A review into the quality of NHS complaints investigations where serious or avoidable harm has been alleged

Annex C: The survey – summary


In March 2015, we sent a survey about the way complaints about patient safety incidents are investigated to complaints managers in all acute trusts in England, 171 in total. The purpose of the survey was to understand the trusts’ processes, and gain insight into best practices and areas for improvement. 

What we found

The survey asked closed questions and gave staff the opportunity to provide qualitative comments. Feedback was anonymous. We received 104 responses after a three-week period, which is a response rate of 61%.  

Below is a breakdown of the key results by question.

1. Does your trust’s complaint team follow different investigation processes for complaints of avoidable harm, in comparison to other complaints?

  • Just under a tenth of respondents did not know whether they have different processes in place for avoidable harm complaints.
  • Out of the remaining respondents, approximately half follow a different investigation process for complaints about avoidable harm.  

2. In your opinion, do you think that improvements are required in the complaints process to adequately investigate allegations of avoidable harm?

  • No respondents selected that ‘a lot of improvements’ were required to their complaints process.
  • However, over half (53%) stated that ‘some’ improvements were required.
  • 47% felt ‘no improvements’ were needed.

3. If a complaints investigation identifies that something has gone wrong with the care provided, do you feel that there is an adequate process at your trust to find out why things went wrong?

  • The majority (91%) felt that there is an adequate process at their trust to find out why things went wrong.

4. If a complaints investigation identifies that something went wrong with the care provided, do you feel that your trust has a sufficient process to prevent the same mistakes happening again? 

  • In contrast to the previous question, only 6 in 10 respondents felt that their trust has sufficient processes in place to prevent mistakes happening again.
  • Over a quarter of respondents were ‘unsure’, with over a tenth stating their trust did not have sufficient processes in place.

5. Is there a process at your trust to identify a serious incident? 

  • The majority of respondents (96%) said that there is a process to identify a serious incident at their trust.

6. Is there a process for your complaints team to trigger a serious incident once the complaint has been identified as requiring one?

  • As in the previous question, the majority of respondents (96%) said that there is a process to trigger a serious incident.

7. In your opinion do you consider that the complaints process at your trust can identify and trigger a serious incident when necessary?

  • The majority of respondents (92%) felt their trust’s processes can identify and trigger a serious incident when needed.

8. Has your trust signed up to NHS England’s safety campaign?

  • Just over half of respondents said their trust has signed up to this campaign. 
  • However, 45% of respondents said their trust had not.

Qualitative statements

Respondents were asked to offer ideas for improvements to complaint-handling processes. These centred on the following themes:

  • Better training (for complaints teams, as well as others in trusts);
  • Being more open, and creating a culture of openness; 
  • Better engagement between divisions and cross-department collaboration when  investigating a complaint, so that people can learn from complaints;
  • National guidelines and nationwide consistency (as it was felt that current complaints regulations are outdated);
  • Greater ownership of the complaint and taking responsibility for actions relating to it, and for sharing any learning from it;
  • Better resources; more time, money, and appropriate manpower;
  • Involving more independent opinions in the complaints process;
  • Greater focus on quality and consistency of the trust’s responses; and
  • Auditing the effectiveness of the actions taken.

We also asked respondents to share experiences about serious incident processes at their trust.  They raised issues about decisions and processes being out of the complaint team’s hands, meaning that staff in the complaints team had less influence in decisions.  However, it was noted that things that worked well include: 

  • Sharing complaints and what is learned from them with other teams;
  • Deciding the importance and urgency of complaints;
  • Close working with other teams, for example, weekly meetings;
  • Clear and consistent processes to deal with the complaint; and
  • Having personnel involved who have experience of investigating and handling complaints.