In the latest episode of our podcast we're joined by:
- Paul Hetherington, Inclusion and Experience Specialist, Improving Customer Delivery at DEFRA
- Gemma Rauer, Deputy Director of Communications and Engagement and Director of Patient Relations at University Hospital Birmingham
- Tina Bige, Principal Customer Engagement Manager at Natural England.
Our guests shared how the Complaint Standards have helped them to learn from feedback to create lasting change.
The Complaint Standards set out how NHS and UK central government organisations should approach complaint handling in a clear and consistent way. They help organisations to:
- deliver everyday good complaint handling
- meet the expectations of people making complaints about their service
- use feedback from complaints to make service improvements.
Steve: Hello, everyone. Welcome to Making Complaints Count. This is the podcast from the Parliamentary and Health Service Ombudsman. I'm Steve Hannay, I’m one of the Stakeholder Engagement Managers and today I'm joined by three guests who have been helping to embed the Complaint Standards over the last year or so.
I’m joined by Paul Hetherington, who is from DEFRA. I'm joined by Gemma from University Hospital Birmingham and Tina, who joins us from Natural England.
Really delighted you can all join us. Really grateful for you taking the time to join us and talk about the Standards today.
The Complaint Standards set out how organisations like yours, DEFRA, UHB, Natural England, should approach complaint handling in a clear and consistent way.
So welcome, everyone. Some good questions and hopefully some good discussion to go through today.
Just to start things off and for everyone's benefit, can I just go round to get information from each of you about your background and what your day-to-day role entails? Gemma, can we go to you first, if that's okay?
Gemma: Thanks, Steve. And hi, everyone. I work at University Hospitals Birmingham, and I've been here for four years, but my career in the NHS started 21 years ago in 2004.
My background is in primarily communications and engagement, and I have worked in patient relations and patient experience over the years as well.
I am currently Deputy Director of Communications, Engagement and Patient Relations at University Hospitals Birmingham or UHB as we like to call it, and I’ve been doing the patient relations patient experience roll for about a year now.
Steve: Thanks Gemma. Tina, over to you.
Tina: Hello, everyone. My name's Tina Bige and I'm the Principal Customer Engagement Manager for Natural England. Our team handles customer feedback, complaints and general customer enquiries. We're quite a small but dedicated team, and we take the lead with customer complaint investigations and gathering insights from specialist teams across Natural England to provide our customers with feedback and a detailed, empathetic, professional response.
I joined Natural England three years ago. Prior to that, I had a 12 year career with the Department of Work and Pensions, starting off as a work coach, helping customers back to work and then progressing through DWP to be a job centre manager.
Steve: Thanks Tina. And Paul, last but absolutely not least over to you.
Paul: My background is in,before joining the Civil Service, I worked in local government in a variety of customer service, customer facing, operational and management roles.
I now work as a Customer Business Partner Inclusion and Experience Specialist in the Improving Customer Delivery team in DEFRA. So we work across DEFRA and its delivery landscape, looking at the customer journey, service delivery and providing accessibility and inclusion assurance and guidance.
Steve: Lovely. Thank you, Paul. And as you can see people from lots of different organisations, different backgrounds, all using the Standards in their day-to-day work, which is one of the ideas behind the Standards. I think you each touched a little bit on feedback and complaints and that sort of thing. Just wonder what the importance of feedback was in each of your roles. Tina, going to go to you first for this one, if that's okay.
Tina: Definitely. In Natural England complaints aren't just about fixing problems, but they're also a way for us to learn and to improve our services and make sure that we're meeting the needs of our customers. So by addressing customer feedback effectively, we can build trust with customers, and we also can demonstrate that Natural England care about what our customers have to say, and that we’ll act on feedback to improve our processes going forward.
Steve: Thanks, Tina. Paul, what about at DEFRA?
Paul: Yeah, so across DEFRA feedback is really important to us. Reiterating what Tina said in terms of learning from complaints and improving service delivery. So in DEFRA our landscape is evolving post-EU exit and now is a crucial time to listen to customers, understand our relationships with them. And if there are occasions where they have been let down to learn from that, make improvements and put things right.
Steve: Thanks, Paul. What about your experience of feedback, Gemma? Obviously a key role in what you do.
