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EventuntilLast year, our helpline advisers dealt with an average of two calls a day relating to complaints – could the caller complain about what had happened? How to complain? Who to complain to? This event is for patients and carers who would like answers to some basic questions about complaining about care. Solicitors Chris James and Josh Hughes from law firm Bolt Burdon Kemp will be joining our Chief Executive Rachel Power in this online event. Between them they’ll: Help people understand the NHS complaints process, including its limitations Describe how to get the most out of making a complaint Explain were the distinction can lie between poor service and a claim in negligence. Register
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EventThis virtual masterclass will build confidence in compassionately engaging and involving families and loved ones to work within the requirements of PSIRF and the Complaints Standards Framework. But more than this, the masterclass will support staff to go beyond compliance to understand the issues and emotional component on a deeper level; to have real authentic engagement and involvement with patients and families. New frameworks such as PSIRF are now in place, but how do we not only comply with these, but go beyond compliance to have real authentic compassionate engagement and involvement with patients, families and indeed staff to make a real positive difference? Connecting new knowledge with emotions can really support long term learning, which is an important part of this masterclass. Knowing things may have gone wrong can feel a heavy burden and a complex emotional situation to be managing. Often, we avoid visiting difficult emotions in others, as well as ourselves, because we don’t feel confident or skilled, or we feel fearful of not doing it perfectly. This one-day masterclass will look at the new PSIRF and the Complaints Standards Framework and through real life content, bringing the human focus for the patients, loved ones, and indeed staff to the forefront. It will support staff to explore what compassionate engagement looks like, feels like, and how to communicate it authentically and meaningfully. In a supportive and relaxed environment, delegates will have the opportunity to gain in depth knowledge of the emotional component, relate to, analyse and realise the significance of and believe in their own abilities in creating practices that not only support the PSIRF but go beyond compliance to be working in a way that supports gaining an optimum outcome for patients, families and staff, in often a less than optimum situation. Key learning objectives: Feel, analyse, and explore the presence and absence of compassionate engagement within life, trauma, and a healthcare incident and how empathy is the gateway to compassion. Seeing perspectives and understanding emotional motivations and the emotional component recognising vulnerability in others and self. Seeing the bigger picture and having an enquiring mind to understand the story and how the ‘Funnel of Life’ can impact on our ability to engage. Build confidence in the positive impact of compassionate engagement and really being authentically interested in the emotional component to be able to create an optimum outcome in often a less than optimum situation. Explore and have a good grasp of how internal unconscious belief systems, can link through to the outcomes we achieve. We know what works with compassionate engagement, but why do we so often struggle? Explore and analyse biases, judgments, and how a lack of compassionate engagement not only has the potential to cause psychological harm, but can prevent optimum outcomes for the organisation. Realise the significance of authenticity rather than feeling fearful of not doing things perfectly. Examine where can we get emotional information from to support us, even if we are not aware we are doing it! Identify the importance of an enquiring mind and a hypothesis as we try and understand the story that we are aiming to compassionately engage with. Develop understanding of Safeguarded Personal Resolution (SPR ®) to formulate compassionate engagement under PSIRF and the Complaints Standards Framework. Develop awareness on personal wellbeing and resilience. Register hub members receive a 20% discount. Email info@pslhub.org for discount code.
