Making Complaints Count: Supporting complaints handling in the NHS and UK Government Departments (Executive Summary)

Being thorough and fair

An effective complaint handling system requires all complaints to be resolved via an open, transparent, and responsive process that thoroughly examines the issues raised in a timely and proportionate way. Staff responsible for resolving complaints should be properly trained and ensure that all parties – including staff who are cited in the complaint – are kept involved and engaged throughout.

Analysis of our casework often tells us not all organisations meet these expectations. There are many reasons for this, but a recurring theme in our research is that investigations are often carried out by staff who have limited or no training, or who lack appropriate support to carry out this important role. This often leaves them under significant pressure.

The 2009 NHS Complaint Regulations provide a high-level framework for how NHS organisations are expected to handle complaints. While this provides staff with a large amount of discretion, our casework and research found that it often results in very different qualities of experience for complainants and advocacy services. There are no national guidelines for how to carry out a detailed investigation, and no consistent guidance on what service standards staff should be meeting, including how long it should take to receive a response to a complaint.

It is right that organisations should be able to tailor their responses to complaints to meet the needs of different people, but everyone should be able to expect the same core standards of service. A lack of consistency in guidance and approach can have a negative impact on the experience of those who raise complaints.

The most common theme identified in a review of our casework was delays in NHS organisations and UK Government departments responding to people’s complaints. These are often compounded by a lack of national service standards for how long investigations should take.

The 2009 NHS Complaints Regulations do not include a standard timeframe for organisations to respond to complaints. In the absence of detailed national standards, timeframes vary significantly between NHS organisations.

This suggests that clear standards around timeliness would help NHS complaints managers leverage influence within their organisations to make sure clinicians and other colleagues helped resolve complaints in a timely way.

Poor communication is one of the most common reasons for poor complaint handling overall. It is important that organisations agree how people will be kept informed when they look into their concerns or complaints. However, our evidence shows that this does not always happen.

Organisations not keeping individuals updated was the second most common issue identified in our casework. In these cases, NHS organisations could often have communicated better with the complainant and managed the delays appropriately. We often found that organisations that do this alleviate the concern and frustration that complainants experience during protracted investigations.

The 2009 NHS Complaints Regulations state that NHS and adult social care organisations must co-operate to ensure that an individual receives a co ordinated response to any complaint about more than one organisation. It also requires organisations to agree which of them should take the lead in co ordinating the handling of the complaints and communicating with the complainant.

The issue of better co ordination and collaboration between organisations when handling complaints is a central expectation in the Complaint Standards Framework. This is particularly so for complaints that cover both Health and Social Care issues.