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NHS given 12 months to improve complaints system

Report calls for NHS to listen to patients and take criticisms to most senior staff

Mark Gould

Tuesday, 29 October 2013

A government commissioned review says the NHS has 12 months in which to improve accountability and transparency in the way it handles complaints.

The review was commissioned by the government after the public inquiry into the Stafford Hospital scandal. Labour MP Ann Clwyd was asked to lead it after she broke down in a BBC interview last December describing how her dying husband was treated with "coldness, resentment, indifference and contempt" by hospital staff.

She was sent more than 2,500 letters and emails from people describing similar problems and dissatisfaction with the way complaints are handled and said the NHS had presided over “decade of failure” to reform the way in which complaints are handled. They said people were often unaware of how to make complaints or of the identities of staff they wanted to complain about.

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."

Recommendations include:

Board level responsibility – Chief Executives need to take responsibility for signing off complaints. The Trust Board should also scrutinise all complaints and evaluate what action has been taken. A board member with responsibility for whistleblowing should also be accessible to staff on a regular basis.

Transparency – Trusts must publish an annual complaints report in plain English which should state complaints made and changes that have taken place.

More information on the wards – Trusts should ensure that there is a range of basic information and support on the ward for patients, such as a description of who is who on the ward and what time visiting and meals take place.

Trust complaints scrutiny – Patients and communities should be involved in designing and monitoring the complaints system in hospitals.

Easier ways to communicate – Trusts should 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.

Patient services and independent advice – the Patient Advice and Liaison Service should be rebranded and reviewed so its offer to patients is clearer and it should be adequately resourced in every hospital. The Independent Advocacy Services should also be rebranded and reorganised.

The Government will now consider this report and respond in full later this autumn.

Ms Clywd said that to ensure real change the review has taken the unusual step of securing undertakings from key health organisations to ensure that action will be taken within the next year. These include:

  • The Nursing and Midwifery Council to include new duties over complaints handling in its code of conduct.
  • A pledge from Health Education England to develop an e-learning course to improve training.
  • NHS England promising to work with local managers to hold hospitals and other providers to account.
  • The Care Quality Commission to place a strong focus on complaints in its new hospital inspection regime.
  • Hospitals will also be expected to publish annual reports in "plain English" on complaints.

Health Secretary Jeremy Hunt welcomed the report and said a full response to the Stafford Hospital inquiry and the reports that have followed, which include this one as well as others on healthcare assistants, mortality rates and patient safety, would be made before the end of the year.

As well as the commitments to change from health organisations Mr Hunt said other main drivers for change will be led by consumer and patient bodies agreeing to work together locally and nationally to oversee and monitor implementation of the recommendations, and championing complaints reform.

Mr Hunt said Professor Sir Mike Richards, the Chief Inspector of Hospitals, is making complaints a central part of CQC inspections of hospitals. He will develop standards for the handling of complaints by NHS organisations, ensure inspectors’ judgements are fully informed by what people say about the quality of care in a hospital, and publish his findings on complaints across hospitals in a year’s time.

Mr Hunt said: "We saw in Mid Staffs how badly things go wrong when patients and families’ complaints aren’t taken seriously. I want to see a complete transformation in hospitals’ approach to complaints, so that they become valued as vital learning tools. There can be no place for closing ranks or covering backs when patient safety is at stake.

"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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