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News ArticleAfter receiving more than 12,000 complaints about Australia's Victorian mental health services, the state’s regulator has not taken compliance action against a single mental healthcare provider in seven years. This is despite the royal commission into the Victorian mental health sector last year finding systemic breaches of the law and human rights across the system. Annual reports from Victoria’s mental health complaints commissioner (MHCC) showed that in the seven years since it was first established in July 2014, it received 14,160 inquiries, of which 12,470 were complaints. Yet no compliance notices were issued, despite the MHCC having regulatory powers to compel providers to improve. The MHCC is an independent body that resolves complaints about Victoria’s public mental health services and makes recommendations for improvements. The MHCC’s service provider complaint reports, obtained under freedom of information, show that some mental health services do not hand over data on the outcomes of complaints, in breach of the state’s Mental Health Act (2014). The chief executive of Mind Australia – a community-based mental health provider, Gill Callister, said it was vital people with mental health concerns, their families and carers had access to “information about the performance and approach” of the mental health services they access. “For a lot of people, a lack of transparency reinforces the view that they’re sitting at the bottom of the pile in terms of priority even when seeking information about their own care,” she said. Read full story Source: The Guardian, 25 May 2022
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News Article
Governance scandal trust failing to manage complaints
Patient Safety Learning posted a news article in News
A trust which is facing major governance issues is failing to respond to hundreds of complaints properly, with patients and families waiting more than twice as long as the NHS target for responses to their concerns, an external review has found. Cornwall Partnership Foundation Trust, which is subject to regulatory action by NHS England, was found to be “not classifying complaints, concerns and comments accurately”, while staff had “no formal training”, meaning complaints were “not investigated appropriately”. Last year, the trust was embroiled in a governance scandal in which NHSE investigated multiple allegations of finance and governance failings, resulting in the departure of former CEO Phil Confue. Rachel Power, chief executive of the advocacy group Patients Association, told HSJ patient complaints often contain “vital intelligence” on how trusts can improve services and “essential warnings about any area where things might be going wrong”. According to the review, the backlog had stemmed from several factors. These included more work being needed on investigations that had not been thorough enough, and the relevant service teams not responding to enquiries by the complaints team. Additionally, there was a “lack of formal monitoring and review” to ensure complaint points were reported appropriately and consistently, and an “apparent lack of accountability by local teams for complaints” triaged through the trust’s patient liaison and complaints team. Read full story (paywalled) Source: HSJ, 12 April 2022- Posted
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News Article
GPs to face six-month complaint response targets under ombudsman proposals
Patient Safety Learning posted a news article in News
GP practices are set to face new targets for responding to patient complaints under standards being piloted by the health ombudsman. All ‘straightforward’ complaints should be dealt with within six months and 95% within three, while 80% of ‘complex’ complaints should be completed within six months and half within three, under the proposals. The new Parliamentary and Health Service Ombudsman (PHSO) complaint standards are currently being piloted in every sector of the NHS – including one GP practice – and were due to be implemented across the NHS this year. However, a PHSO spokesperson told Pulse that due to delays caused by the pandemic, the full rollout is now planned for the beginning of next year, with the ombudsman to implement the standards from April 2023. The proposed complaints standards said staff should ensure they ‘consistently meet expected timescales for acknowledging a complaint’ and ‘respond to complaints at the earliest opportunity’, providing ‘regular updates throughout’. They should also give ‘clear timeframes’ for how long investigating the complaint will take and ‘agree timescales with everyone involved’, including the complainant. An accompanying draft model complaint handling procedure said that complaints will be acknowledged within three working days either verbally or in writing. Read full story Source: Pulse, 24 March 2022 -
News ArticleMore than one fifth of complaints about Irish hospitals were deemed ‘high severity' including one from a person who claimed their mother should not have died and another who alleged a patient was turned away from an A&E even though she was at risk of self-harming. An analysis of 641 complaints about HSE hospitals between October and December 2019 by NUI Galway and the HSE separated them into high severity (22%), medium severity (56%) and low severity (also 22%). Among those complaints highlighted as potentially linked to ‘catastrophic harm’ was this: “My mother would still be alive if this had not happened." However the largest number were about hospital systems at 392 — including complaints about waiting lists. “I was left on a waiting list for surgery for years,” at least one person wrote. The analysis also found 322 complaints centred around patients’ arrival into hospitals including emergency departments (ED). “She was turned away instead of admitted even though she was at risk of self-harming,” one person wrote. Some 92 complaints related to staff not listening to patients, including new parents who said: "While our newborn son was on the ward they took too long to notice his difficulty breathing and transfer him to the NICU (neonatal intensive care unit)." Read full story Source: Irish Examiner, 11 July 2022
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News ArticleTwo-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
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Content ArticleA recently published report highlights the shortcomings in care provided by the NHS. Peter Walsh, Joanne Hughes and James Titcombe emphasise how millions could be saved if people were empowered early on to have their needs met without the need to turn to litigation
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Content ArticleA complaint from a patient was made to the Scottish Public Services Ombudsman (SPSO) about the care and treatment provided during the period January 2018 to September 2021. In January 2018 the patient underwent emergency surgery for a perforated sigmoid diverticulum (a complication of diverticulitis, an infection or inflammation of pouches that can form in the intestines). An emergency Hartmann's procedure (a surgical procedure for the removal of a section of the bowel and the formation of a stoma - an opening in the bowel) was performed. In April 2018, the patient was seen in an outpatient clinic and informed it would be possible to have a stoma reversal. The patient complained that the Board had continually delayed the stoma reversal surgery which they required, which as of September 2021 had not taken place. The patient also complained that Covid-19 could not account for the delays between the Board informing patient they were ready for surgery around December 2018 and the start of the pandemic in March 2020. The patient noted that as a consequence they had developed significant complications: a large hernia. The patient added that this had severely impacted their personal life and self-esteem, and left them unable to work and reliant on welfare benefits.
