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NHS missing an 'opportunity' over complaints

Poor communication leads to thousands of complaints being referred to the health service ombudsman unnecessarily, a review of complaints handling in the NHS has concluded.

The report analysed the 15,066 complaints received by the ombudsman about the NHS in 2010-11. It found that in 62 per cent of these cases the complainant had not completed the complaints procedure with the NHS organisation in question while in 22 per cent of cases the ombudsman was satisfied there was no case to answer or the NHS organisation had already put things right.

Poor explanation and failure to acknowledge mistakes were the biggest reasons given for complainants being unhappy with the way complaints were handled and contacting the ombudsman.

Ombudsman Ann Abraham said: “While these matters may seem insignificant alongside complex clinical judgments and treatment, they contribute to a patient’s overall experience of NHS care.

“What is more, the escalation of such small, everyday incidents represents a hidden cost, adding to the burden on clinical practitioners and taking up time for health service managers, while causing added difficulty for people struggling with illness or caring responsibilities.”

NHS Confederation deputy director of policy Jo Webber said the high proportion of complaints referred to the ombudsman unnecessarily suggested the NHS was “missing opportunities to resolve things at an early stage”.

“It also suggests that a lot of effort could be saved if we did more to communicate how people can raise their concerns,” she added.

Complaints about hospitals accounted for the highest proportion of complaints received, at 46 per cent of the total, followed by primary care trusts at 18 per cent and GPs at 17 per cent.

In 2010-11, 21 per cent of all complaints about GPs investigated by the ombudsman were about the removal of patients from practice lists, a rise of six percentage points on the previous year. In one case, a terminally ill woman was removed from her GP’s list following a dispute between the practice and her daughter, a registered nurse. On another occassion a whole family removed following a few angry words.

Ms Abraham said: “As GPs prepare for the increased commissioning responsibilities outlined in the Government’s health reforms, it is essential that they get the basics of communication right.”

Readers' comments (7)

  • I work in mediation and have previously worked in NHS Complaints mediation as long ago as 1999. The issue of patients being struck off was occurring then as now and the usual history behind it was a fallout between patient and receptionist rather than with the Doctors themselves. As it was a lot of 'hassle' to spend time resolving it with the patient, it was easier to strike patients off than to spend time resolving an issue between patient and receptionist/practice manager. It would often be portrayed as the patient being 'abusive' when further discussion revealed it was a breakdown in communication and ineffective responses to conflict on both sides......but a Dr is not going to side against their employee. Mediation was able to help in many of the cases to re-establish the status of being on the list, or in some cases to prevent being struck off in the first place. But not always.

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  • michael stone

    Most NHS staff/bodies simply do not respond to complaints/concerns fast enough (often, 'immediately' is appropriate), or openly enough. This does lead to patients and relatives deciding that they are 'being ignored or fobbed-off' which in turn leads to escalation - and escalation leads to confrontation and defensiveness, not 'co-operative investigation' nor 'the sorting out of misunderstandings'.

    One problem is that the NHS Formal Complaints Regulations are essentially designed to cope with 'incidents' and are fundamentally unsuited to dealing with 'no-blame confusion, which might however give an insight into the way behaviour/practice could be improved'.

    The NHS, very largely, simply does not take the opportunity to improve its service by learning from feedback.

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  • Health mediation (or NHS Conciliation) is a recognised but often under-utilized component of the NHS Complaints Process.

    The main advantages of this process are:

    1. It is independent and impartial.

    2. It reduces the time, energy and costs
    associated with complaint handling.

    3. It shows that the NHS organisation is
    committed to resolving the complaint
    fairly.

    4. It has been cited in the literature as
    very effective in resolving complaints.

    5. It aims to promote early resolution by
    effective, facilitated communication.

    Any interested practitioner can enquire about health mediation (NHS Conciliation) via their complaints lead.

    Terry Leigh
    Mediation Consultant

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  • michael stone

    Terry Leigh | 19-Oct-2011 4:05 pm

    Re your point 5: the fastest and potentially most satisfactory way of dealing with many complaints and concerns, would be for the staff to openly and directly discuss the issue when it was raised with them - it is called 'talking to each other' when normal human beings do it !

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  • michael stone

    PS to previous - I did mean to discuss the issue with the person who raised it.

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  • rovergirl6@hotmail.com

    As i have said in previous times that if a patient has a problem , it should be taken seriously and that the patient could leave the ward ,clinic feeling satisfied that they have been listened to and whatever the problem was will be rectified. a little chat at the time of complaint with the patient would stop it escalating out of all proportion.

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  • michael stone

    Sandra Joyce Powell | 23-Oct-2011 11:58 pm

    Yes - exactly ! Talking about the complaint or concern, and seeing if there is a simple 'misunderstanding' going on, at the time it is raised, often prevents escalation out of all proportion, as you state.

    But that 'honest little chat' seems sadly missing, in the experience of some patients and relatives.

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