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About my complaint, doctor...

Update from Care Opinion

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picture of James Munro

A rather depressing posting arrived on the Patient Opinion site today.

A sentence near the end sums it up rather well: "How do I complain about the waste-of-time complaints procedure?"

The posting reminded me that the Patients Association had recently published their report NHS Complaints: who cares? who can make it better? So I went off to read it and see how typical this contributor's experience might be.

The Patients Association surveyed 1500 patients for its report, of whom fewer than 500 responded, so there is plenty of room for bias. But one finding caught my eye: of those with experience of using the NHS complaints system, 20% had found the process "pointless" and almost a further 30% had found it "totally pointless". By contrast, about 13% had found it "useful" and a further 2% "very useful".

There is quite a strong message here. Whatever it is that patients are trying to achieve through the complaints system, it evidently fails to deliver for a large proportion. But what are patients trying to achieve?

The report's findings suggest that a large proportion of patients want the system to:

  • make sure everyone learns from a mistake
  • ensure it doesn't happen to other people
  • ensure patient's views are heard in the future
  • change clinical behaviour

Interestingly, this fits exactly with our own experience at Patient Opinion. Sometimes a hospital will contact us about a critical posting on our site. "Can you remove it?" they say, "and ask the patient to make a complaint instead?" We don't remove it (of course), but we will email the patient in confidence to ask if they would like to make a complaint. And in every case to date, the patient has replied: "No, I don't want to make a complaint. I'm not trying to get anyone into trouble. I just want the problem fixed so it doesn't happen to anyone else."

Reflecting on this, a series of vague but insistent thoughts are beginning to form:

  • Is the number of complaints in the NHS driven by the lack of alternative ways to feed in one's experience?
  • Do hospitals drive people towards the complaints process because it is the only institutional system available?
  • If other systems were available (you can see where I'm going here) which offered the possibility of being heard, helping people to learn, and making a difference to the service, would patients prefer that to the existing complaints system?
  • And what would need to happen (in any system) for the majority of people to say that the process had been "useful" rather than "pointless"?

I might as well be blunt: could Patient Opinion help hospitals move towards a triple benefit: fewer complaints, greater learning from experience, and happier patients? I think we should find out!

Response from DrGrumble on

Getting the problem fixed is, of course, the key challenge. Entering a bureaucratic process is not obviously a good way of achieving this. Lots of words get generated but there is not necessarily meaningful action. Even if you work within a hospital seeing an obvious problem for patient care and flagging it up does not necessarily result in a solution. Sometimes, if enough people keep at it, eventually there is <a href="http://drgrumble.blogspot.com/2008/09/why-do-managers-ignore-patient-safety.html">progress</a>. The lesson is that if you work within the system and see a recurring important problem you should keep on and on reporting it - which is, to be fair, what managers ask for. Eventually the system may respond with real action. Unfortunately problems that seem simple are not necessarily so simple to fix. Hospitals are complicated places and the calibre of the staff can be very variable.

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