NHS criticised for defensive culture over complaints

Patients who suffer poor care “too often” face a defensive culture in the health service when they try to complain, according to a health watchdog.

Half of those who did put in a complaint felt it took too long to deal with and around six in 10 found the experience stressful, the Care Quality Commission (CQC) found.

It said there was a wide variation in the way complaints were treated, with “far too much” poor practice in acute, mental health and community health services.

The number of written complaints received by NHS hospital, mental health and community health services has gone up every year since 2011/12, although an increase in the number of people being treated means the rate for every 1,000 patients has stayed about the same, the CQC said.

Top concerns among those who did complain were over the clinical care they had received, the information they were given, delays and the attitude of staff.

Sir Mike Richards, chief inspector of hospitals at the CQC, said: “A service that is safe, responsive and well-led will treat every concern as an opportunity to improve, will encourage its staff to raise concerns without fear of reprisal, and will respond to complaints openly and honestly.

“Unfortunately this is not happening everywhere. While most providers have complaints systems in place, people’s experiences of these are not consistently good.

“We know from the thousands of people who contact CQC every year that many people do not even get as far as making a complaint as they are put off by the confusing system or worried about the impact that complaining might have on their or their loved one’s care.

“More needs to be done to encourage an open culture where concerns are welcomed and learned from.

“Through our inspections, we have a big role to play in supporting this change. We will continue to hold health and adult social care services to the high standards that people both expect and deserve.”

The number of complaints about acute hospital services rose by 1.14% to 75,424 between 2012/13 and the last financial year, according to the report.

Mental health services recorded a 4% hike to 12,221 while community health services went up by 1.69% to 8,293.

Katherine Rake, chief executive of Healthwatch England, said: “Complaints handling cannot just be about driving improvement. Fundamentally complaints are stories about what happens when things go wrong and people are failed.

“First and foremost every case must be dealt with compassionately with those involved kept informed about how their complaint has made a difference.”

Parliamentary and Health Service Ombudsman, Julie Mellor, said: “Today’s findings mirror our own research which shows there is significant variation in complaint handling in hospitals.

“Every complaint presents an opportunity to learn and improve services. We agree with the CQC that listening and learning when things go wrong needs to be embedded into an organisation’s culture.”

Richard Lloyd, Which? executive director, said: “For too long the views of health and social care users have not been heard, so it’s good the regulator is taking steps to improve complaints handling and put patient feedback at the heart of what it does.

“We now need greater detail on how complaints will trigger action from the regulator, to give people confidence it’s worthwhile speaking up and that something can, and will, be done.”

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