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Found 63 results
  1. Content Article
    In our recent blog Analysing the Cumberlege Review; Who should join the dots for patient safety? we identified a number of key patient safety issues which were reflected in the Review’s findings. One theme running throughout the Review was a lack of support for patients after incidents of unsafe care, particularly around patient complaints. Why are complaints important for patient safety? Complaint processes are often viewed in a negative light, with patients and families not being recognised as playing a ‘primary source of learning for safety’.[1] Too often, processes are variable in their quality and are insensitive and adversarial, frustrating patients further and causing additional harm. Review findings The Review reflects on the complexity of the complaints system in health acting as a significant barrier to patients raising concerns, highlighting issues around: 1) Difficulties navigating the system – the Review notes that they have heard from many patients who “have expressed their frustration at the lack of a clear pathway for them to make a complaint or raise concerns about aspects of their care”.[2] They note that the length of time this can take, all while patients are living with complications from their original complaint, results in some patients describing themselves as being “broken” by this experience.[3] 2) Failure to listen – another issue cited was dissatisfaction with the complaints system itself. The Review notes that complainants feel that they are being treated unfairly during the process. It expressed concerns that this could discourage patients from making complaints again, reinforcing a “culture of denial and resistance to acknowledging mistakes”.[4] 3) Time limits – the Review raises the issue that “where there is a pattern of complaints relating to an individual doctor that spans years, these restrictions mean older complaints are not investigated by the GMC”.[5] Investigations into clinical matters by the GMC are limited to the event taking place within five years of the allegation. The Review notes that this may risk prevent exposing “a pattern of poor practice” where complaints relating to an individual doctor may span a number of years.[6] There is a significant amount of literature on complaints in healthcare. Earlier this year, Healthwatch published a report looking at complaints processes in the NHS, finding inconsistent local reporting and a focus on counting complaints rather than demonstrating learning.[7] The Paterson Inquiry in February also highlighted concerns about this, noting that “while there were differences in the way patients complained in the NHS and the independent sector and how they escalated their complaints, the response was inadequate in both sectors”.[8] What needs to be done to improve complaints processes? The Cumberlege Review suggests some specific recommendations around complaints processes, including: Patients across the NHS and private sector must have a clear, well-publicised route to raise their concerns about aspects of their experiences in the healthcare system.[9] All organisations who take complaints from the public should designate a non-executive member of the board to oversee the complaint-handling processes and outcomes, and ensure that appropriate action is taken.[10] The Parliamentary and Health Service Ombudsman (PHSO) are currently working to develop a Complaints Standards Framework to provide a “shared vision for NHS complaint handling”.[11] In their proposals for public consultation, they suggest an effective complaint handling system is one that: promotes a learning and improvement culture positively seeks feedback is thorough and fair gives a fair and accountable decision [12]. At Patient Safety Learning, we concur with these points and think it is vital that we have systems where harm is properly investigated and where learning is applied to prevent future harm. Further to the PHSO’s suggestions, we believe that it is important that learning from complaints processes is shared widely and feeds directly into the actions taken. Organisations should be able to demonstrate how complaints have been acted on, and resulted in, improvements. What are your thoughts on this issue? Are you a patient or member of staff who has had a negative or positive experience of the complaints process. Do you have examples of good practice that we can share? Let us know in the comments below. References 1. Patient Safety Learning, The Patient-Safe Future: A Blueprint For Action, 2019. https://s3-eu-west-1.amazonaws.com/ddme-psl/content/A-Blueprint-for-Action-240619.pdf?mtime=20190701143409 2. The Independent Medicines and Medical Devices Safety Review, First Do No Harm, 8 July 2020. https://www.immdsreview.org.uk/downloads/IMMDSReview_Web.pdf 3. Ibid. 4. Ibid. 5. Ibid. 6. The Independent Medicines and Medical Devices Safety Review, First Do No Harm, 8 July 2020. https://www.immdsreview.org.uk/downloads/IMMDSReview_Web.pdf 7. Healthwatch, Shifting the mindset: A closer look at hospital complaints, January 2020. https://www.healthwatch.co.uk/sites/healthwatch.co.uk/files/20191126%20-%20Shifting%20the%20mindset%20-%20NHS%20complaints%20.pdf 8. The Right Reverend Graham Jones, Report of the Independent Inquiry into the Issues raised by Paterson, 2020. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/863211/issues -raised-by-paterson-independent-inquiry-report-web-accessible.pdf 9. The Independent Medicines and Medical Devices Safety Review, First Do No Harm, 8 July 2020. https://www.immdsreview.org.uk/downloads/IMMDSReview_Web.pdf 10. Ibid. 11. PHSO, Have your say in shaping the future of NHS complaint handing, Last Accessed 17 July 2020. https://www.ombudsman.org.uk/csf 12. PHSO, Complaint Standards Framework: Summary of core expectations for NHS organisations and staff, Last Accessed 17 July 2020. https://www.ombudsman.org.uk/sites/default/files/Complaint_Standards_Framework-Summary_of_core_expectations%20.pdf
