Using people’s views of good complaint handling to improve experiences

‘My expectations for raising concerns and complaints’ report, published today by the Parliamentary and Health Service Ombudsman, the Local Government Ombudsman and Healthwatch England, describes people’s view of what good complaint handling should look like at each stage of the complaints journey.

This includes, knowing they have a right to complain, where to complain, being kept informed and feeling their complaint made a difference so the same thing does not happen to anyone else and feeling confident to complain again.

For the first time health and social care providers, from GP surgeries to hospitals and home care services to residential care homes in England, will be able to use this work to measure people’s experiences of complaints and help them improve.

The work comes one year after the Department of Health’s ‘Hard Truths’ report following the failings at Mid Staffordshire Trust. This highlighted the need, across the NHS and social care organisations, to recognise the importance of people’s complaints and to measure whether their actions were really making a difference to their experience of complaining.

The patient and service-led expectations were developed with more than 100 service users and tested with over 40 organisations. It shows people’s complaints journey in the form of ‘I statements’ describing what people would say if their experience of making a complaint is a good one.

The expectations are consistent with the assessment framework used by the Care Quality Commission in its inspections of health and adult social care services in England.

The following organisations have signed-up to using the expectations:

• NHS England welcomes these ‘I statements’ and is committed to their use, in the way it handles complaints and also in its commissioning arrangements with the NHS. NHS England will explore whether these can be incorporated into the Planning Guidance for the NHS in 2015/16 and also in its routine survey of people who have complained. NHS England will also work with their directly commissioned services to see how these ‘I statements’ can be used at a local level
• the CQC, which has committed to using the vision in its work, how a trust deals with and learns from complaints to improve the quality of care will continue to inform Monitor’s view of whether a trust meets our requirements of being well-led
• the Trust Development Authority will use it to support trusts to improve their complaint handling processes
• the Foundation Trust Network will support NHS trusts and foundation trusts to explore how the work can be used to establish and share best practice about managing and resolving complaints
• the Local Government Ombudsman will use the expectations to form the basis of their ‘good complaint handling’ training, delivered to local authorities and to be extended to private social care providers. It will be applied to the investigations they undertake and to complaints about themselves.
• the Parliamentary and Health Service Ombudsman will use the expectations for complaints about themselves. It will also provide a useful insight in the development of the Service Charter.
• Healthwatch England will also use the work to support their national and local influencing work.

Parliamentary and Health Service Ombudsman Julie Mellor, said:

“For the first time patients and service users’ expectations and experiences of raising a concern and complaint can be measured and used to drive improvements in complaint handling.

“Ultimately we want all patients and service users to be able to say: ‘I felt confident to speak up and making my complaint was simple. I felt listened to and understood. I feel that my complaint made a difference’.

“We will now work with regulators, commissioners and providers to develop measurement tools to establish areas they need to improve, take actions to get there and see if they have succeeded in delivering an experience the public say is better.”

Local Government Ombudsman Jane Martin, said:

“The importance of this research is that it has care users and patients at the heart of it. This is because it is developed from the experiences of people who have complained and presented in their language. It is also provides a framework that is relevant across health and social care, which is vital as the two sectors become increasingly integrated.”

Anna Bradley, chair of consumer champion organisation Healthwatch England, said:

“Compassion is key to good complaints handling, remembering that those affected are people not case files.

“All the Healthwatch England research shows people are not providing feedback and making complaints when they would like to do so, because the system puts them off. By starting with what people say they want, this new document puts the public in the driving seat.

“The fact that this will be used in the inspection process means the public’s expectations will be built into the foundations of the system so that not only will complaints be properly addressed they will also be learnt from.”

Secretary of State for Health Jeremy Hunt said:

“Mid Staffs was a turning point for the NHS - it is now more transparent than ever before, but we know patient feedback is essential so mistakes are not repeated. I welcome this work that will help improve the complaints procedure.”

David Behan, Care Quality Commission chief executive, said:

“Complaints and concerns raised by people who use services, those close to them, and staff provide us with vital information that helps us to understand what a care service is really like.

“A service that is safe, responsive and well-led will treat every concern as an opportunity to improve and will respond to complaints openly and honestly.

“These expectations for complaints handling published today are consistent with the good practice we look for.”

Research by the Parliamentary and Health Service Ombudsman, supported by the findings of Healthwatch England’s ‘Suffering in Silence’ report, shows people are reluctant to complain - often fearing it will be complicated, they won't be taken seriously or it could affect their treatment. Those that do complain say they are met with defensive responses and so complaining does not make a difference for them or improve quality and safety for those that follow.