Communication
Our case files reveal a significant increase in people who came to us because they felt that the NHS had not acknowledged mistakes in their care – 50% more people came to us for this reason than in the previous year. Better communication would help the NHS understand the needs of patients and allow patients to understand the decisions made about their care and treatment. Inadequate communication was an issue in over 35% of complaints we resolved without the need for a formal investigation.
Good communication demands good explanation of why decisions were made, particularly where there is disagreement between the patient and the NHS. Last year, there was a 13% increase in complainants who came to us saying that they had received poor explanations in response to their complaint.
Quality of care is not just about getting the treatment and care of patients right. It is also about putting things right when mistakes occur. This means handling complaints promptly and sensitively, and carrying out thorough investigations to establish the facts of the case. It also means giving complainants timely and evidence-based responses, ensuring that any failings in care are properly acknowledged and explained.
The case studies in this report are examples of where things have gone wrong and how we’ve helped to resolve them.
Getting it wrong
Common pitfalls amongst NHS responses to complaints:
- Equivocal language and sitting on the fence over decisions that were made during the care complained about;
- Getting key facts wrong;
- Using technical language, without appropriate explanations;
- False apologies: for example ‘I’m sorry you feel the care wasn’t good enough’.
We see lots of examples of poor communication between the NHS and patients. Some quotes taken from letters from organisations in response to NHS complaints are shown below.
Examples of poor communication by organisations in response to NHS complaints.
‘In regard to the months leading up to it [sic] is probably best to chronicle the situation as I have read from his medical records; I have found that this is the best way to explain how the world of medical treatment and evaluation/reading of symptoms and having a working diagnosis, with a view to always keeping a suspicious eye on any background dangers that may be evident (i.e. cancer) that are notoriously difficult to detect when the classical textbook symptoms are missing and other, much more evident and treatment responsive conditions such as chronic obstructive pulmonary disease dominate the picture and are the primary reasons for coming to a doctor.’
‘Unfortunately [the surgeon] was unwell on [the day of the appointment], his operating lists were cancelled but I apologise if we failed to notify you before you left the clinic. Unfortunately you left before another appointment could be arranged.’
‘Death is rarely an ideal situation for anyone and I take comfort knowing that your mum did not die alone and to the contrary spent her last few hours comforted by one of our best carers.
I accept you would have liked to have been there in those last few minutes but in practice this is so hard to achieve and like life itself is left to chance.
Truth be told your mother probably said her goodbyes long before the final moments.’
Getting it right in the new NHS
We will work to help trust boards learn from their patients’ complaints. We will visit boards of the most complained about trusts to share directly with them our perspective on their patients’ experiences of using their services and on complaining to them.
