F114 Response Accepted

Complaints handling

Recommendation

Comments or complaints which describe events amounting to an adverse or serious untoward incident should trigger an investigation.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
- The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 mandate that NHS bodies investigate and respond to complaints regarding health services (The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, SI 2009/309).
- The Patient Safety Incident Response Framework (PSIRF) provides guidance on combining complaint investigations with patient safety incident investigations where appropriate (Patient Safety Incident Response Framework, NHS England, August 2022).
- The Department of Health and Social Care and NHS England stated in April 2025 that where a complaint is unresolved within one working day, there is a statutory requirement to investigate (DHSC/NHS England implementation update to the Thirlwall Inquiry, April 2025).
- The NHS Complaint Standards require organisations to identify when a complaint involves a patient safety incident and ensure it is investigated accordingly (NHS Complaint Standards, PHSO, April 2022).
How was this evidence gathered?
Evidence searched by Gemini (Google) on 30 Jun 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.legislation.gov.uk, hansard.parliament.uk
This recommendation applies across many organisations. The evidence above reflects central policy activity; adoption in individual organisations may vary.
Jurisdiction
England
Response
Accepted
Accepted Department of Health and Social Care
19 Nov 2013

The government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf

Read Full Response
Note: Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Progress Timeline
Official Report
01 Apr 2025

DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Superseded. Where a complaint is made by someone other than another NHS body, local authority or by an employee of the relevant NHS body and such complaint is unresolved to the satisfaction of the complainant within 1 working day there is a statutory requirement on NHS bodies to investigate and respond to complaints made to them regarding the provision of health services (see regulations 8 and 14 of the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009). Guidance on engaging and involving patients, families and staff following a patient safety incident is available under the Patient Safety Incident Response Framework. Where possible, and if the complainant agrees, the complaint investigation and patient safety incident investigation should be combined so that the patient/family get all the answers they are seeking together. Note, however, that the complaint may not limit itself to learning issues. When it is not possible to combine the two responses, how communication with those affected is best managed needs to be considered (see also PHSO Complaints Standards Framework).

Published Evidence

Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.

Reasonable Progress
06 Feb 2023
Academic Review - Ten Years After Francis

Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.

University of Birmingham: Ten years after Francis View Source
Confirmed Completed
01 Apr 2022
PHSO - NHS Complaint Standards

PHSO developed NHS Complaint Standards framework providing consistent approach to complaint handling across NHS. Piloted 2021-2022, introduced across NHS from 2022. Applies to all NHS organisations and independent healthcare providers delivering NHS-funded care.

NHS Complaint Standards Framework View Source
Good Progress
11 Feb 2015
UK Government - Culture Change in the NHS

Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.

Good Progress
19 Nov 2013
UK Government - Hard Truths Vol 1 & 2

Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.

Confirmed Completed
28 Oct 2013
UK Government - Clwyd-Hart Review

Ann Clwyd MP and Professor Tricia Hart published review of NHS hospital complaints handling on 28 October 2013. Key recommendations: Chief Executives must sign off complaint responses; Trust Boards must scrutinise complaints; trusts must publish annual complaints reports in plain English.

Review of NHS Hospital Complaints System View Source
Source
Report Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry 06 Feb 2013
Responsible Bodies
Healthcare providers Primary
Recommendation age 13.5 yrs
Last formal update 484 days ago