Throughout the last year we have been sharing this information at all levels: nationally with Parliament, Government, and senior NHS leaders; regionally with NHS complaints managers; and locally with individual trusts.

Sharing information nationally

We shared our unique perspective on complaint handling in the NHS in our evidence to two major inquiries into patients’ experiences – the Complaints and Litigation Inquiry conducted by the Health Committee and the Mid Staffordshire NHS Foundation Trust Public Inquiry.

The Ombudsman told both inquiries that the new NHS complaints system is demonstrating its potential and needs to be given time to prove its worth. Complaints about the NHS now receive faster consideration locally and are referred to us more quickly. In the Ombudsman’s evidence to the Mid Staffordshire NHS Foundation Trust Public Inquiry, she identified four critical success factors for the new system. First, the role of advocacy in providing support and encouragement for patients Sharing information and learning to speak up; second, the need for clear, consistent, comprehensive and meaningful information about complaints; third, the importance of good leadership and governance; and finally, time for the new complaints system to bear fruit.

The Health Committee’s report acknowledged the success of the new complaints system and called for the collation of complaints data in a meaningful way to be part of the Government’s proposed ‘Information Revolution’. Together with the NHS, the Care Quality Commission (CQC), Monitor, the Department of Health, the NHS Information Centre, National Voices and the National Association of LINks Members we submitted a joint statement in response to the proposals calling for more reliable, meaningful and comparable complaints information to inform learning within and across the NHS.

Complaints information is most effective when it is shared across organisations committed to improving the quality of care and service throughout the NHS. To this end, we proposed that complaints information and associated learning should inform trusts’ annual quality accounts, and the Department of Health’s revised guidance to trusts on this issue incorporated our proposals. CQC fed the information from our 2009-10 complaint handling performance report into their Quality and Risk Profiles, providing an immediate and updated risk assessment for all NHS providers. Summaries of our recommendations for systemic remedy inform the regulators’ assessments and help them carry out effective monitoring. In specific cases, where the evidence from our casework raised concerns about the fitness to practise of individual doctors or dentists, we shared information with the General Medical Council and the General Dental Council, so that they could consider appropriate action in relation to the practitioners involved.

Care and compassion?

The shocking issues highlighted in our Care and compassion? report featured prominently in our discussions with national leaders, from the Chief Executive of the NHS to the leaders of the professional bodies and regulators. Our report was quickly followed by the CQC’s programme of unannounced inspection visits to 100 hospital trusts, which were able to take into account the aspects of care we had highlighted. One fifth of the trusts visited failed to meet all the relevant dignity or nutrition standards, prompting the CQC to call for improvements. In another development, the NHS Confederation, Local Government Group and Age UK set up a commission to look at improving dignity in the care that older patients receive in hospitals and care homes.

Sharing information regionally

Sharing complaints data regionally and locally within the NHS can lead to very tangible improvements in the care and treatment offered to patients. At six regional conferences for nearly 500 complaints managers across England last year, we highlighted how health bodies in each region had performed in the first year of the NHS complaints system.

We continued our work with South East Coast Strategic Health Authority to help them resolve complaints about their continuing healthcare funding. As we show later in this report, the number of complaints about South East Coast Strategic Health Authority accepted for formal investigation this year fell to four, down from the twelve complaints we accepted in 2009-10.

Elsewhere, last year’s complaint handling performance report, Listening and Learning, prompted South West Strategic Health Authority to investigate how their trusts had addressed the issues we had highlighted. The Chief Executive, Sir Ian Carruthers, asked trusts to discuss and act on the SHA’s audit results, emphasising that:

‘Complaints offer NHS organisations an insight and a reflection of the public’s and patients’ experience ... If learning opportunities are identified and lessons learned, the complaint can also offer an avenue to improve service delivery.’

Following a consultation, we published our policy, Sharing and publishing information about NHS complaints: The policy and practice of the Health Service Ombudsman for England, which came into effect on 1 January 2011. It states that we will share all reports of our health investigations with the relevant strategic health authority and the commissioning body, to help them to monitor performance.

Sharing information locally

During the year we visited the health bodies which generated the largest number of complaints to us, or where we had concerns about specific cases or operational issues, such as delay. These visits set out clearly our expectations for complaint handling and provide detailed analysis about the number of complaints received about the body, the reasons for those complaints and our decisions. Using complaints information to identify areas for improvement can have a tangible effect on complaints to the Ombudsman. For example, the most complained about trust last year, Barts and The London NHS Trust, has reduced the number of complaints coming to us from 146 to 112 (click here to view chart for more details). The visits also enable us to hear directly about the challenges complaints managers face working with patients, their families and clinical colleagues in a changing NHS.

Our complaints figures often differ from those held by the body concerned because not all the complaints we receive are progressed directly by us. This can highlight issues about complaints being brought to the Ombudsman too soon, before the health body concerned has had an opportunity to resolve the complaint. Here, our discussions can lead to improved signposting by the health body and better information for patients who have a complaint. At present, our legislation limits what information we can share about cases we have not formally investigated. In order to share more information about our casework and help drive improvements in healthcare, we asked the Secretary of State for Health to amend our legislation to remove the existing constraints. This proposal is included in the current Health and Social Care Bill which is now going through Parliament.