Do national policies for complaint handling in English hospitals support quality improvement? Lessons from a case study (31 May 2022)

Summary

This study, published in the Journal of the Royal Society of Medicine, examines national policies of complaint handling in English hospitals, how they are understood by those responsible for enacting them, and explores if there are any discrepancies between policies-as-intended and their reality in local practice.

Content

The study was conducted at a multi-site acute NHS Trust in London, which consists of five acute sites and a range of community services. The Trust is one of the largest in the country, with an average of over 1,000 complaints per year between 2015 and 2019.

Key findings of this study included:

• Confusion and lack of awareness of routes for raising concerns, both among patients and frontline staff.
• Investigative procedures structured to scrutinise the ‘validity’ of complaints, rather than focusing on improvement.
• Data collection systems not being set up to effectively support learning from complaints.
• Adverse incentives and workarounds resulting from bureaucratic performance targets.

In the conclusion, the authors note that the study has contributed to existing evidence by demonstrating how challenges to translating complaints into quality improvement can originate from nationally defined policies and regulations for complaint handling. Recommendations for change include patient involvement in complaints investigations, the establishment of independent investigation bodies, and more meaningful data analysis strategies to uncover and address systemic causes behind recurring complaints at national and organisational levels.