Gemma: Absolutely, Steve. So, you know, feedback from the people who use our services - patients, their relatives, their carers and also from our staff is absolutely crucial for us at UHB.
We are absolutely striving to be a learning organisation and feedback from compliments, complaints, enquiries, PALS (Patient Advice and Liaison Service), friends and family tests and surveys really gives us a good insight into what people see and think about our services. It helps us to listen and act on what people want to see changed or do more of even.
I guess the beauty of my role, given what I've just said about my communications experience, is I see feedback from a multitude of different channels. So not just the channels I’ve just mentioned, but also things like social media comments, media enquiries, web enquiries, all sorts of different points of feedback really.
So that gives us lots of opportunity to look at things, you know, holistically and triangulate that data and that feedback to try and make real improvements for patients and staff.
Steve: Well, that's a great point. You know, feedback is from all sources, and it’s from staff as well. Staff can identify where things can be better and taking that feedback on board is super important. And it’s one of the things that the Standards talk about with the learning culture and listening to the experts on things.
So I mentioned the Standards at the start. I was just interested how you would describe the Standards to somebody who's not aware of them, setting out what they are and how they work. Paul, I'll go to you first on this one. If somebody had never heard of the Standards, what would you say about them?
Paul: I would say that the Standards provided us with the framework guidance and tools to enable change and set a standard across the organisation for complaints handling.
Steve: That's a nice snapshot. Gemma, what about the NHS side of things?
Gemma: Yeah. Quite similar to Paul, really. Absolutely a really useful framework to improve the way that we handle complaints, to ensure they are addressed fairly, openly, transparently and that learning from complaints is really embedded in the organisation so that it leads to improvements in the services that we deliver. I think how I’d describe it.
Steve: Tina, anything to add?
Tina: I think the Complaint Standards offer a consistency across public services, that we're all following the same standards and our customers are receiving the same level of service wherever they're accessing public services and just allows us to be consistent.
And it gives us a really good idea of what good looks like so we can strive to make sure that we make improvements within our own organisation if we need to.
Steve: But yeah, key point, what good looks like for everyone, but also that consistency piece. Obviously Paul and Tina from the UK Central Government Complaint Standards, Gemma uses the NHS Complaint Standards but they're broadly very, very similar only some subtle differences.
It's ensuring that anybody who complains about government services is going to have a consistent approach to the way they’re responded to.
So this is the Making Complaints Count podcast and as part of a social media campaign we're encouraging organisations who've used the Standards to kind of share their stories which is what today is all about.
I'm just interested if any of you feel that the Standards have changed how you handle complaints since the introduction of the NHS or UK Central Government Complaint Standards, and if that's improved the service for your service users.
We're going to pick on you first Gemma.
Gemma: So yeah, there’s three things really that I’d like to talk about. I think the Complaint Standards and also the overall package of resources from PHSO have been really quite empowering actually to encourage us to look at our processes, to make sure that they are the best they can be. Whilst they're not perfect we should be striving to make them the best they can be.
And I think with this in mind we have taken the decision to reintroduce our tiered response rates for complaints. This is something that we did before COVID - basic, regular and complex. Complainants are very clear about the timescales in which they will receive a response from us. And, you know, all of those timescales are agreed upfront depending on the severity of the complaint.
Whilst we've just introduced that a few weeks ago, early signs are that it’s embedding really well. Not just for our patients and their families, but also for our staff as well. Not just the staff from the complaints team, but our colleagues from across our hospital trust as well.
So we're hoping to see some real improvements, some real progress in that area with that reintroduction of the three tier system.
I guess the second thing is around thinking about improving and simplifying our processes. We’re just about to launch a web form on our website, which hopefully will be very user friendly. We're going to be testing it very soon.
Complainants can complete the web form and that gets sent into us. And it has all the required fields that we need to quickly and efficiently process and log their complaint. It really reduces the to-ing and fro-ing, the emails, maybe the phone calls, you know, back and forth, trying to reestablish the basic details and what people would like us to investigate on their behalf.
And actually, could this complaint or this issue be resolved in another way? You know, it doesn't have to be a formal complaint, with agreement with the person involved.
So that's something else that we're going to be launching, which PHSO and all of the materials inspired us to do again. And also the access to the training and support from the PHSO team is really good. And I would encourage people to really look at the resources and the support that's out there.
