Role of the Health and Social Care Information Centre
The Information Centre, in consultation with the Department of Health, the NHS Commissioning Board and the Parliamentary and Health Service Ombudsman, should develop a means of publishing more detailed breakdowns of clinically related complaints.
- NHS England (formerly NHS Digital) publishes statistics on written complaints made about NHS hospital, community, and primary care services using the KO41a and KO41b data collections. Publication frequency changed from quarterly (2015-16 to 2021-22) to annual (2022-23 onwards). The data covers complaints received by NHS organisations themselves, broken down by subject, service area, and outcome (NHS England Digital, Data on Written Complaints in the NHS).
- The Parliamentary and Health Service Ombudsman (PHSO) publishes its own quarterly reports on complaints about NHS organisations and annual data on complaints received and decisions made, providing statistics on cases escalated beyond the NHS internal complaints process (PHSO, Quarterly Reports on Complaints).
- However, NHS complaints data and PHSO complaints data are published separately by different bodies. Francis recommended that the Information Centre should develop, in consultation with PHSO, a means of publishing more detailed breakdowns of clinically related complaints — this integrated publication bringing together NHS-level and Ombudsman-level complaints data in a single analytical framework has not been established.
- The separation means stakeholders must cross-reference two different publications to understand the full complaints picture for a given organisation, from initial complaint through to Ombudsman investigation.
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe 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
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.
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.
Clinical Commissioning Groups replaced by 42 Integrated Care Boards from 1 July 2022 under Health and Care Act 2022. ICBs have broader responsibilities for population health, bringing together NHS organisations, local authorities and partners. Implements some Francis recommendations on commissioning integration.
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.
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.
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.
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.