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How can services learn when care goes wrong?
By Neil Tester - Deputy Director on 19/05/16
When care goes wrong and people have bad experiences, it’s vital that services put things right. But it’s just as important that they use complaints to learn and improve. Read what the Healthwatch network is doing to help ensure this happens.
In 2014 we published ‘Suffering In Silence’ which set out what people had told Healthwatch about their experience of making a complaint. It highlighted the importance of listening and learning when care goes wrong and handling complaints effectively.
Now we’re launching a complaints toolkit to support local Healthwatch as they scrutinise local complaints handling and help deliver a better experience for people.
The polling we commissioned indicated that people often don’t complain in the first place. Two thirds of people surveyed who had experienced or witnessed poor care in the previous two years told us they hadn’t raised a complaint, either because they didn’t know how to do it or they didn’t think they’d be taken seriously.
People who had complained told us their experience wasn’t always as good as it could or should have been. ‘Suffering in Silence’– which arose from our involvement in a Department of Health programme to improve the way services deal with complaints - told us that people:
- Were not given the information they needed to complain;
- Did not have confidence in the system to resolve their concerns;
- Found the complaints system complex and confusing;
- Needed support to ensure their voices were heard;
- Needed to know that health and social care services would learn from complaints.
We also found that 70 different organisations were involved in complaints handling across health and social care. This had created a complex and frustrating landscape that patients, service users, carers and families found hard to navigate.
Putting people first
Following our report we worked with the Local Government Ombudsman and the Parliamentary and Health Service Ombudsman to produce ‘My Expectations’, Published last year, it set out what people expect to happen when they complain or raise concerns about poor care.
It explained that people should feel that they can speak up; that making a complaint is simple; that they have been listened to and understood; and that their complaint has made a difference.
That final point is really important. Our polling on this issue indicates that most people would be more likely to complain if they knew it would stop the same thing happening to someone else.
Helping to improve national policy
Since 2014, we have also worked with others to help them start to address the issues highlighted by our own and other organisations’ reports on complaints.
We secured a requirement that organisations providing services under the NHS Standard Contract must visibly promote their approach to complaints and feedback, as well as signposting patients to their local Healthwatch.
We also made use of our role as a statutory consultee on the NHS Mandate, the document in which the Government sets NHS England’s objectives. In 2015, our intervention made sure that NHS organisations are now expected to learn from feedback including complaints. We have also focused on improving complaints handling in specific areas of care, working with partner organisations to develop thinking, policy, planning and support in both dentistry and general practice.
Stronger local scrutiny
I’m pleased that Healthwatch has played its part in keeping this issue moving forward at national level. The next challenge is to make sure the right changes continue to take effect locally. In 2015, responding to our complaints action plan, the Secretary of State for Health made clear his belief that more could be done on the local scrutiny of complaints handling - something in which he hoped local Healthwatch would play “a strong, visible role”.
We know the Healthwatch network shares that ambition. That’s why we have worked with three local Healthwatch to produce a toolkit that will help other Healthwatch who are planning work on complaints.
You can download the resource below. It will support local Healthwatch to see how well things are working, if improvements are being made and if patients, service users and families who complain are now having a better experience.
Health and social care services are organised and delivered by dedicated professionals who are nonetheless human and capable of making mistakes. It’s in everyone’s interests that local services and organisations should get better at listening to and learning from people’s experiences when things haven’t gone to plan.
Local Healthwatch, with support from Healthwatch England, will continue to help ensure this happens.