I know we've had a lot to do with each with each other Steve over recent months in terms of training and support and conversations and it's been really valuable.
Steve: Yeah, we'll come onto training in a minute. I know each of you have been involved in the training or received some of the training in different formats.
Tina, over to you. I know you’ve been using the matrix which is one of the tools that Gemma was talking about as part of embedding the Standards.
Tina: I mean, I was actually new to this role about a year ago, and one of the first activities I did was to complete the matrix or the assessment tool through with support from Paul from DEFRA.
And it was great to me because it allowed me to really spend some time with the complaints team to see where they thought we sat on that assessment tool at the moment. Then we followed that up with a wider staff survey because we had a perception of complaints, but we wanted to see what the wider perception was and how it landed across the organisation.
We had a really good number of returns on that. We got some really good feedback and some really good ideas from staff who highlighted things like the fact that there wasn't very much complaints training available.
A few of us on the complaints team have done the PHSO complaints training, so we're able to put that forward as a suggestion when people were coming to us. We investigate some of the complaints when they come in, but some of them are quite complex and they tend to go to specialist teams to do the investigation. But none of those people have necessarily done any training in how to investigate that.
So whilst our team will give as much help and support as they can through that, knowing that there's free training that's available on the PHSO website, which we can signpost those staff to, they can undertake a bit of training just to give them a more thorough investigation. That’s been really, really helpful.
Steve: And Paul, you've also got a slightly different perspective maybe as a Central Government rather than a delivery body in terms of how you've used the Standards.
Paul: Yeah, it's been really interesting because I sit within the core DEFRA function, but I've been embedding the Complaint Standards with several of our delivery partners.
So as Tina mentioned, working alongside Tina in Natural England, also other delivery partners such as Animal and Plant Health Agency, Rural Payments Agency, various sizes of organisation as well, some of them smaller, some of them bigger.
The standards have enabled us to raise the profile of complaints across DEFRA Group and use the assessment tool with the different delivery partners to review and align our processes and how they sit in DEFRA as a whole.
Following on from that, we’ve designed central guidance for DEFRA group and we've adopted in that the customer friendly approach and tone of the PHSO training, which was something I really liked. I found it really refreshing that the training felt modern and relevant to customers today. As well as that, as Tina mentioned, getting the impact of the staff involved. People are enjoying learning from complaints and in developing this work and learning about their organisation, also enjoying the networking opportunities to work across delivery partners and learn from each other as well.
Steve: Well, you've all kind of talked about the training and different aspects of that, and you’ve given some good examples of how that's been helpful.
Anything else you can pick out that surprised you about the training that particularly stuck with you or been helpful? Gemma, I’ll come to you on that one first.
Gemma: Yeah, I mean, as I said, Steve, you know, I think the training has been incredibly helpful, even for the most experienced members of staff in the team really.
It's an opportunity to take some time to think and review our own processes, to think about what we could be doing differently and make those improvements.
Sometimes it’s a confirmation that actually we're doing okay. We deal with a lot of complaints, some very complex issues. And we are a really, really busy team. We need to recognise that we do a really good job in the main. We don't get it right all the time.
We’re just consolidating the processes, the learning, the thinking and having the time and space to do that with colleagues from PHSO is just incredibly helpful.
Steve: I think you kind of touched on two of the key points that we see when we deliver the training. We love the fact that you get a real mixture of people in those sessions. We'll get people who are six weeks into a complaints role, we’ll get people who are 26 years in but everyone picks up something different and takes a different thing away from those sessions which is always good.
And that confirmation thing as well. Lots of the feedback we get is that it reassured us that we're doing the right things, it gave us the confidence that our processes are robust and we are we are in line with the Standards. Tina is that hopefully what your experience was?
Tina: Absolutely, I really enjoyed the workshop where you got to join and talk to other complaints departments. That was really useful.
But I also really enjoyed the online training. I found it really interactive and actually, I took the time to complete the work because I went through it rather than rushing through, which is sometimes tempting.
But I really considered the responses that I recorded in there, and actually, it helped me embed that learning. I can go back to that as a resource and refresh my memory when I need to.
When I completed the ’How to investigate and respond to a complaint‘ training, I actually did some quality assurance on complaints for my team. It was so much easier being able to really look at the complaint and really think about it from the customer's perspective. What are they asking for here? Have we responded to every point they have raised in an empathetic way? Have we communicated our responses in a way the customer will understand?
