A report by the National Audit Office (NAO) has found that navigating complaints systems is not straightforward, particularly for health service users, and handling some complaints takes too long. There is little sharing of lessons from complaints or evidence that services are improving as a result.
Karen Taylor, from the NAO, which compiled the study, said: “The main reason people do not complain, whether in NHS or social care, is that they do not think anything will be done as a result.”
The NAO also found that two thirds of complainants were not offered help navigating the system. A national advocacy service is available to help NHS complainants, but awareness of it is low. For adult social care, complainants do not have an entitlement to advocacy support, and local authorities make their own advocacy arrangements.
There is a lack of systematic learning from complaints to improve services. Neither the NHS nor social care have any formal means of capturing learning from complaints. Monitoring and implementation of recommendations arising from complaints need to be improved.
Handling some complaints takes too long. Around 95% of complaints are concluded locally and three quarters of these are concluded within 20-25 working days. NHS complaints that progress to the second, independent review stage by the Healthcare Commission took an average of 171 working days and social care took an average of 63 working days.
Recognising the failings in the existing complaints systems, in 2006, the Department of Health announced it would introduce a single complaints system across health and social care in England by 2009. Until now, there has been no detailed evaluation of the effectiveness of the existing systems, however.
Tim Burr, head of the NAO, said: “The complaints systems for health and social care are not yet as accessible and responsive as they could be. There is a lack of learning from complaints, and providers are not making clear to users that services are being improved as result. Adequate staff training; proper tackling of complaints; and evidence of improvements in response to complaints are key pointers for the planned introduction of a new comprehensive complaints system across health and social care next year.”
Dr Michael Devlin, an adviser at the Medical Defence Union, commented: “Patients and their representatives often say that their motivation in making a complaint is to find out what went wrong and they would like an apology. Equally important, they seek assurances that steps have been put in place to stop the same thing happening again. We recommend to all members that they log all significant events, including complaints, and have a system in place to ensure they are thoroughly investigated and that lessons are learnt and, if appropriate, systems or practice are altered accordingly.
“This will also include follow up to ensure that any changes put in place have had the desired effect. If practices are willing to share what they have learnt with their colleagues in neighbouring practices, they may also be able to adapt their own procedures and to avoid similar problems arising themselves.”