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News Article
Complaint about ‘misleading’ NHS waiting times figures
Patient Safety Learning posted a news article in News
Watchdogs have been asked to investigate a Scottish government overhaul of NHS waiting times information after surgeons said that some of the figures were “grossly misleading”. A complaint has been made to the Office for Statistics Regulation, which ensures that important public data is trustworthy, about a new guide for patients on the NHS Inform website. Concerns have also been raised with Audit Scotland, which monitors public spending and NHS performance. Last month Humza Yousaf, Scottish health secretary, unveiled the platform claiming that it would reassure patients about waiting times. But the times given reflect only the experience of patients treated over a three-month period. In orthopaedics, surgeons say, only the most urgent cases are being prioritised while some patients face languishing on waiting lists for years due to lack of capacity. NHS Inform says that people waited a median of 26 weeks between April and June for orthopaedic care, but surgeons argue that this gives a false impression. Dr Iain Kennedy, new chairman of the British Medical Association in Scotland, said the way the figures have been compiled would suggest that people are still not getting a realistic picture of delays. Read full story (paywalled) Source: The Times, 16 September 2022 -
Content ArticleIn this podcast, Care Opinion Chief Executive James Munro speaks to Alex Gillespie and Tom Reader of the Department of Psychological and Behavioural Science at LSE about their research paper 'Online patient feedback as a safety valve: An automated language analysis of unnoticed and unresolved safety incidents'. Their research analysed over 146,000 stories on Care Opinion using an automated machine-learning approach. Key findings included: automated analysis can reliably detect patient safety issues reported by patients. online patient safety concerns are associated with hospital level mortality. staff reported patient safety concerns are not associated with hospital level mortality.
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Content ArticleWomen should be able to have confidence that they will receive safe, effective, compassionate maternity care that focuses on their individual needs. That is the experience of many people. But too many families still face care that puts the safety and wellbeing of women and babies at risk. This Parliamentary and Health Service Ombudsman (PHSO) report looks at themes from maternity complaints families have brought to us, to shine a light on their experiences and encourage others to let their voices be heard. It shares case summaries and guidance to help families complain and help NHS organisations understand the issues.
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News Article
NHS Highland slammed over three year wait for bowel op
Patient Safety Learning posted a news article in News
A report by the Scottish Public Services Ombudsman (SPSO) said the health board's own investigation into the patient's complaint was of "poor quality" and "failed to acknowledge the significant and unreasonable delays" suffered. The delays led 'Patient C' to develop a severe hernia which left them unable to work, reliant on welfare benefits, and requiring riskier and more complex surgery than originally planned. The watchdog criticised NHS bosses for blaming Covid for the delays when the patient had been ready for surgery since December 2018, and said there had been "no sense of urgency" despite "the gravity of C's situation". The report said: "It is of significant concern that the Board has failed to fully acknowledge the consequences of the delays and the adverse effects upon C's physical and mental health as a result. "The consequences for C of these delays cannot and should not be underestimated." Read full story Source: The Herald, 24 November 2022 -
News Article
Have your say in shaping the future of NHS complaint handling
Patient Safety Learning posted a news article in News
The Parliament and Health Service Ombudsman (PHSO) been working with the NHS and other public service organisations, members of the public and advocacy groups to develop a shared vision for NHS complaint handling. We've called this the Complaint Standards Framework. Now they want to hear from you. Have your say in shaping the future of NHS complaint handling by taking part in their survey. Read the Complaint Standards Framework: Summary of core expectations for NHS organisations and staff -
News Article
Coronavirus: Calls for government to plan public inquiry
Patient Safety Learning posted a news article in News
The government must set out plans for an inquiry into its handling of the coronavirus pandemic, the health service ombudsman has said. This was not about blaming staff but about "learning lessons", he said. Ombudsman Rob Behrens said patients were reporting concerns about cancelled cancer treatment and incorrect COVID-19 test results. Ministers have not committed to holding an inquiry, but have accepted there are lessons to be learned. The Parliamentary and Health Service Ombudsman (PHSO) stopped investigating complaints against the NHS on 26 March, to allow it to focus on tackling the COVID-19 outbreak. But people had continued to phone in with these concerns, Mr Behrens said. "Complaining when something has gone wrong should not be about criticising doctors, nurses or other front-line public servants, who have often been under extraordinary pressure dealing with the Covid-19 crisis," he said. "It is about identifying where things have gone wrong systematically and making sure lessons are learned so mistakes are not repeated." Read full story Source: BBC News, 1 July 2020 -