I think if I hadn’t done that training, I would have had a slightly different perspective in the way I’d look at it. So doing that just before the quality assurance was really, really helpful.
We’ve rolled out the initial training to everyone on our customer services team, and it was really useful because it tends to look at dissatisfaction and how to handle, or almost how to head off, getting to the complaint stage.
That’s something we’ve rolled out for all of our customer service staff, and then our complaints staff and anybody who may be involved in investigating complaints has taken on the second course and has found it really, really useful.
Steve: Thanks, Tina. I know we delivered the ‘Early resolution’ training to your team early this year when we came down to Birmingham, Gemma. I thought it was a really good session.
And Paul, I know you’ve been a massive advocate for the training and really supportive of getting this out across your delivery bodies. How did you find the training and what was helpful for you?
Paul: I really enjoyed it. Echoing what Gemma and Tina have said, we’ve really enjoyed the content but also collaborating with other organisations that we may not have taken time to do so in those breakout rooms.
I was talking to colleagues from the NHS, sharing experiences, making network opportunities to learn from each other. I really like the customer-friendly language that the training is delivered in.
I think Tina touched on it as well. The training itself is a great baseline tool for anyone who’s dealing with customers and feedback to get a good feel for what is a complaint and what is feedback, what are the expectations. And that doesn’t have to be in a customer service role. I think anybody dealing with customers generally can find it really, really useful.
Steve: I was just interested if any of you have any really good examples or stories about changes your organisation has made based on feedback? Gemma, over to you.
Gemma: Yeah, thanks Steve. I’ve got an example here actually. This is regarding our ophthalmology services across the hospital trust.
We had several PALS and complaints enquiries raised by patients, advocates, and carers around the lack of reasonable adjustments made for adults visiting their appointments across our sites.
Based on this feedback, our medical and nursing teams collaborated and came up with a very robust plan to make sure we were absolutely understanding and accommodating the needs of these patients both in- and out-patient settings.
Some of the things that happened as a result were alerts being made more robust on our clinical systems, clinic staff identifying vulnerable patients with additional needs earlier on, discussing them in morning meetings, appointment times being moved, making adjustments to waiting lists and things like that.
All staff have updated their vulnerability awareness training, there’s 100% compliance now from what I understand. So things like Accessible Information Standard or Oliver McGowan [mandatory training for health care staff], safeguarding etc. which is really positive. There was also improved visibility and communication with patients from clinical leaders in the department, so they or their relatives and carers can ask for extra support.
Clinic letters were updated to advise who can offer support and provide an additional layer of information that people would find helpful. This has all been captured and reviewed in monthly audits to ensure that the work has been fully integrated and is continuing.
That’s just a bit of a snapshot of something we’ve done here at UHB. I hope that’s helpful.
Steve: That’s a really good example of making complaints count. All that came out of seeing trends in complaints and repeated themes, then taking action to learn and improve services.
Paul, any examples you can think of from DEFRA about making changes and improvements?
Paul: Yeah, following feedback from our Complaints Working Group, where delivery partners and myself get together to review how complaints are going across DEFRA, we decided to produce some central complaints guidance. This is linked to the PHSO Standards, follows the same tone and is applicable broadly across all of DEFRA group. This should make processes and procedures easier for people to follow and provide one source of truth.
Steve: Thanks Paul. Lots of hopefully good points for organisations that weren’t familiar with the Standards or maybe haven’t engaged so far.
Just wondering if I could ask each of you to give a quick pitch on behalf of the Standards to organisations that haven’t really used them so far. Paul, how would you sell it to somebody, another department looking to do a similar role in overseeing their delivery bodies?
Paul: I’d say make the time to do it because it’ll give you a fresh pair of eyes into your complaint handling. It may reassure you that what you’re doing is correct but take the time to start with a fresh mind and a clean slate. Think about how complaints are for you in 2025.
Steve: Gemma, how about you for other NHS colleagues who may not be totally familiar with the Standards or haven’t found out much about them?
Gemma: Yeah, I’d say there are so many good resources from the PHSO. Not just the Complaint Standards. They’re all really accessible. I think that’s really come across from Paul and Tina as well. Really easy to access and extremely useful.
