The health and social care complaints system must be simple, speedy and compassionate
The complaints system for health and social care is “bewildering and largely ineffective” according to a new report from Healthwatch England.
It should be replaced with “a system that is simple, seamless and stress free”; one that “offers users meaningful resolution.”
The report - Suffering in Silence – which draws on an August 2014 online survey of 1676 adults, along with other background data – spotlights a patchwork complaints system involving around 70 different organisations – providers, commissioners, ombudsmen and regulators.
The report found that 61% of people who said they had either witnessed or experienced poor care had not reported it. Often they were unable to access information on how to complain, or who to complain to.
The procedures for complaining were sometimes “unnecessarily bureaucratic and adversarial” and did not reflect the real-life experiences of complainants who frequently felt that they were not being listened to. Many simply wanted an acknowledgement that something had gone wrong, an explanation, or an assurance that the same thing would not happen to other people in the future. However, only 49% of those who complained received an apology.
26% did not complain because they feared negative repercussions in their future treatment or care.
The importance of advocacy
Less than a third of people received support when making a complaint and less than 10% received any kind of independent advocacy.
However, 70% of those who had not complained said that would be more likely to do so in the future so if they were offered this kind of assistance. Over 80% said they would be more likely to complain if the lessons learned were used to improve and develop services. 81% said that seeing other peoples’ complaints being used to make a positive impact on services would encourage them to complain.
The report recommends that:
- Organisations that are involved in health and social care acknowledge that everyone has a right to complain. This includes third parties and bystanders and those who wish to complain anonymously.
- Staff should proactively seek feedback from patients and respond positively to any complaints or concerns.
- Information on how to complain should be clear, up to date and on open display. It should be made easier to access the complaints system online. Those who do complain should be given additional information and advice, and signposted to advocacy services.
- Responsibly for finding out who to complain to should be taken off the shoulders of patients. A “no wrong door” approach should be adopted where if a complaint is made to the wrong person or department, it is forwarded to the person who is best qualified to resolve it.
- There should be a review of PALS (Patient Advice Liaison Services) and NHS complaints advocacy. These services should be well publicised and steps should be taken to ensure that they are available to all health and social care users. They should be focused solely on the interests of the individual and underpinned by a new set of national standards.
- Healthwatch England should be given the power to act as a super complainant on behalf of groups on national issues.
- There should be a commitment towards a simplified complaints system that is clear and compassionate and responds to all complaints within three working days. Part of this response should include an apology for any failings in care. Attempts should be made to identify the desired outcome of a complaint and to outline the steps that will bring about this resolution. There should be a named case handler for every complaint so people have a consistent point of contact. People making complaints should be allowed to proceed at a pace that suits them and allowed to place a complaint on hold while they deal with illness, trauma or grief.
- There should be mandatory training for frontline staff making them better equipped to handle complaints. This training should include a clarification that they can apologise without fear of legal repercussions. There should be a recognition of the stress that complaints place on staff and efforts should be made to support them and allow them time to reflect upon any lessons that have been learned.
- Complaints in health and social care should be overseen by a single public services ombudsman.
The report also calls for national oversight of complaints about social care in line with NHS complaints, for Care Quality Commission (CQC) inspections to be guided by local complaints data, and for the CQC to take a more active role in developing and implementing guidance for complaints handling. Those who consistently fail to listen or respond to complaints should be held to account and subject to financial penalties. In extreme cases, failing services should be decommissioned.
(Click on the pink text below to access the Suffering in Silence report. These are hosted on the Healthwatch England website and will open as PDF files)