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'NHS complaints systems need to be rigorously fair'

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NHS omplaints systems need to be rigorously fair, not just to complainants but also to nurses who will inevitably encounter dissatisfied patients, says Jane Wright

Nothing is certain except death and taxes unless you work in health care. In health care you can also be certain of complaints.

This is not because staff are careless or inept but because we deal with the general public at their most vulnerable. We work with those facing death, pain, fear and loss of independence.

Inevitably, some of those feelings get projected on to staff by patients and relatives who need to have someone to ‘blame’. Other complainants may have unrealistic expectations or are just hard to please.

Occasionally, complaints are malicious but often there has just been a misunderstanding.

A couple of years ago, one family complained that a nurse had tried to convert their Roman Catholic mother to the Anglican faith while in hospital. The mother had heard the nurse tell a porter that the lady needed to go to CoE (Care of the Elderly) and had presumed it was being suggested that she should join the Church of England. The result was a distressing allegation against a kind nurse who had no recollection of the incident and who was left feeling that she had done something wrong.

However, some complaints will be valid and require an apology and an assurance that whatever went wrong will be remedied. These can result from serious errors or from unbelievably trivial occurrences. My favourite example was a woman who complained about a small hole in her blanket during her stay in A&E.

So why do we still see complaints as something that only happen to bad nurses? Is it that we still have a ‘blame culture’ or is there an inherent unfairness in a complaints system that mollifies the most ludicrous complainant but fails to acknowledge the professionals’ efforts?

Someone I know recently received a complaint that could at best be described as spurious and at worst vexatious. Although his colleagues agreed that his actions were more than justified, the complainant was told that the person had apologised and was given the impression that knuckles had been rapped. The complaints officer explained that this was how they kept the public happy. But how satisfactory a result was this? The complainant now has her mistaken prejudices justified by a fake apology and the trust now has a member of staff who is cynical about its complaints system.

The essence of any complaints system should be rigorous fairness, not just to the complainant but also to those who will inevitably encounter dissatisfied patients.

Staff who are supported and treated fairly are more likely to cooperate with complaints managers and work to improve the service. Systems that apologise automatically create a ‘damned if I do, damned if I don’t’ atmosphere that is not conducive to
service improvement.

The lack of formal support for staff can make them feel isolated and threatened. While unions can offer some backing, trusts should have a formal support system of individuals who can provide advice and back-up seven days a week.

Some police services have a system of ‘friends’ (senior officers) who provide support not only to officers but also to their families. They are not part of any investigation but are there to prevent feelings of isolation and defencelessness. Less serious complaints are dealt with at a local level and complainants are told if their complaints are not upheld. Malicious complainants are warned. Most officers I know have a higher degree of confidence in their complaints systems than most nurses.

And let’s not forget about compliments. Last year, I wrote to thank a trust for the outstanding care delivered to an aunt during her final illness. Nothing more could have been done to make her comfortable and no effort was spared to make things as easy as possible for my family. As I wrote, I wondered if my praise would be passed on and given the same attention as a complaint. I’ll never know. The chief executive to whom I wrote never acknowledged my letter.

Jane Wright is nurse education consultant at Beeches Management Centre, Belfast

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Readers' comments (1)

  • As someone who has been through the complaints process , I can tell you all that it needs serious overhauling . I was twive misdiagnosed with a D.V.T. which led to a P.E. This in it's self was bad enogh but when I made my complaint to the Hospital trust I was treated with almost total disregard . Ameeting was held with the head of A/E and a complaints officer in April last year after six months i had heard nothing so took it to the Health Care Commission {soon to be disbanded} who asked the hospital for a copy of the minutes of the meeting only to b=e told that the hospital had LOST them . Eventually another meeting was scheduled and this was taped to ensure nothing untoward happened , Still not happy I wanted to take things further STILL WAITING . As a Nurse myself I understand the sometimes stupid complaints by the general public and as such did not take this course of action lightly , but it has shown me an almost total lack of concern for the publics needs to be addressed.

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