  2. News Article
    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
  3. Content Article
    This version of the Framework is for: All NHS staff, including all clinical and non-clinical staff and senior leaders, to: provide a clear vision of how to approach feedback and complaints effectively set out how they should approach learning from complaints to improve services. Everyone who provides feedback or makes a complaint about the NHS, and the people who support, advise or advocate for them. It sets out what they can expect to see and experience when doing so. NHS staff who are being complained about. It will make sure they are supported and that the complaint is seen as a learning opportunity rather than a finger-pointing exercise. The Framework is built on the following four principles: Promoting and learning and improvement culture. Positively seeking feedback. Being thorough and fair. Giving fair and accountable decisions.
  4. News Article
    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
  5. News Article
    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
  6. News Article
    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
  7. News Article
    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
  8. Content Article
    In a blog in the Patient Safety Movement newsletter, James Titcombe talks about his son's death and how speaking out can save lives.
  9. Content Article
    The complaints included in the report are not thematic or related to a specific incident or body. Instead, these new annual Ombudsman Casework Reports will share some of the most significant findings from cases completed over the year, including complaints against: NHS in England Mental Health Care. The report offers valuable lessons about the importance of good complaint handling and how complaints can be used to drive improvements.
  10. News Article
    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
  11. News Article
    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
  12. Content Article
    Key findings Local reporting on complaints is inconsistent and inaccessible. Staff are not empowered to communicate with the public on complaints. Reporting focuses on counting complaints, not demonstrating learning.
  13. News Article
    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
  14. Content Article
    Key findings from report Local reporting on complaints is inconsistent and inaccessible All hospital trusts are reporting to NHS Digital on the numbers of complaints they receive; however, only a minority of trusts report any more meaningful data at a local level. Analysis shows just 1 in 8 hospitals trusts (12%) are demonstrating that they are compliant with the statutory regulations when it comes reporting on complaints. Staff are not empowered to communicate with the public on complaints: All hospitals must produce an annual statutory complaints report but they are only required to make it available to people upon request. Yet we found that hospital complaints staff were often not aware of the reports or who could access them. Reporting focuses on counting complaints and not demonstrating learning: Only 38% of trusts make public any information on the changes they’ve made in response to complaints. Much of this reporting is still only high-level, telling us little detail about what has changed and only stating that “improvements were made”.
  15. News Article
    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
  16. Content Article
    Advocacy is a free and confidential service. Advocates are independent to the NHS. The NHS Complaints Advocacy service is there to: Give you information about different NHS complaints processes. Help you understand the different options you have in raising your concerns. Offer you support to help you think about your complaint and what you want to get from making your complaint. Help you make your complaint if you want us to. If you would like an advocate to assist you now or would like to talk to someone about advocacy, please contact the Helpline on 0300 330 5454. You can complain about any aspect of NHS care and services but might include: poor treatment or care the attitude of staff poor communication waiting times lack of information failure of diagnose a condition. NHS Complaints Advocacy can only support you if your complaint is about NHS funded healthcare. There are some limits on what can be achieved using the NHS Complaints Procedure. Where the outcome you are looking for is more likely to be achieved through another route, we can explain this and give you information about who best to contact instead. We can support you to make this contact, where required.
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