Learning and information from complaints

Accepted.
Information received from people who use care services about the quality and safety of their care, including concerns and complaints, is a vital source of information which needs to be available to the regulator. The Care Quality Commission accesses and uses a range of information about complaints to inform the timing and focus of its inspections. This information ranges from aggregated numbers and patterns of complaints, to individuals who contact the Care Quality Commission and tell inspectors about their experience. The Care Quality Commission participates in the Quality Surveillance Groups that have been established in each area. These groups actively share between commissioners, regulators, all local NHS organisations and others, information and intelligence on the quality of care being delivered.
The new approach to inspection that the Care Quality Commission has introduced places a stronger focus on how care is delivered in practice and how it is experienced, rather than just compliance with regulations. In line with this, the Care Quality Commission is now making greater use of the information that it has on complaints.
In light of the recommendations made in Review of the Handling of Complaints in NHS Hospitals the Care Quality Commission will review how it makes best use of the complaints that it receives directly from individuals, and the individual stories in complaints, as well as the aggregated trends. As it continues to test and engage on refining its new approach to inspection between now and April 2014, it will also review whether or not routinely to require of providers a report on complaints, self-assessment or other form of declaration, to inform its monitoring and inspections. This consideration will be coordinated with other information requirements on providers, and decided in light of the NHS Confederation’s Review of Bureaucracy in the NHS.
The Department of Health will work with the Care Quality Commission to ensure that its new surveillance model for monitoring risk at NHS acute hospitals includes information on complaints handling.

The CQC has 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 CQC has powers to compel providers to share details of complaints under Regulation 16(3) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014).

Quality Surveillance Groups exist to identify risks to quality at as early a stage as possible, by actively sharing information and intelligence between commissioners, regulators and those with a system oversight role. Quality Surveillance Groups support cooperation between different parts of the system to safeguard the quality of care patients receive.

The quality of complaints handling by a provider is now a key component of the Care Quality Commission’s inspection programme. The Care Quality Commission have reached outside the organisation to draw on expertise from those who have experienced the complaints system, and been a “whistleblower”. This includes employing James Titcombe as their National Patient Safety Advisor and Dr Kim Holt as an advisor in developing proposals to test how providers manage staff concerns.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said the Care Quality Commission would review how it makes best use of complaints and what information on complaints it should require from providers.

In the February 2015 Culture Change report, the Government said that Quality Surveillance Groups had been established to identify risks to quality at an early stage by actively sharing information and intelligence.