Hospitals need to do more to show people how they learn from complaints

Sir Robert Francis QC explains how hospitals can cultivate public trust in complaints. Read more.
Sir Robert Francis

Our new report – Shifting the mindset (2020) – investigates how hospitals report on complaints and whether current efforts are sufficient to build public trust. 

Complaints should be seen by hospitals as an opportunity to learn 

The public expects the NHS to learn from mistakes, and to be kept informed about how these changes are made. Four in five people have told us that seeing where other people’s complaints have made a difference would encourage them to speak up. Yet fewer than half of NHS hospitals in England (38%) are reporting on any action taken in response to complaints raised by patients and loved ones. 

Complaints are a valuable tool which help hospitals spot and tackle issues quickly. They should not be seen by hospitals as something to ‘be managed’, but as an opportunity to learn and improve. To have a complaints system that works, the NHS must give patients the confidence to speak up by showing them how their views are heard and acted upon.  

Shifting the mindset – our key findings

Local reporting on complaints is inconsistent and inaccessible 

  • All hospital trusts are reporting to NHS Digital on the numbers of complaints they receive; however, only a minority of trusts report any more meaningful data at a local level. 
  • Our analysis shows just 1 in 8 hospitals trusts (12%) are demonstrating that they are compliant with the statutory regulations when it comes reporting on complaints. 

Staff are not empowered to communicate with the public on complaints 

  • All hospitals must produce an annual statutory complaints report but they are only required to make it available to people upon request. Yet we found that hospital complaints staff were often not aware of the reports or who could access them. 

Reporting focuses on counting complaints, not demonstrating learning 

  • Only 38% of trusts make public any information on the changes they’ve made in response to complaints. 

  • Much of this reporting is still only high-level, telling us little detail about what has changed and only stating that “improvements were made”.

Read the report

How can hospitals cultivate public trust in complaints? 

Worryingly, research by the Care Quality Commission shows that more than a third of people believe nothing will change even if they do complain. This shows a lack of belief in the NHS and its ability to listen. This must change. 

To us at Healthwatch the solution is clear. The NHS needs to step up efforts to show people what it is doing with their complaints and the direct improvements that happen as a result. This is not just about feeding back to individuals, but ensuring all patients understand how their voice can lead to change. Getting this right will require a mix of local action and national leadership.  

Why are complaints a focus for Healthwatch? 

It’s vital that everybody’s views are listened to and acted upon, and it’s our duty to help drive this forward. Improving awareness of how to complain and making this process simple has always been a priority for Healthwatch. 

Since 2013 we have: 

  • Set out six core principles for complaint reform, which built on the findings of the Francis Inquiry. 

  • Worked with Parliamentary and Health Service Ombudsman (PHSO) and the Local Government and Social Care Ombudsman (LGSCO) to produce My expectations (2014), a vision for good complaint handling and what the public should expect. 

  • Published our report Suffering in Silence (2014) to show how confidence in the complaints system depends on whether people can see clear evidence of learning from complaints.

  • Committed to Quality matters, a sector-wide initiative aimed at improving social care. We published a toolkit to improve social care complaints handling. 

  • Worked with the PHSO, regulators and advocacy groups to design a framework, which will provide a sector-wide vision for best practice when handling complaints, as well as guidance for NHS staff. 

  • Analysed how local authorities report on complaints and found that councils are not taking opportunities to demonstrate how responsive they are to feedback. 

We are calling on you to make a difference 

The most effective services are shaped by the people who use them, and professionals who listen. I will be writing to every trust in the country with the findings from our report, and the need for leaders to shift their focus from the number of complaints, to the people behind them, and what needs to change. 

If you are a member of the public, we need you to continue sharing your experiences. Please take a few minutes to take part in our ‘Speak up’ campaign and have your say about the NHS services you use.

Go to #SpeakUp2020 survey

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You can help make health and care services better by sharing your experiences and ideas. Talk to your local Healthwatch.

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