So I would absolutely make the time to see what’s out there, what resources are relevant to you. They might not all be relevant from the start, but really make the time to have a look, have a chat with PHSO colleagues, and immerse yourself in it.
That’s what I did, and I found it so useful.
Steve: It goes without saying, myself, and the rest of the colleagues in the Stakeholder Engagement team are always happy to talk Standards. That’s all it seems we talk about sometimes, so very happy to help people out.
Tina, what about you? Because you’re a delivery organisation, what’s your pitch?
Tina: I would definitely recommend using the assessment tool to see where your organisation’s processes compare against the Standards.
We found it really easy and it just gave us a really good snapshot of where we are at the moment and more ideas as to how we can improve our service.
Steve: Excellent. Thank you. So we've talked a lot about the Standards there. So let's maybe talk a bit more generally about complaints in general and making complaints count. Having worked in frontline planning for a long time I know what a difficult job it is and how tough it can be, but what do you find the most rewarding thing is working in this kind of role, Gemma?
Gemma: So I think the most rewarding thing is probably that it is a real privilege to be able to support somebody through a very difficult time in their life. Because obviously, you know, with the NHS, we have some very, very difficult complaints. We have some very, very emotional complaints that we deal with.
Being able to support someone through a very difficult time, to support them to get the answers they need. And then hopefully see learning and actions as a result of a complaint being embedded in the organisation. That's what makes it really worth it actually.
You are often there for people at a very, very vulnerable time in their lives. And to be able to offer some comfort and support, advice, guidance, some answers, that's what motivates me to do this job and that's really important to me. And that's what aligns with my personal values as well, really. So yeah, that's probably how I describe it.
Steve: Thanks, Gemma. So Tina, what about you in that kind of delivery role, what's the most kind of rewarding thing you would say from complaints on a day-to-day basis?
Tina: I think being able to put something right when it's gone wrong is definitely the aim, isn't it? And then restoring that trust in that customer relationship. I think the ultimate reward is if a customer says, thank you for resolving their complaint. You know you've done a really good job when they say thank you.
Steve: What about you Paul? Slightly different perspective from a more central oversight role.
Paul: I think complaints and feedback can sometimes be viewed as a negative area of work to be involved in. You know, people may think that you spend all day listening to people shouting and screaming and being angry with you.
But seeing that as an opportunity to make a difference and help customers.
But also on the other side of things using staff feedback to make improvements. And do that for both customers and staff so that they know that you've listened. And seeing the outcome of that can be really rewarding.
Steve: I think we're really keen here at PHSO in stressing the importance of complaints teams across the NHS and Central Government. It’s seen a really, really key part of the process.
What would you say to someone who is thinking about taking up a complaints role or never having worked in complaints before? What are your words of wisdom be to them?
Tina, I know you’ve moved from a different kind of role to a complaints one?
Tina: So yeah, I mean, the thing I found with complaints work is it gives you a really excellent insight into all the different work areas that your organisation offers. Natural England have a number of different work areas and whatever role you’re in you only really see a snapshot of what Natural England do.
But in complaints, the complaints can be about anything. I'll often read a complaint and just not even know that that was something that Natural England did. So it gives you a really, really good understanding of the organisation.
It can be really, really challenging working with complaints, as Paul said, but it's also very rewarding when you can turn things around and make that customer happy. You have a really good opportunity to learn to improve your skills and contribute to a more positive environment.
Steve: I think that’s a great point about having the oversight and getting involved in all different parts of the business. You’re absolutely right, you’ll see all sorts. Especially at PHSO we can get complaints about any number of those things and learning about those things is absolutely fascinating.
Paul, anything to add to that? You touched on it already, but in terms of complaints as a career.
Paul: 100% what Gemma and Tina said. Were I not involved in complaints, I don't think I would have got the knowledge of policy and legislation and the really interesting sides to that. Decision making can be very empowering. And as you say, you get a length and breadth across your service that you just wouldn't get in one single department or that would take a number of years to get that that level of experience.
Steve: I think that's something I've seen working in this role for the past 12 months and talking to colleagues in complaints in different areas. The amount of delegation, the amount of authority, responsibility you get in the complaints area, you might not get which people can find really empowering.
Gemma: And I also think when you get that really nice blend, from my experience, of a really nice blend of office space work, but also engagement with the public, patients, other colleagues. There's lots of different opportunities, lots of different forums.
