72. We accept this recommendation in principle and recognise that there are still
challenges to overcome if we are to see improvements in the way complaints are
handled in the NHS. However, we do not believe that another fundamental review
will help. The issues are already well documented.
73. Complaints handling has been an important part of the Government’s
programme of work, particularly following the Inquiries into Mid Staffordshire NHS
Foundation Trust. We are working to put in place a more open and transparent
culture in which all forms of feedback – comments, concerns, compliments and
complaints – are welcomed and acted upon. Over the last two years we have sought
to achieve this by focusing on action in a number of areas. We have increased
transparency by improving the quality and frequency of national complaints data in
secondary care. The first quarterly data returns will be published in the summer and
for the first time will have more granular detail on the issues being complained about.
74. We have sought to improve the information available locally for patients on how
to complain, including by publishing a national advice guide, providing templates for
posters on every hospital ward and, through Healthwatch England working with
Citizen’s Advice, ensured there is accurate information online about how to
complain.
75. The Parliamentary and Health Service Ombudsman and Healthwatch
developed a set of expectations which define what a “good” complaints experience
feels like from the patient perspective. This provides a clear guide for Boards and
Chief Executives to refer to when considering how to improve their complaint
handling locally. We have added new commitments to the NHS Standard Contract
on the importance of promoting information about how to complain and where to get
advocacy support. New education and training tools have been produced by Health
Education England and the Royal College of Nursing. The right to complain remains
enshrined in the NHS Constitution.
76. To reinforce all of this, the Care Quality Commission inspection process now
considers complaints as part of every inspection in primary, secondary and social
care and takes a sample of complaints to look at how they have been handled in
practice. The local scrutiny function performed by local Healthwatch is also very
important as a check and balance on the action taken by the local NHS to handle
complaints.
77. We also have ways to benchmark progress, using the annual Care Quality
Commission inpatient survey to track whether information is available to people
about how to complain, and the tracking survey capturing public perceptions of the
NHS, including how people feel about complaining; the results of the winter 2014
tracking survey were published in January and showed around seven in ten people
say they would feel comfortable making a complaint about a poor experience at an
NHS hospital (71%)18 . A full summary of the Government’s work and progress to
improve complaints handling across the board was set out in our “Culture Change in
the NHS”19 progress report in February.
78. However, there is more to do. NHS England is taking forward a number of
actions to improve complaints handling over the coming months. This includes
developing a toolkit for commissioners to help commissioners deal with complaints
more effectively and hold providers to account. NHS England are also working with
the Parliamentary and Health Service Ombudsman to pilot ways of surveying
patients about their experience of complaining, based on the statements set out in
18 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/439487/14­
05840601_NHS_Tracker_Report_Winter_2014__new.pdf
19 https://www.gov.uk/government/publications/culture-change-in-the-nhs
the Ombudsman/Healthwatch document My expectations for raising concerns and
complaints20 . We will consider what additional action could be taken to improve
complaint handling; this includes looking at ways to improve collaboration across
organisational boundaries and create a culture where lessons are learnt.
79. The Parliamentary and Health Service Ombudsman remains an important
element of the complaints process and provides an independent view for individuals
who are dissatisfied with the outcome of their complaint locally. However, we agree
that improved local handling of complaints would reduce the proportion of
complainants who remain dissatisfied and take their cases to the Ombudsman.
80. The Government are leading work to reform the Ombudsman landscape
following on from the proposals set out in Robert Gordon’s report. A consultation on
these proposals, including the option of creating a single Public Services
Ombudsman has just closed. Plans for a draft Bill were announced in the Queen’s
Speech and the Cabinet Office is working on the Bill which is due to be published
later on in this Parliamentary session. As the Ombudsman is the final stage of the
complaints process it is important that the infrastructure which surrounds them is as
effective as possible and easy for people to use.
81. We continue to believe it important that improvement in the handling of
complaints is linked to wider issues around hearing the patient voice, learning
lessons and focussing on providing safe quality services. Delivering this requires the
whole care system to play its part. In its role as steward of the system the
Department will convene a new national partnership of organisations which looks at
complaints improvement within a wider context, building on the work done to deliver
commitments set out in “Hard Truths”, and considering how to improve the culture
around patient feedback, including complaints.
82. Finally, as discussed earlier in this document, the Government can now confirm
that they accept the Public Administration Select Committee’s recommendation to
establish an independent patient safety investigation function (the Independent
Patient Safety Investigation Service) for the NHS, and will be taking this forward in
the coming months. As part of the work that is done to improve the investigation of
patient safety incidents in the NHS, there will be consideration given to how local
organisations can align their processes for handling complaints and investigations
into serious incidents.
20 http://www.ombudsman.org.uk/__data/assets/pdf_file/0010/28774/Vision_report.pdf
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