News Article
PHSO to restart their work on NHS complaints
Patient Safety Learning posted a news article in News
NHS England and Improvement have announced changes to the NHS’s complaints process during the coronavirus emergency. Individual NHS organisations are being told to ensure complaints are still taken, and monitored for patient safety issues. However, NHS organisations have been given latitude over whether they launch full investigation processes in the short term, and being advised to ‘manage expectations’ about investigations being launched. Complaints that are logged will remain open until further notice. The advice to NHS providers also says that where patients have been waiting over six months for a resolution to their complaint, consideration should be given now to making an effort to see if the complaint can be resolved. NHS England and Improvement have announced that they will be advising NHS bodies to end their 'pause' in complaints handling from 1 July onwards. Similarly, the Parliamentary and Health Service Ombudsman (PHSO) reduced its complaints-handling activity during the emergency period. It is not accepting new complaints, and its helpline is temporarily closed. PHSO has announced that it will recommence work on existing complaints, and begin accepting new ones from 1 July. Read full story Source: The Patients Association, 15 June 2020 -
News Article
Isle of Wight patient sent home on first day of COVID-19 lockdown almost died
Patient Safety Learning posted a news article in News
A patient almost died after being misdiagnosed and sent home from hospital on the first day of the lockdown as the NHS curtailed many normal services to focus on COVID-19. The NHS trust involved has admitted that its failings led to the man suffering excruciating pain, developing life-threatening blood poisoning, and contracting the flesh-eating bug necrotising fasciitis. He needed eight operations to remedy the damage caused by his misdiagnosis. The man, his wife and his GP spent three weeks after his discharge trying to get him urgent medical care. However, St Mary’s hospital on the Isle of Wight rejected repeated pleas by them for doctors to help him, even though his health was deteriorating sharply. The man, who does not want to be named, said his experience of seeking NHS care for something other than COVID-19 during the pandemic had been “debilitating and exhausting” and that feeling the NHS “was not there” for him had been “very distressing” for him and his wife. Mary Smith, of the solicitors Novum Law, who are representing the man in his complaint against the trust, said his plight highlighted the growing number of cases that were emerging of people whose health had suffered because they could not access normal NHS care in recent months. Read full story Source: The Guardian, 16 June 2020 -
News Article
NHS staff 'not told when colleagues test positive for COVID-19'
Patient Safety Learning posted a news article in News
NHS staff at a hospital that has stopped taking new patients amid a COVID-19 spike have lodged a series of concerns, including that they are not routinely being informed of when colleagues test positive for the virus. The concerns were laid out in a letter from union representatives to management at Weston general hospital in Somerset, which is now testing all staff while carrying out a deep clean. Another concern raised by Unison was that priority for testing was not being given to BAME staff. University Hospitals Bristol and Weston NHS foundation trust said on Wednesday that as many as 40% of staff from a cohort tested after contact with infected patients were found to be positive. The trust’s chief executive, Robert Woolley, told the BBC the figure was from a sample testing last week and authorities were now attempting to understand the scale of the infection. More than 60 patients were found to be infected last weekend. Read full story Source: The Guardian, 28 May 2020 -
News Article
Only six of 200 NHS private units signed up to complaints watchdog
Patient Safety Learning posted a news article in News
Just six of the English NHS’s more than 200 private patient units (PPUs) are signed up to the independent complaints adjudicator, HSJ has learned. The figures follow the publication of the Paterson Inquiry earlier this month. The inquiry’s report warned patients treated in private units, including PPUs, which are not regulated by the Independent Sector Complaints Adjudication Service (ISCAS) “will not have access to independent investigation or adjudication of their complaint”. ISCAS is the main independent adjudicator for the private healthcare sector and takes on approximately 125 adjudications each year on unresolved patient complaints. Most standalone independent providers have signed up to the watchdog. However, ISCAS membership is not mandatory and it is concerned patients wishing to complain about care at PPUs will have little choice but to pursue costly legal action. The government is now considering the inquiry’s recommendation that all private patients are given the right to a mandatory independent resolution of their complaint. Read full story Source: HSJ, 26 February 2020 -
News Article
"Get doctors in the room for clinical negligence mediation," lawyers told
Patient Safety Learning posted a news article in News
