Carrying out good local investigations

This page contains tips for NHS complaints handlers. We are working on information for complaints handlers in government departments and other public organisations.

What we look for in a good complaint response

Part of our consideration and investigation of complaints includes looking at the response the NHS organisation has already given. We recommend that, before you send your final response to the complainant, you satisfy yourself that it is as good a response as you would like to receive yourself.

You should always try to make sure that your response does the following:

  • Meet the requirements of the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 (the NHS complaints regulations).
  • Clearly set out the issues the complainant raised and what they want to achieve by complaining. You should agree with the complainant the precise issues that the investigation should answer.
  • Set out how you have investigated the complaint and what evidence you considered. This may include extracts from clinical records and interviews with relevant staff.
  • In cases where a complainant raises concerns about the standard of care and treatment given, include a clinical opinion from a suitable clinician who has not previously been involved in the care complained about.
  • Include an explanation of what happened with reference to the evidence.
  • Set out any relevant care standards, guidance, policies or good practice applicable to the case and whether they were met.
  • Give your view about the care or service provided and clear reasons for every decision you have reached.
  • Make sure that the language is empathetic and that the complainant can understand it.
  • Where you have found failings, include:
    • a suitable apology and offer to put things right (including financial redress where appropriate)
    • explanations of what lessons have been learnt
    • details of how the organisation will put matters right for other service users.
  • Where appropriate, offer to involve the complainant in the changes that take place as a result of their complaint and promise to keep them updated on the action you take.
  • If the complainant is not satisfied, direct them to us. Please refer them to the Making a complaint area of this site or ask them to ring us on 0345 015 4033.

Please note that health organisations can refer complaints directly to us, and ask us to investigate if they feel they cannot properly investigate a complaint. Organisations wanting to make a self-referral to us must do so within 12 months of receiving the complaint. When considering such a referral organisations should contact our helpline for further advice.

Maintaining good complaint files

It is always helpful to us if your complaint file is well structured and contains all the evidence you have considered and relied on when reaching your decision. Ideally it should include:

  • all the complaint correspondence and notes of relevant telephone conversations and meetings
  • any internal and external emails that are relevant
  • any statements taken from staff or witnesses
  • copies of all of the relevant clinical records
  • copies of any relevant local policies and guidance
  • any internal clinical advice or scrutiny provided during the investigation
  • documentation about how you have implemented any action you have taken as a result of the complaint.

Carrying out good local investigations

There are also some publications that we have produced that might help you when you plan and carry out your investigation and draft your decision letter. It may be helpful to refer to our:

We have also worked with patients and service users to define what would make complaining about the NHS or social care a positive experience for them. You can find the outcome of this work in My expectations for raising concerns and complaints (PDF 9MB).

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