Hospital complaints system blasted
Monday 28th October 2013, 2:50AM GMT.
Too often hospitals are seen to be “marking their own homework” when handling complaints, a review has concluded.
Many people think there is a ” lack of independence” in the current system, according to the review into the way the health service handles complaints.
It concluded that t here must be a “revolution” in the way the NHS deals with complaints after hearing that t here is a “toxic cocktail” that prevents concerns being heard and addressed.
Patients and their families are reluctant to complain about poor care and hospitals are too “defensive” to hear and address concerns, the review found.
It concluded that it should not be “painful or difficult ” to complain about bad care and made a string of recommendations from patients’ bedsides to hospital board room.
Many find the system confusing or they did not want to raise concerns for fear that their future care could in jeopardy , the report found.
And it said people who want to complain often feel “out gunned by a powerful monolithic organisation”.
The review, led by MP Ann Clwyd – who protested about the care her late husband received while in hospital last year – calls for some basic levels of redress such as giving every hospital patient a pen and paper so they can jot down worries and making sure patients know who to speak to if they have a concern.
And hospital bosses should scrutinise every single complaint made and compile an annual report detailing concerns raised and what changes have been made as a result.
It also calls for more complex reform such as the rebranding of Patient Advice and Liaison Service – which provides general help, support and information for patients at a local level.
“Too often patients feel uncertain or confused when they feel they have a problem,” the report states.
“Some never complain because they feel is may be unjustified or because they think staff are too busy. Others may lack confidence or feel intimidated or find the compliants procedure hard to understand, too complex or tiring.
“It should not be difficult to complain, and when patients do complain it should not be up to them or their relatives to continually chase progress.”
The Prime Minister appointed Ms Clwyd, along with Professor Tricia Hart, the chief executive of South Tees Hospitals NHS Foundation Trust, to conduct the review in the wake of the scandal at Mid Staffordshire NHS Foundation Trust.
Last year the Cynon Valley MP said her husband Owen Roberts died “like a battery hen” at the University Hospital of Wales and spoke of the “coldness, resentment indifference and contempt” of some of the nurses who were supposed to be caring for him.
Publishing the review findings, she 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. It made me determined to do my best to get change in the system.
“We have given patients and their families a voice in this report, and their message to the NHS on complaints is clear. 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.”
The NHS in England received 162,000 complaints last year – or 3,000 a week.
Many of the complaints would not have been formally raised if issued had been addressed quickly, the review found.
The authors found people complained because the lack of information they had been given, a lack of compassion and care and the absence of basic supplies such as extra blankets and pillows.
Many who raised concerns to the review felt the quality of nursing care is “in decline”.
A relative of a patient who wrote to the review team said: “I went to the nursing station on one occasion to see the entire team bidding at the end of an eBay auction. I was kept waiting, ignored, until it was over.”
Another added: “If you can’t understand that a patient needs a drink, is cold, or needs to go to the toilet, then you shouldn’t be in nursing.”
And another said: “The most common thing I hear from nurses was that ‘I am too busy, I will do it later’ and later never came.”
Government will consider the review’s findings and will respond next month when it formally responds to the Francis Report into serious care failings at Mid Staffordshire NHS Foundation Trust.
Health Secretary Jeremy 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.”
Ms Clwyd added: “Complaints should be gold dust and should not be cast aside.”
The review also raised concerns that the Parliamentary Health Service Ombudsman is “too far removed” and lacks accountability to local people.
The Ombudsman was also criticised for not acting on complaints about the poor quality care people received during the care crisis at Mid Staffordshire NHS Foundation Trust.
The authors suggested the Ombudsman should set up regional offices so it is more accountable to local communities.
The review also details concerns that recent health reforms had exacerbated difficulties within the complaints system.
The NHS Confederation told the review authors: “We have serious concerns that following the NHS reforms the complaints system has become more difficult to navigate and risks leaving patients confused about who to complain to.”
Health Service Ombudsman Dame Julie Mellor said: “We know from the cases we see that the report needed to address the ‘toxic cocktail’ of reluctance by patients, carers and families to complain, combined with a defensive response when people do complain.
“Tackling this issue is vital if we are to deliver the step change in complaint handling that is needed to achieve justice for patients and help learning and improvement by providers. This will help to restore the public’s confidence in the NHS and ensure the same mistakes don’t happen again.
“We welcome the focus on greater independence in the operation of the complaints system. We are completely independent of government and the NHS, and are the final adjudicator on complaints about NHS services. We believe our service has a significant contribution to make to increasing independence in the complaints system for both patients and NHS hospitals.”
Labour’s shadow health secretary Andy Burnham said: “The NHS has an unfortunate tendency to push complainants away and pull down the shutters. That has to change.
“Most people who bring a complaint do so purely because they don’t want others to go through the same experience. NHS organisations should use complaints positively as part the drive to improve care.”