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An opportunity to improve

Foreword

The Parliamentary and Health Service Ombudsman makes final decisions on complaints that have not been resolved by the NHS in England and UK government departments and some UK public organisations. We use our casework to shine a light on service failures and share this insight to help others improve public services and complaint handling. We want to use our own experience of investigating complaints about GP practices to help the NHS support general practice to do better. 

We have pooled evidence from our casework with intelligence gathered by the Care Quality Commission, NHS England and Healthwatch England to review how well GP practices in England are handling concerns and complaints when things go wrong. 

In 2014-15 the Parliamentary and Health Service Ombudsman completed 3,274 NHS investigations (79% of all investigations), and of these we upheld or partly upheld 1,229 investigations (37%). In the same year, the Parliamentary and Health Service Ombudsman received 5,086 complaint enquiries about general practice. 696 (14%) of these enquiries were investigated and 32% were upheld. This is at the lower end of our uphold rate - we uphold 44% of cases about acute trusts and 33% of mental health, social care and learning disability trusts. 

From looking closely at these investigations, as well as cases from the Care Quality Commission and NHS England, we found that the quality of general practice complaint handling paints a mixed picture. Our review found 55% of general practices were doing a good job – dealing with complaints swiftly, taking them seriously and being open and honest. This is good news. But 45% of practices were falling short – failing to acknowledge mistakes, not providing proper apologies and not following guidance on handling complaints. 

Most people have far more contact with their GP practice than with any other NHS service, and they are often an individual’s link in to other NHS services. That’s why getting complaint handling right in general practice is so important – it has the potential to make a difference to everybody who uses the NHS. I hope this work helps GPs. 

Our review has identified five areas where there is most scope for improvement. These include: 

  • developing a listening culture 
  • being clear about what is expected of practices 
  • ensuring professional values 
  • apologies and being open and honest
  • sharing learning from complaints

With co-ordinated action, we believe our shared commitments and recommendations around: education and training, sharing and acting on what has been learned, and communication will lead to general practices being able to improve individuals’ experience of complaining. 

We appreciate many of the difficulties general practices face in getting this right. This is why we have worked together to consider what our four organisations can do to help improve the quality of complaint handling in general practice. For example, we are delighted that NHS England is leading work to ensure high quality and relevant training for primary care complaint handlers. 

We are proud to have worked with the Care Quality Commission, NHS England and Healthwatch England on this review. Together, we can support practices to listen, respond and act to improve services for all.       

Dame Julie Mellor DBE
Chair and Ombudsman, Parliamentary and Health Service Ombudsman
 
March 2016