A report by the Healthcare Commission shows that patients remain concerned about how Trusts deal with their complaints. The way complaints are handled is still the number one issue raised by complainants, accounting for 19% of cases reviewed, up from 16% last year.
The watchdog found that some NHS Trusts are still not responding to complaints effectively or learning lessons from them. In almost half of complaints reviewed, the Commission either upheld the complaint or sent it back to the Trust for further work because the Trust’s initial response to the complainant was not good enough. Patients and the public also continue to raise issues about the same basic aspects of healthcare such as: poor communication (12% of cases, down from 17% in 2006/07), standard of treatment (11% up from 6% in 2006/07), delay or failure to diagnosis a condition (9%), and delays in accessing care (8% up from 4% in 2006/07). Each year the NHS delivers 380 million treatments and receives around 135,000 complaints. The Commission reviews cases where the patient is unhappy with the response from the Trust. The report, the third of its kind, covers the 8,949 complaints reviewed in the year to 31 July 2008. The Commission upheld 30% of the cases reviewed in this period, up from almost 20% last year. In a further 17% of cases (down from 26% in 2006/07), the Commission found the Trust’s response to the complainant was not sufficient and it was sent back to the Trust for further work. This means almost half of complaints reviewed required further work by the Trust. Anna Walker, the Commission’s chief executive, said: “It is concerning that around half of complainants received an inadequate response from the Trust when they first complained and we required further work to be done on the complaint. “It is clear from our wider work on complaints that Trusts are not always systematically learning from them and improving their services for the future. It is very important that people feel that they can complain about their NHS Trust if they need to and that the Trust will respond positively to their complaint and learn general lessons from it.” The majority of complaints about hospitals were concerning nursing care. Of these, 43.5% were about general care, highlighting issues such as nutrition, falls and observation of patients. In the case of accident and emergency care, the main issues were related to treatment (24%). There were concerns about ambulance response times and incorrect treatment. The Commission has made 12 key recommendations to all NHS Trusts to improve the way they resolve complaints in preparation for the new complaints system. It recommends Trusts should: acknowledge the person’s right to complain, take statements and interview staff involved in events leading to the complaint, ensure any letters to the person are clearly written and free from complex clinical terminology, ensure that the person is kept informed of progress, offer an unequivocal apology where appropriate, and ensure that general learning is taken from specific complaints and is embedded into the system. From 1 April 2009, a new two-tier complaints handling system replaces the current three-tier procedure. If a person complains to a Trust and they are unhappy with the Trust’s response they will be able to request a review from the Parliamentary and Health Service Ombudsman. The new system will put more emphasis on Trusts resolving complaints at a local level. It is therefore even more important that they improve their initial handling of complaints to make sure patients are not disadvantaged.
