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News and updates from today's Complaints conference

Conference chair, Geoff Delissen Senior Policy Officer (Complaints) Department of Health, opens today's conference with a national update from the Department of Health.

Linda Tomlinson Liaison Manager Parliamentary & Health Service Ombudsman, continues with a session on 'Getting it right first time: What people want' and covers:

  • lessons from complaints to the ombudsman and investigations
  • how do we make it easier for people to complain?
  • outcomes and resolution of complaints: what do people want?
  • current issues: complaints regarding avoidable death and delayed cancer diagnosis
  • how do we quality assure investigation of complaints and ensure change happens as a result of complaints at a local level
  • national developments 

In her presentation Linda stated: 

“We needed to do a lot to change our practice for both the complainants and healthcare services”

“We have made some key changes to the way we investigate and report on complaints”

“We have looked at sharing the learning the from complaints – on our website we have development a section for case summarise to provide you with learning and information on cases”

“We are looking to be clear on what people can expect from us – we developed our service charter which sets out very clearly what we do and the services we provide. This is also on our website”

“The legislation for a single service ombudsman is currently in progress”

“Between 2015/16 we fully and partly upheld complaint: 38% for the NHS overall, 46% NHS Acute trusts, 35% Dentists and 29% GPs”

“By investigating more complaints we are seeing that the NHS and public services and getting it right the vast majority of the time”

“Complaints handling in the NHS is done really well and its time we celebrated this”

“As a team fins as many ways as you can to actively seek feedback and empower staff to act on it”

“Ensure feedback and complaints are a part of every team meeting when discussing ‘how are we doing’. Talking to people can help with the little issues and ensure you are making changes. Listening and acting on little issue can show people you are really listening and is very powerful”

“Deal with complaints as a team and support individuals involved. Taking the time to let staff know we are in this together, it’s a team service and we are in this together”

“Promote how your team has listened and learnt ‘you said we did’ and ‘patient stories’. One of the things that stops people from complaining is that it wont make a difference. You need to make it clear and publish that you are listening and ready to make changes. This will help you to reduce complaints in the first place”

“The most important thing people want is to be heard and listen to”

“Sharing how you are investigation the complaint is key and the process need to be available to the complainant.”

“They are looking for the people handling complaints to be neutral, that they can be trusted, they have a clear and open process to dealing with the complaint and that you will investigate the complaint fairly”

Response to complaints 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
  • opinion from an ‘independent’ clinician
  • Explanation of what happened - with reference to the evidence
  • Explanation of what should have happened - quoting relevant regulations, standards, policies, guidance or established good practice 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

“Using the language of the complaint is key and will help you in the complaints process”

“The ombudsman has principles set out for good complaints processes – again this is on the website”

“One of the things services users have said is how do we know we have had a good complaints process. So what the Ombudsman has done is developed guidance with 5 sections on what they should expect from a good complaints process. This can also be used by you as a self assessment to look at what service users will be saying to you. NHS Improvement have done a lot of work on this with us they are currently doing a pilot survey based on this guidance on what it is like to complain”.

Presentation abstract:

In this presentation, Steve Tennant, Director of Operational Delivery, discusses the role of the Parliamentary and Health Service Ombudsman (PHSO), including how it works with others to use its casework insight to support real improvements in public services and complaint handling.

Steve initially introduces PHSO, explaining how the organisation has been changing its service in recent years in response to feedback. In light of the recent draft Public Ombudsman Service Bill, published by the Cabinet Office last December, Steve discusses the importance of Ombudsman reform and how a new public service ombudsman will be better for service-users and health and social care providers.  

Steve highlights some of the good practice examples the PHSO has encountered, including the role that NHS team leaders can play and the importance of acting on feedback and demonstrating how complaints have made a difference.

Based on his significant experience in different industries, Steve discusses some of the key things people expect when making a complaint. Steve then talks through what the PHSO looks for in a good local complaints response, and what organisations and staff can do to get it right first time.

Steve ends his presentation by giving oversight to national developments which focus on improving the complaints process across health and social care.

Download the full presentation here

Mark McKenna Head of Patient Experience The Walton Centre NHS Foundation Trust, follows with a session focusing on 'Recognising and acting upon human factors in complaints handling', and covers:

  • complexities in complaint
  • human factors for complainants
  • human factors for staff
  • acting upon human factors
  • examples in practice

In his presentation Mark looked at the human factors for both complainants and staff. Mark stated: ​

Review of complaints in two organisations looking at themes of complaints that staff had found difficult to handle:

  • Higher/unrealistic expectations of how complaint should be managed
  • Unreasonable behaviour from complainants
  • Limited staff engagement – timeliness and quality
  • Disagreements between staff / teams
  • Tension about how complaint responses are worded
  • Unrealistic expectations from ‘management’ on resource required for complaint investigations

Consistent theme of human factors influencing behaviours

“One of the biggest issues in complaints is communications. The human factors in complaints and can determine if things go well or wrong. Dealing with the human factors for both the complainant and staff can be difficult and we need to look closely at this. The complainants will be looking for personalised/ individualised contact, confidence they have been listened to, clear and early expectation of what will/will not happen, the opportunity to discuss and challenge findings (this need to be used where appropriate, more complicated complaints you should share this at each stage, but some times this can cause more anger if a relationship has not been built), involvement/awareness of actions and treated as a person. We need to ensure we look at the human factors for staff also and they are looking for clear and early expectation of what is required, recognition of impact on staff, support throughout, see things through patients eyes, involvement/awareness of compliant until conclusion, chance for reflection on the complaint experience and also treated like a person”

“It is important for staff to look at the complaint from the complainant’s perspective as well as there own. This will help to understand why the complaint has been made.”

Mark's presentation Abstract:

Complaints inherently raise emotions from both complainants and staff involved. To provide support to complainants and staff, it is important to recognise and act upon the human factors involved for all parties. This presentation looks at the human factors involved and the practical solutions to embedding these into an effective complaints process.

Download the full presentation here

Speaker biographies:

Geoff Delissen: Geoff joined the civil service in 1979 working for the Ministry of Defence in Logistics and Procurement moving on to central finance and latterly Internal Audit where he qualified as an Internal Auditor. Subsequently moving to the Crown Prosecution Service from there into the private sector in 2000 as Group Internal Auditor re-joining the civil service in 2004 in the Department of Health initially as a Senior Auditor then as the ICAS contract manager moving to NHS complaints policy in 2012.

Mark McKenna: Prior to joining the NHS, I was an investigator for the Parliamentary and Health Service Ombudsman, gaining an insight into complaint handling practice in NHS organisations nationwide. I was keen to use this insight and experience within the NHS, so joined Wirral University Teaching Hospital NHS Teaching Hospital NHS Foundation Trust (WUTH) to manage their complaints function. During my time at WUTH, as Deputy Head and then Head of Patient Experience,  we developed innovative initiatives to patient experience and complaints management. This led to WUTH being a runner up at the 2014 PENNA Awards for how complaints and patient experience was used to improve care, and I was named Patient Experience Professional of the Year at the 2015 PENNA Awards. During 2016 I moved to The Walton Centre NHS Foundation Trust as Head of Patient Experience and also currently work on a consultancy basis as an Associate for the Parliamentary and Health Service Ombudsman.

Also of interest:

Masterclass: Complaints Handling & Response Letters
Tuesday 23 May 2017 
De Vere West One Conference Centre

 


25 April 2017

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