, so that they become valued as vital learning tools. There can be no place for closing ranks or covering backs when patient safety is at stake.”

The Government will respond in full this autumn.

NHS Confederation chairman Michael O'Higgins, who was a member of the Review's external partnership panel, said it would be “foolish” to ignore the feedback of patients, who can help to improve its services.

He added: “We want to make use of our unique ability to bring together our members from all parts of the NHS; providers and commissioners, large and small, and from all sectors – to support implementation of the Review's findings.

“There won't be one approach that fits all, but by sharing what works and what can be improved, every part of the NHS organisation will be able to develop the best solution for their patients, service users and local people.”

Paul Philip, acting chief executive of the General Medical Council, said: “Complaints from members of the public give the health service the chance to reflect and improve the care and treatment that patients receive.

“That is why, in our four pledges to this review, we committed to do more to support people who raise concerns about their doctor, and to increase the role of patient feedback in revalidation – a new system of checks to ensure that all doctors are competent and fit to practise.”

Dr Peter Carter, chief executive & general secretary of the RCN said: “It is clear that the culture in a hospital or trust has a real impact on the quality of patient care. This report makes it clear that managers have a responsibility to show leadership in creating an environment where complaints are regarded as a valuable tool to address poor practice and make changes.

“One instance of poor care is one instance too many, and everyone in the health service from the highest levels of management to frontline staff must now act on this report to create a culture where staff, patients and relatives do not feel helpless when things go wrong.”

Tell us what you think – have your say below, or email us directly at [email protected]


Peggy Banks   18/12/2014 at 18:34

Interesting reading and similar to many other statements from a host of sources. Yes, indeed, denial and defence needs to end. Speaking as someone who has an unresolved complaint, due to needless damage, so far nobody helps at all. Nobody wants to know at all. I just get passed around and around and around and around, it is never in anyone's remit. If the damage I suffered had been explained to me and dealt with in the first place, I would still have my job, I would not have needed to go around and around and around and around and around and around and read endless, endless, endless, endless, endless reports about proposed accountability and transparency and doing away with denial and doing away with the defensive attitude that causes all concerned so much trouble. It seems that it has become a habit to lie and cover up and lie and cover up and lie and cover up and lie and cover up. All, all of the above does is risk lives, risk people's health, risk medical reputation, and cause unnecessary litigation. Personally I would have preferred honesty and appropropriate treatment, instead of being shouted at to intimidate on more than one occassion (as so much anger was directed at me once occupational health at work pointed me in the right direction) the ghastly unforgettable mask of a grimace as I was lied to over and over again, my medical records now contain inacurracies to keep up the pathetic cover up.I was wondering what was wrong for ages. But I get passed around to cover up, I had to leave my job early on top of a lot of painand get passed around and around and around and around and around and around, I had tried to enlighten for future improvements, but on that count just get ignored and ignored and ignored and ignored and ignored. So I have a simple question here, instead of all these reports and discussions and endless bodies that keep on sprouting extra endless bodies to pass people around and around and around and around and ignore, try to confuse, deny, lie, pretend something should/will be done, and all the endless tricky regulations to deflect any complainant who has half a wit to tackle this, why not either say there is nothing that can be done as no-one has any guts to deal with it, or just being an ordinary person means that it is too bad as most people get through the medical system, enough for the workforce to keep working for the economy. Are we now going to just get on with a simple complaints system. (There is definitely no system at the moment). And what about the plight of the whistleblowers who get bullied and bullied and lose their career so the bullies and liars stay put and carry on covering up, lying, denying and defending. And the endless pr spin. It is all such a waste in every way and fools no-one. I have not enjoyed my wild goose chase at all.

Zerojustice   23/12/2014 at 12:29

I would concur with the above respondent's points. It is all lip service, PHSO for instance, top of the food chain and in my personal experience responsible for corruption and procedural irregularities. Very buddy-buddy with the body complained about. No wonder there is no justice. PHSO states it is investigating more complaints, but it is cherry-picking and massaging figures, it's all spin. There are many unhappy complainants. Speak to the Patients Association, speak to, there are many. We are all being ignored. Excuses sprout aplenty, they drag it out long enough and then say it's out of time or no useful result will be forthcoming due to elapse of time. PHSO has "wide discretionary powers" which just about covers every negative and dishonest action you could think up, and it appears those powers are not used to support complainants, but to shut them down. If you've ever seen the film "The Matrix" you will have a good idea of what we are saying. It's an illusion basically, we are being hoodwinked into believing there actually exists a complaints system in this country. PALS just colludes with the department you are complaining about and sends it back to them to investigate themselves, how independent is that? No wonder they are all so keen to send you to PHSO, because they know with every confidence that the complainant will gain nothing by going there. And do you know the biggest farce? Every single regulatory body says the same thing, that your complaint has had consideration, as if that means they have done their job. But here's a newsflash, opening a file, looking at papers and replying in some form is not an investigation. An investigation means actually investigating the facts, not automatically siding with the NHS department, being qualified to understand the nature of the complaint, giving the complaint a fair, logical and just investigation. It isn't meant to be an administrative exercise, which is what it currently is. No matter what PHSO says, they are lying and many of us out there have proof of it. They are stating it's about customer service, it's not, it's about remedying the injustices we have suffered, actually taking action to put things right. They are using smoke and mirrors and if they think we are falling for it, they are very much mistaken.

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