Mediators want more clinicians to come forward – and lawyers to enable them – to speak directly to patients bringing medical negligence claims against the NHS. Alan Jacobs, mediator at the Centre for Effective Dispute Resolution, told a conference of lawyers that they should do more to encourage discussions between injured people and those allegedly responsible. His call came as figures show record numbers of clinical claims against the NHS went to mediation in 2018/19 – with the majority of mediations resulting in damages being agreed on the day. Jacobs, speaking at the Claims Media conference in Manchester, said the challenge now is to ensure medical professionals volunteer to take part in the process. "It allows an apology to be given face to face and allows explanations to be given," he said. "It is also an opportunity for the clinician to have a discussion, sit down with the claimant and answer questions and concerns. It can be tremendously important for a claimant to vent and express their frustrations and for the trust to hear that." Both claimant and defendant lawyers agreed on the merits of bringing doctors in to the room, but stressed this was not always a realistic aim. Barrister Daniel Frieze, head of the personal injury team at St Johns Buildings, said: "Often it is too late and there is too much water under the bridge. Claimants are very stressed and it may be counter-productive for them to face the other side. I know the idea is of being collaborative but I’m not sure that’s necessarily always true." Read full story Source: 21 February 2020, The Law Society Gazette -
News Article
NHS faces huge clinical negligence legal fees bill
Patient Safety Learning posted a news article in News
The NHS in England faces paying out £4.3 billion in legal fees to settle outstanding claims of clinical negligence, the BBC has learned through a Freedom of Information request. Each year the NHS receives more than 10,000 new claims for compensation. The Department of Health has pledged to tackle "the unsustainable rise in the cost of clinical negligence". Estimates published last year put the total cost of outstanding compensation claims at £83 billion. NHS England's total budget in 2018-19 was £129 billion. The Association of Personal Injuries Lawyers (APIL) believes the cost is driven by failures in patient safety. Doctors represented by the Medical Defence Union (MDU), which supports doctors at risk of litigation, are calling for "a fundamental" reform of the current system. Suzanne White, from APIL, said people came to her on a daily basis with no intention of suing the NHS. But she said they often found it difficult to get answers from the medical authorities - and were left with no other option but to sue. "What they want to do is find out what went wrong, why they have received these injuries ... and to make sure it doesn't happen to other patients." Read full story Source: BBC News, 21 January 2020 -
News Article
Lack of transparency on patient complaints risks confidence in the NHS
Patient Safety Learning posted a news article in News
Public confidence in the health service is being undermined by a lack of transparency from hospitals about patient complaints, the man who led the investigation into one of the NHS’s worst care disasters has warned. Sir Robert Francis QC, who chaired the public inquiry into the Mid Staffordshire hospital scandal, has called for a new national organisation with powers to set standards on the handling of patient complaints after research found seven in eight hospital trusts do not follow existing rules. The prominent barrister is now chair of Healthwatch England, a statutory body, which analysed 149 hospitals’ handling of complaints. Under current legislation every hospital is required to collect and report on the number of complaints they receive, what they were about and what action has been taken. Healthwatch England found just 12% of NHS trusts were compliant with all the rules. Only 16% published the required complaints reports while just 38% reported any details about learning or actions taken after a grievance. Speaking to The Independent, Sir Roberts said better reporting, including the outcome and changes made after a complaint, would create a “collaborative” environment to improving the system with patients and staff alike seeing complaints as a valuable resource. One persistent problem remained the gap, he said, between hospitals and the national Parliamentary and Health Service Ombudsman. Sir Robert argued commissioners of NHS services should be more involved. Read full story Source: The Independent, 15 January 2020 -
Content ArticleThis is draft material and is not live guidance. It is shared for information and will be tested with organisations who have agreed to pilot the new Complaint Standards. The model complaint handling procedure describes how your organisation will meet the expectations of the NHS Complaint Standards in practice. Download a Word version of the model complaints handling procedure from the link below to test within your NHS organisation.
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Content Article
NHS Resolution report - Extravasation (30 November 2022)
Patient-Safety-Learning posted an article in Extravasation
Extravasation is the accidental leakage of any liquid from a vein into the surrounding tissues, which can cause serious harm to the patient. This report analyses the 467 claims relating to extravasation injuries received by NHS Resolution between 1 April 2010 and 1 December 2021. It includes information about specific injuries caused by extravasation, factors that led to injuries and specialities in which most injuries occurred. -
Content ArticleThis is the report of an independent assurance review of an independent investigation which considered the care and treatment of mental health service user David at North West Boroughs Healthcare NHS Foundation Trust, published in June 2020.
