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News and updates from today's Complaints conference

Conference chair Tom Grimes Head of Enquiries, Complaints and Whistleblowing NHS Improvement opens the day with a welcome and National update followeed by an opening address from Dr Henrietta Hughes The National Guardian.

Henrietta discussed the role of the National Guardian and the development of the Freedom to Speak up Guardians in NHS Trusts. The case review process was also discussed in terms of learning and supporting Freedom to Speak up Guardians. Henrietta said "Freedom to Speak up Guardians cannot operate in a vacuum" - they need the right systems and support to enable them to work effectively. 

Henriettas slides are available here 

The conference continued with a presentation from Sam Stone, Public Affairs and Insight Manager at the Parliamentary & Health Service Ombudsmans Office. Sam discussed their guides to carrying out good local investigations and what to do if someone complains about your organisation which are both available on the Ombusdman's website. Sam said we will be working in partnership to improve responses when things go wrong. Sam also invited delegates to the next meet the Ombudsman Open Meeting in London on 22nd May 2018. Sam continued to discuss the Ombudsmans role in the second and final stage of the complaints process.

Sam went on to discuss 'My Expectations'  - a user led vision for raising concerns and complaints in health and social care, and mentioned the NHS Toolkit developed by NHS England in this area.

Sam said the complaints to the Ombudsman have gone up year on year. In 2016/17 36% of complaints referred to the Ombudsman were fully or partially upheld.  Sam discussed the national themes they are seeing which are available in the slides below. The elements of a good local complaints response were outlined

The response should set out:

•The issues raised and what complainant wants to achieve
•How you have investigated and the evidence considered including:  
– the complainant’s evidence
– staff/witness statements
– relevant extracts from clinical records
– independent clinical opinion

•Explanation of whether or not something went wrong by setting out:

–what happened - with reference to the evidence
–what should have happened - quoting relevant regulations, standards, policies, guidance and if they were met
•Your view of care/service provided in appropriate, clear, empathetic language
•If there is a shortfall (between what happened and what should have happened) an explanation of the shortfall and the impact it has had
•If failings have caused injustice or hardship - suitable apology and redress
•If appropriate, explain how it will be put right for other service users
•Explain how the complainant will be updated/involved in the changes
•Signpost to the Ombudsman service

Follow us on twitter @PHSOmbudsman

Sams Slides are available here 

Lee Bennett Head of Patient Experience (Complaints, Quality Assurance and Staff) NHS England, continues with a focus on: Managing Complaints at the point of service, and discusses:
NHS England’s approach to peer review: Peer review – why?  Success/quality viewed largely through performance KPI’s; increasingly aware of regional variation, created a quality framework – tells us what good looks like - how do we know its beign implemented?  How do we share good practice across regions as well as learning how we could do better?

Peer review – the sample – ten CLOSED complaints chosen at random from complaints closed three months previously, only non random element is 2 of 10 didn’t meet KPI’s

5 key documents are reviewed:

  • The complaint
  • The acknowledgement letter – an undervalued tool, first chance to impress and reassure complainant that we are taking this seriously, real personalization is important.  Mention the fact that you picked up the phone initially i.e. further to our discussion, when we talked about… - this personalizes the letter and demonstrates verbal contact has already taken place.
  • The provider response – do you get the feeling that the provider cares?
  • Clinical or contractual advice – excellence looks like - added value and provided good evidence and commentary re best practice, guidelines etc
  • The Director response

The panel - Aim is impartiality and objectivity:

  • Chaired by strategic complaints lead
  • Includes internal complaints peer – senior complaints manager from outside of region
  • Healthwatch rep local to the region
  • NHS complaints advocate local to the region
  • From mid 2018 include member from cross government complaints forum


The Process:

  • 15 mins to read the 5 docs, discuss thoughts and views
  • All notes are shared – transparency
  • 6-8 hours to do a full panel review of ten complaints
  • Initial feedback offered to senior management team in region at close of panel
  • Full report from Chair with recommendations shared 2-4 weeks after panel has met


Looking Back:

  • Process is working!
  • 5 panels now complete
  • Identified a number of actions – mixture of expected and not so expected!
  • Success can be dependent on culture within the region
  • Some actions are owned locally but some big ticket items for national consideration
  • Suggested additional panel members
  • Undertaking mini review after 6 month to check against implementation recommendations


Ian Adams Director of Membership and Stakeholder Engagement NHS Resolution, opens the afternoon session with a presentation on: Improving practice in early resolution, covering:
• what does resolution mean to a complainant?
• the work of NHS Resolution
• improving learning and local resolution 

Also of interest:

Quality Summit 2018 Meeting and Measuring Progress against the CQC Quality Ratings
Monday 30 April 
De Vere West One Conference Centre, London

Root Cause Analysis Review & Quality Assurance Masterclass
Friday 16 March 
De Vere West One Conference Centre, London

Reducing Medication Errors National Summit 2018
Wednesday 18 April 
De Vere West One Conference Centre, London

Root Cause Analysis: 2 Day Intensive Training Course
Wednesday 25 April — Thursday 26 April 
De Vere West One Conference Centre, London

Root Cause Analysis Summit 2018
Friday 11 May 
De Vere W1 Conference Centre, London

Root Cause Analysis: 2 Day Intensive Training Course
Tuesday 22 May — Wednesday 23 May 
De Vere West One Conference Centre, London



9 March 2018


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