You do really have that nice blend of more public and patient facing role that you probably wouldn't get in another team. That's what I particularly enjoy about it as well.
Steve: Thanks, Gemma. So I know all of you will be really experienced in handling complaints, but I was just wondering if there are any essentials in your kit to help you do that more effectively? Gemma, over to you first.
Gemma: Things on my toolkit list would be the PHSO resources, of course, including the Complaint Standards, a consistent supply of hot drinks and snacks wouldn't go amiss either to keep us going.
You need all of the right interpersonal skills. So approach it with patience, empathy and an open mind. So really thinking about how you show up with the team and how you show up with the person who's complaining or raising the enquiry, it's really important.
And just some determination and some tenacity and a willingness to learn and just to reiterate what Tina said. It's a great opportunity. It's a great career path and the skills and experiences you'll gain from working in a well-run, well-led complaints team or a patient relations team really are worthy. And will set you in very good stead for your onward career, whatever you decide to do.
Steve: Thanks, Gemma. You kind of touched on what’s in your survival tool kit when there's a complaint. What about you, Tina? What would you say your key things are? Hot drinks, obviously, very important!
Tina: Absolutely. I think having a really good knowledge base, so having some kind of customer knowledge base, gives you a really good overview of the organisation. I sometimes think half of the challenge with ours is trying to determine which specialist team actually is the best placed to deal with the complaint because of the complexities of them. But also we've got quick reference to things like policies, procedures, frequently asked questions, things like that.
And also resilience. You've got to be strong and you've got to be quite resilient. You need to be able to bounce back. You do have some difficult conversations working in complaints, so you need to not take that home with you at the end of the day and you need to recognise you've done the best that you can and then move on to the next one.
Steve: Resilience would absolutely be in my top three I have to say. Paul, what about you? What would you bring to the party with the toolkit?
Paul: As well as a large pot of coffee, which I think we've already mentioned, those good working relationships both within your team but outside of your team too. Knowing the person to contact when you need to get answers.
But you're also the person that they know to contact if they need support and advice from you, be that on a policy or procedure or independent or to bounce an idea off. And I think that works both ways and that's really crucial in complaint handling.
Steve: That's great, collaboration is so important to get the results you need from complaints processes. So it's working with the person making the complaint, the people who have been investigating and the people who actually empowered and take the steps to put things right. So, yeah, absolutely. Those interpersonal skills are vital, aren't they?
Final one as we draw so close. Just interested in the next 12 months. What would you like to see in the development of the Standards going forward? What new innovations could we think about. Tina, what do you think? Where could the Standards go in future?
Tina: I'm quite interested in AI and where that's going. And what that could do to improve the way that we look at complaints and again, bring that consistent approach across government. on everyone's list of things to talk about. Yeah.
Steve: That’s on everyone’s list of things to talk about. Well, Paul, what about you?
Paul: I think I would find helpful some further guidance in relation to policy complaints. That can sometimes be a challenging area, and particularly if you're working across multiple delivery partners. We have a complicated delivery landscape at times in Central Government.
I want to do some further work looking at policy complaints. I know I will be supported by the PHSO in that area. So it's something, but it's something I would like to explore further.
Steve: Something we've talked about quite a bit. Paul Yeah. And what about you Gemma? What else could we do to help embed or improve things through the standards?
Gemma: I would like to see a little bit more work around bereavement complaints. I know it's quite niche in the NHS. We are doing some work locally, but really having a consistent view on what good looks like for supporting a family who've suffered a bereavement and complain about the care that their loved one has received., I think that would be really interesting from an NHS perspective.
And I also must agree with Tina, I think we're absolutely crying out for support around AI and some guidance and some collaboration on that really.
Bereavement and AI would be my to two things that are high on my agenda at the moment.
Steve: Excellent. Thank you for that. Some really good discussions. Really good to hear that the Standards are making a difference. And that you are making complaints count through using the Standards standards in your very different delivery landscapes and different use of the complaints tools.
Really appreciate your time. Hopefully you enjoyed being on this and sharing that knowledge with other people. Hopefully happy to talk to other colleagues in that space who aren't familiar to extoll the virtues of:
- complaints
- the tools that PHSO offer.
Well on that note, we will draw the the podcast to a close. Thanks so much for your time.
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