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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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What do you think?

Is an overhaul needed? What changes should be made?

We’re going to be debating the review and recommendations at 1pm today (30 October) on twitter. Join in by searching for #NTtwitchat and using this hashtag in all your tweets



Readers' comments (9)

  • michael stone

    '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.'

    Definitely - I'm with this 100%.

    The LCP Review team also called for folders at bedsides which relatives could make entries in.

    Unless EVERYONE can contemporaneously record events, it gets very difficult subsequently to sort out who did/said what and when !

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  • i'll back up 101% if the patient gets the right name on the right shift?

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  • Reading the press about this today I see it has just changed into a nurse bashing exercise. It's all getting rather tedious now. I think I might take my training that the taxpayers funded somewhere where I'm actually appreciated.

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  • some patients nearing the end of their liverpool pathway may not be capable of writing on their pads.

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  • michael stone

    Anonymous | 29-Oct-2013 2:49 pm

    The LCP is supposed to be going - and visitors can at stage of a terminal decline, do the writing, instead.

    And this isn't about 'nurse bashing', it is about collecting feedback - how do you know the single commonest comment, wouldn't be 'there never seem to be enough nurses on duty' ?

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  • Nurses as we saw in Mid Staff are to blame for every failing in the NHS and are left to stand alone and carry the can for all because we do every body else's job and have marginalised what pure nursing is.

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  • I want my patients to complain, if it is genuine. I would also like my colleagues to complain. If enough people complain then the causes will become very obvious and not so easy for management to ignore.

    But let's ensure that the bedside pen and paper are not used simply for silly moaning. Today I had to deal with an irate father whose otherwise healthy 22 year old son was discharged last friday after some minor day surgery on his knee. He left the ward safe on crutches and with all relevant advice and analgesia. His father and mother (with whom he lives) decided to go ahead with a planned weekend away, so his girlfriend stayed with him over the weekend. The father's complaint? "Where the f*** was the home help?!!! His girlfriend had to make him his meals. What the f*** kind of people are you to leave him like that?"

    I suspect he reads the Dail Fail.

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  • Indeed I am fine about people complaining about patient care etc. I will be especially happy for an inspector to come shadow me on any of my shift, I should be getting an OBE or MBE or whatever people get from the queen for doing well. I work my socks off but I am not recognised for my hard work, in fact all patients and relatives want is, more from me.
    I think that nurses should also have special paper and pen in their pockets to write down complaints on whatever.
    Lets all complain and lets sort the problems out.

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  • nurses seem to be considered as some kind of servants who can and will do absolutely everything for everybody and act as the nearest and biggest target when things go wrong, and their professional boundaries have become blurred.

    positive and negative criticism and feedback which can be used constructively is excellent.

    seeking and collecting feedback every minute of the day is how we navigate our way through our natural environment and what we humans do in order to survive. however, this seems more successful if we can keep to objectivity and take on board what is helpful to us rather than giving or accepting subjective and unnecessary criticism which arises out of anger or unchecked emotions and designed to hit out and wound another (something we all need to learn throughout our childhood). As well as keeping a check on ourselves we need to develop strong filters for our own protection and be self reflective and have a good knowledge of our own strengths and weakness and having confidence in what we do well and where we can improve all helps and applies to all of our relationships no matter how brief or profound and lasting as well as our practical skills.

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