Use of information about compliance by regulator from: Complaints

Accepted.
In June 2013, the Care Quality Commission issued A new start – Consultation on changes to the way the Care Quality Commission regulates, inspects and monitors care. This made clear that information from individual members of the public who make complaints, raise concerns and provide feedback about the quality and safety of their care would be a vital source of information and that a well-led service or organisation would have a good complaints procedure that drives improvement. On 17 October 2013, it published the responses to the consultation in A new start: Responses to our consultation on changes to the way the Care Quality Commission regulates, inspects and monitors care services, which showed that there is broad agreement with the new approach.
The Care Quality Commission already has a customer service centre which receives comments from the public, and it ensures that these comments are fed into inspections. No legal obstacles to the Care Quality Commission accessing information have been identified. Any bureaucratic obstacles to information sharing are being addressed through the development of information sharing protocols. The Care Quality Commission and the General Medical Council have published an operational protocol which sets out in detail how coordination and information sharing will work between the two regulators. The Care Quality Commission is in agreement with the Nursing and Midwifery Council that they will develop a similar joint working protocol by December 2013. Arrangements are in place for updated information sharing arrangements thereafter with the General Dental Council and the Health and Care Professions Council.
The Care Quality Commission is examining how it needs to develop its systems further to ensure that it can use feedback and complaints from all sources to inform its inspection system, and ensure that people contacting the Care Quality Commission with information are clear what the Care Quality Commission will do with that information, and what action it may take in response. This work will be shaped by findings set out in A review of the NHS hospitals complaints system: putting patients back in the picture, and to ensure that complaints information and feedback from people who use services is embedded consistently and given significant weighting, the Care Quality Commission has committed to develop the way it uses these in its surveillance model by early 2014.

CQC have moved away from mandated ‘Provider Information Returns’ in sectors apart from Adult Social Care (ASC), which includes some basic questions about complaint numbers under the Quality assurance and risk management section.

In all sectors, evidence about complaints, and the complaints management process, is requested as part of ongoing assessment, and we have powers to compel providers to share details of complaints under Regulation 16(3)(a,b,c).

All providers and commissioners of NHS services are subject to a statutory duty to handle complaints in accordance with the requirements of the Local Authority, Social Services and National Health Service Complaint Regulations 2009 and the Health Service and Social Care Act 2008(Regulated Activities) Regulations 2014. This includes primary care providers and independent sector providers.

In December 2022, the Parliamentary and Health Service Ombudsman issued Complaints Standards which include expectations on how providers and commissioners will handle complaints, together with a model complaint handling procedure and detailed guidance on how the Complaint Standards can be applied in practice.

The NHS Standard Contract requires providers to publish complaints monitoring reports (Schedule 6).

Ahead of any inspection, the Care Quality Commission requests a range of information relating to complaints from providers. This includes numbers of complaints, themes of complaints and the timeliness of resolution of complaints.

The Care Quality Commission will also ask providers to share with us any survey they have carried out of people who have complained to them in the last 12 months.

The new fundamental standards will place a legal requirement on registered providers to provide the Care Quality Commission with information about complaints.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government referred to the Care Quality Commission already having a customer service centre which received comments from the public, and that it ensured these comments were fed into inspections. The Government said that no legal obstacles to the Care Quality Commission accessing information had been identified and any bureaucratic obstacles to information sharing were being addressed through the development of information sharing protocols.

The Care Quality Commission published its ‘Complaints Matter’ report in December 2014. It set out its ‘Intelligent Monitoring’ process, which used various indicators including negative patient comments, complaints received by the Care Quality Commission and provider complaints. Information relating to complaints from providers would include numbers of complaints, their themes and timeliness of resolution. The Care Quality Commission also set out the contact before site inspections its local inspections team would make, in order to find out more about concerns and complaints and how these are handled. During the site visit, the member of staff with responsibility for complaints would be interviewed.