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Patients want direct response from nurses on complaints


Trusts should allow frontline nursing staff to respond directly to complaints about care, according to the founder of an unofficial website that publishes patients’ views and experiences of NHS services.

Patients prefer honest explanations from staff on the wards to carefully-worded PR statements, said ex-GP Paul Hodgkin, who set up the Patient Opinion website in 2006.

His comments follow an analysis of five years’ worth of complaints received from patients and carers and published by the website, which features anonymous comments about named NHS organisations.

While many – nearly 80% of contributors to Patient Opinion – made positive comments about NHS care, the study focused on a sample of the 530 worst complaints in an effort to identify the top concerns.

A rude or negative attitude from NHS staff, including nurses, was the most common problem – 33% of complaints raised were on this issue. Additionally 30% said they experienced insufficient “care and compassion”, while 22% commented on a disappointing lack of responsiveness from staff.

The findings follow last week’s damning report by the health service ombudsman into the care of older patients (news, page 7, 22 February).

Dr Hodgkin said the analysis highlighted the difference something as simple as the attitude of nursing staff made to experiences of care.

“From the study, we can see nurses are absolutely crucial in how people perceive care. When things are good, nurses are often praised but when things are bad nurses often pick up the tab for that too,” he said.

He said trusts had to get better at responding to complaints and dealing with them in a “more human” way, including ensuring feedback – positive and negative – was passed on to nursing managers and staff, and involving nurses in responding directly to patients’ concerns.

“Our experience is that when it gets back to frontline staff they like it,” he told Nursing Times.

“Obviously it’s great to hear the thank-yous but when there is a complaint, they’ll often know why. They can say ‘we had two nurses off sick that day, we’re sorry’ and that’s the kind of honest response patients’ like.”


Readers' comments (6)

  • Based on the experience of my work as an NHS Conciliator, I agree that staff should be able to respond directly to complaints about care.

    INDEPENDENT AND IMPARTIAL NHS Conciliation is extremely effective at helping complainants and NHS staff to resolve outstanding concerns.

    Normally, the Conciliator has initial separate meetings with the complainant and practitioner to clarify individual perspectives. A face to face meeting can then be arranged which is facilitated by the Conciliator. This meeting is safe and controlled and encourages good communication between the parties.

    The process is quick to initiate and complete, thus reducing the long term impact of the complaint on both complainants and NHS staff.

    I am happy to share my knowledge of the field with interested parties.

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  • Haven't we always done this, that is if they ask us?

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  • Having been the subject of complaints from patients, I would gladly have responded to them directly had I been given the chance to do so. On one occasion a patient complained to their consultant who wrote in to the service but I was never shown the letter, but I was told it would have to be investigated. It went to executive director level and I was put through months of worry and stress until being finally "cleared". I was disgusted by how the complaints were initially dealt and after taking into consideration other issues at work I felt I had no choice but to leave my job.

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  • Anonymous | 2-Mar-2011 9:15 am

    That is shocking, which actually isn't the right word, as it isn't a shock because it happens so often. Nurses are put under terrible stress with this system in place. You are guilty until proven innocent and not told any of the details and as good as under house arrest if it results in suspension whilst an investigation is ongoing. A murderer, terrorist, paediphile or rapist, etc. gets more consideration. They are innocent until proven guilty.

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  • The person nearest the source of complaint must do their best possible to offer the first explanation and try to resolve any problems. Personal explanations may be far more effective initially than official ones and it may not be necessary to take it any further, although the nature of the complaint and measures taken to rectify it should be accurately documented in the event of further or official complaint to protect both parties.

    Nurses deliver patient care in teams which means that both the individual and the team are responsible for their standards of care and the immediate safe and comfortable environment in which this is provided.

    0 tolerance at the first hint of a potential problem does not solve anything for the complainant and can escalate the situation as the person concerned feels that they are not being heard or taken seriously. 0 tolerance and formal complaints procedures should only be resorted to if there is no other solution or as a final measure if the nature of the complaint is out of the nurses' realm or too serious for the nurse concerned or team to deal with to everybody's satisfaction.

    It seems that younger individuals do not learn to cope with problems, complaints and criticism and just announce 0 tolerance
    at the drop of a hat which gives the impression either they lack experience or are merely disinterested in the patient or person making the complaint and in this way they are not going to learn to deal with more serious problems as they arise.

    It is very true that in this fast moving and ever evolving world peoples' expectations seem to be ever changing and increasing and some will complain even when it is unreasonable to do so but as nurses we are expected to have the skills to deal with this appropriately without always having to rely on management or more senior members of staff. After all without responsibility and authority the job of nursing can become very mundane.

    Underlying reasons for the many causes for complaints also need skill and understanding, especially in sick people and their relatives. Some complaints are genuine and others less so and some are used to gain attention often by individuals who feel unable to obtain this in other ways, or they may have tried to get nursing and medical attention but to no avail. other reasons behind complaints may be psychological hurt, anger, fear, feelings of insecurity, sudden changes to life's plans through illness, pain, depression, mental health disorders, etc. It It is part of nursing to use skills to determine the underlying causes and to try and help the patient find a solution to their complaint.

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  • michael stone

    It is some time since I read them, but I think the DH's 'Listening, Responding, Improving' series covering learning from feedback, and dealing with complaints, does stress that an honest and open response, from whoever is initially the recipient of the 'complaint', will often work best all around.

    That is not something which large organisations, such as hospitals, universally adopt as a methodology, however.

    As someone who had trouble with my local PCT, I myself find any 'less than open' response to feedback, very annoying !

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