Urgent overhaul of NHS complaints handling needed, says major review
Patients should have a pen and paper by their bedside in order to raise concerns or give feedback on their care, according to an independent report on the way the NHS handles complaints.
Making a raft of recommendations, the report called for a “revolution” in the way in which the NHS handles complaints and said action was needed within 12 months.
It is the result of a review chaired by Ann Clwyd, Labour MP for Cynon Valley, and Professor Tricia Hart, chief executive of South Tees Hospitals NHS Foundation Trust and a former nurse.
Professor Hart was previously an advisor to Robert Francis QC’s review into failings at Mid Staffordshire Foundation Trust, while Ms Clwyd has described her own experiences of poor care.
In an interview last December she criticised the care her late husband, Owen Roberts, had received at the University Hospital of Wales in Cardiff. She told the BBC Radio 4 World at One programme he had died “like a battery hen”.
The review was commissioned by the government, after the Francis report highlighted in February that complaints were a warning sign of problems in a hospital.
The review received 2,500 responses describing poor care and dissatisfaction with complaints handling. It also heard from individuals who had not complained because they felt the process was too confusing, feared for their future care or were concerned about the system’s lack of independence.
The review report has made a series of recommendations aimed at addressing the causes of complaints, improving access to the complaints system and ensuring hospitals adopt an entirely new attitude to complaints and whistleblowing.
These include providing more information on the wards and making it easier for patients to communicate.
For example, it calls on trusts to provide a “range of basic information and support on the ward” for patients, such as a description of who is who and what time visiting and meals take place.
Trusts should also provide patients with a way of feeding back comments and concerns about their care on a ward, including by putting a pen and paper by the bedside and making sure patients know who they can speak to, to raise a concern.
Other key recommendations include that trust chief executives should take responsibility for signing off complaints and a trust board member with responsibility for whistleblowing should also be accessible to staff on a regular basis.
Trusts must publish an annual complaints report in “plain English”, which should state complaints made and changes that have taken place.
The review identified a “decade of failure” to reform the way in which complaints are handled, and has demanded urgent action in the next 12 months.
It has taken the unusual step of securing undertakings from key health organisations to ensure that action will be taken within the next year.
For example, 12 organisations including the Royal College of Nursing, Health Education England and NHS England have jointly signed up to nearly 30 actions to help improve the complaints culture across the NHS.
Among these actions are the drawing up of new guidance for nurses and a review of training and education on complaints handling.
Mike Richards, the new chief inspector of hospitals in England, will also develop standards for the handling of complaints by NHS organisations.
Speaking on her review’s findings, Ms Clwyd said: “When I made public the circumstances of my own husband’s death last year, I was shocked by the deluge of correspondence from people whose experience of hospitals was heart-breaking.
“The days of delay, deny, and defend must end, and hospitals must become open, learning organisations. Our proposals put patients firmly into the driving seat at every level as never before, and we now expect to see progress within 12 months’ time.”
Professor Hart added: “Some of the stories I’ve heard have been the most harrowing of my career.”
She called for a “fundamental change in culture” so that “when things go wrong improvements are made to make sure it doesn’t happen again”.
“But most of all we need action – and that is what sets today’s report apart. Leaders from across the NHS have signed up to concrete actions to start to do better on complaints,” she said.
“The end goal has to be that the NHS provides better, safer, kinder care so that fewer patients feel like they want to complain.”
The government said it would now consider the report’s findings and respond in full later in the autumn.
Health secretary Jeremy Hunt said: “I pay tribute to the great courage and zeal with which Ann Clwyd has championed this cause following her own personal tragedy last year, and am grateful to Tricia Hart for the leadership and frontline insight she has provided.”
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