Learning from Mistakes: The Healthcare Commission's role in handling complaints

Adewale Kadiri April 2007

An overview of the Commission’s role in handling second stage complaints

A discussion of some of the themes coming through from this work
Discussion of the Commission’s report on complaints handling published in January 2007
Summary of early messages from complaints audit March 2007

The Commission’s main roles:

• assessing and rating the NHS
• Registering, assessing and inspecting independent providers to ensure they meet standards and regulations
• conducting investigations into failures in healthcare
• presenting a national picture of healthcare and particular aspects of it
• working with other inspectorates to better coordinate and reduce the burden of inspection
• acting upon NHS complaints where it has not been possible to resolve these locally

Role of the Commission in complaints handling:

• Power given under section 113(3)(b) Health & Social Care (Community Health & Standards Act 2003
• Power to investigate complaints where they have not been resolved locally
• Initial review to see if case falls within our remit
• Can be sent back to trust for further investigation
• Where necessary, full investigation by Commission panel (3 members)
• Outcome of panel investigation can be referred to Health Service Ombudsman

Statistics:

Around 100,00 complaints received about NHS treatment each year (380 million treatments in that period)
90% of complainants satisfied with NHS investigation
But, 16130 requests for reviews from July 2004 to July 2006 (more than double figure before we took over)
33% of these have been referred back to trusts for further work, 8% upheld

Common themes :

Top 4issues:
Safety of clinical practices (22%)
Poor communication and lack of information (16%)
Ineffective clinical practices and procedures (5%)
Discharge and co-ordination of care (4%)

Issues from local handling of complaints:

Tight deadlines (20 working days) make it local resolution difficult, but…
Often there is a failure to acknowledge validity of complaint
Most people just want an apology
Responses don’t always reassure patients that it won’t happen again
Trusts need to keep it simple
Lack of direct involvement by staff directly involved in care

Messages from complaints audit

Consideration of how trusts are doing against core standard C14 a-c
(a) accessible information – generally good, but variable around Braille and other languages
(b) non-discrimination – not a lot of evidence that it’s happening but many trusts unable to show that they actively prevent it
(c) acting appropriately and making changes - variable

Final messages

Large number of complaints not necessarily a bad thing, so long as organisations are learning
Good organisations use it as a temperature check for their services, but poor ones become defensive
Trusts should not be afraid to say sorry, as soon as possible
Get frontline staff involved and encourage face to face meetings
If you promise to make changes, make sure you do; people hate feeling they’ve been fobbed off

last updated 21/05/07