COMPLAINTS HANDLING
The right response “D
Dr Ian Reeves and Gráinne Byrne of the Scottish Public Services Ombudsman discuss why patients complain and how an eff ective response can oſt en prevent complaints from escalating
ELAY, deny and defend” is how the NHS approach to complaints handling was described in a
recent report. An independent government- commissioned inquiry led by Labour MP Ann Clwyd also highlighted “deep dissatisfaction” with a system (in England) in which people oſt en did not bother to complain about poor care because the process was either too confusing or they feared for their future care or that of a loved one. Complaints are usually reviewed negatively
by the recipient, both at an individual and organisational level. Criticism is hard to take and the subsequent response is oſt en ineff ective as noted in the Francis report into deaths at Mid Staff s hospital. T e report stated: “A complaints system
that does not respond fl exibly, promptly and eff ectively to the justifi able concerns of complainants not only allows unacceptable practice to persist, it aggravates the grievance and suff ering of the patient and those associated with the complaint, and undermines the public’s trust in the service.”
Better complaints handling Given these reports, it seems that complaints handling could and should be high on organisations’ agendas. T e Scottish Government’s detailed guidance on the NHS complaints handling procedure is outlined in the document Can I Help You? It emphasises the importance of learning from complaints, which is also a key focus of the work of the Scottish Public Services Ombudsman’s (SPSO) Complaints Standards Authority (CSA), which strives to improve complaints handling across the public sector. T e SPSO is the fi nal stage for complaints about public services in Scotland. (Similar organisations exist in England, Wales and NI). Another crucial focus of the CSA is
ensuring that complaints are handled eff ectively and, if possible, resolved at the fi rst point of contact. T e CSA provides advice and guidance for all complaints, not just those that reach the SPSO, including how to make an
WINTER 2014
apology more meaningful and specifi c. Apologies off ered in
response to a complaint need to show that the reason for the complaint has been understood, and that action will be taken to prevent a recurrence. It is also appropriate to acknowledge that the complainant is ‘right’ and their complaint is justifi ed. T e CSA off ers
training courses on complaint handling which involve analysing the aspects of a complaint, and how to investigate and respond. T is is applicable to all those involved in complaint handling, such as practice managers. With NHS Education for Scotland, the CSA has also developed e-learning modules to support frontline staff and complaints handlers.
SPSO investigations T e SPSO will only investigate complaints aſt er the local organisation has concluded their response, and if the complainant remains dissatisfi ed. A signifi cant proportion of problems from
the complaint process arise from delays in dealing with complaints. Dissatisfaction with the content of the complaint response usually arises where the organisation decides to “defend” the service provided, rather than off er an apology. It is also more likely if the apology is ineff ective. Errors in the complaint response, such as
getting names/dates/clinical details wrong undermine the confi dence of the recipient in the complaint process, so diligent fact- checking and proofreading are essential. Aſt er a dissatisfi ed complainant refers the
complaint to the SPSO it is handled by an SPSO complaints reviewer who requests the relevant notes and, where appropriate, seeks clinical advice from a relevant independent
professional. In the case of GP complaints, this is usually a GP working in Scotland who is familiar with current standards of GP care. T e outcome of the
SPSO process is communicated to the complainant and the relevant service in the form of a letter to both parties. Some investigations are laid before parliament as an investigation report if there
is a specifi c public interest. T e SPSO may make
recommendations to provide redress for the complainant, and to ask the service to make changes to ensure any system errors are corrected. Individuals involved are usually asked to refl ect on the complaint and SPSO fi ndings as part of their annual appraisal.
Summary • Complaints should be valued by organisations and individuals, not feared.
• The SPSO process is not punitive but provides an independent evaluation of the complaint process.
• Following CSA guidance and training can help turn complaints into a positive experience.
• Following complaint handling advice from organisations such as the CSA and SPSO will help ensure complaints are resolved satisfactorily while also improving the quality of the organisation’s services.
Links: • The SPSO:
www.spso.org.uk • The Complaints Standards Authority
www.valuingcomplaints.org.uk • Twitter: @SPSO_ombudsman
Dr Ian Reeves is a professional adviser to the SPSO and Gráinne Byrne is an SPSO communications offi cer
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