Learning and information from complaints

Accepted in part.
An open culture demands that information is available to service users, their families and carers to enable them to make informed choices about their healthcare.
Trusts currently have to publish an annual report on complaints handling. This report contains information on the number of complaints received, the number referred to the Health Service Ombudsman, and a summary of the subject matter of those complaints, any matters arising from them, and any matters where action has been taken (or will be taken) as a result of the complaint. These reports are sent to the commissioning body, and made available to anyone who requests one, but the Government believes we can go further.
Rt Hon Ann Clwyd MP and Professor Tricia Hart’s Review of the Handling of Complaints in NHS Hospitals recommends that:
• There should be Board- led scrutiny of complaints. All Boards and Chief Executives should receive monthly reports on complaints and the action taken, including an evaluation of the effectiveness of the action. These reports should be available to the Chief Inspector of Hospitals.
The Department of Health will ensure that each quarter every hospital publishes information on the complaints it has received. This will include:
• the number of complaints received, as a percentage of patient interventions in that period;
• the number of complaints the hospital has been informed have subsequently been referred to the Ombudsman; and
• lessons learned and improvements made as a result of complaints.
The Department of Health will work with NHS England and other key partners to determine the most effective mechanism through which to achieve these outcomes.The Chief Inspector and Care Quality Commission will require regular reporting of complaints from all providers to inform its surveillance and risk profiling regime. Care Quality Commission will naturally be particularly interested in complaints concerning death, serious injury or ‘near misses’ but will also want to harness information about other aspects of patient experience and concern which would be indicative of trust culture and performance. Care Quality Commission will be discussing with Monitor, Trust Development Authority and providers a proportionate and cost- effective means of doing so.
The Department would wish to reconsider this recommendation in relation to complaints of a serious nature, and making them available in a wider range of formats, once an agreed and consistent standard exists against which to judge the handling of an individual complaint. This would lead to more consistency in outcomes.

DHSC have not taken forward this recommendation as set out. The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 require each NHS organisation to prepare an annual report that includes how many complaints they have received, a summary of the subject areas raised and actions taken as a consequence of the complaints. Under regulation 18, this report must be made available to any person who requests it.

The Ombudsman makes final decisions on complaints about the NHS in England, UK Government departments, agencies and public bodies such as museums. These casework decisions date from April 2021 and are published two months after the case is closed. Summaries per case are published on the PHSO website.

It is important for organisations to be accountable to the public for the way they handle complaints. The Department of Health, working with the Health and Social Care Information Centre, committed to developing a system that enabled Trusts to publish accurate, detailed quarterly data on the number of complaints received, and to enable comparison across hospitals. The overall aim of the revisions is to provide members of the public and regulatory bodies with frequent, more meaningful data which will identify organisations whose level of complaints, whether high or low, suggests there may be cause for concern. Hospitals will begin revised collections from April 2015, with the first quarterly report envisaged by late summer 2015. It is expected the public can begin to compare Trusts’ complaints data by late Autumn 2015.

The Department of Health is working with NHS England to strengthen the 15/16 NHS Standard contract so it includes the need to prominently display complaints information.

Sir Mike Richard’s thematic complaints report was published in December 2014. It covers acute inspections, primary care, and social care and identifies trends and themes in complaints handling drawn from the inspections done by the Care Quality Commission.

This recommendation was accepted in part by the Government.

In the January 2014 Hard Truths report, the Government said it wished to reconsider the recommendation in relation to complaints of a serious nature and making them available in a wider range of formats, once an agreed and consistent standard existed against which to judge the handling of an individual complaint.

The February 2015 Culture Change report did not explicitly address this planned reconsideration.