According to staff representatives and staff themselves, healthcare workers want to be able to provide safe, effective and high quality care and treatment.
The implementation of an effective and efficient feedback process will allow lessons to be learned both from individual complaints investigations and from data analysis of complaints. These can be used to inform service change and to create an environment that supports staff in providing quality healthcare such as decisions around resource allocation, etc.
Expressions of complaint by patients and their advocates reporting poor healthcare experiences represent a valuable data source for learning (see Public Information for information on Trends for Data Analysis) and improving the analysis of complaints is a priority for service providers. This data can facilitate service monitoring and organisational learning. Service users are valuable sources of data as they observe and experience a huge amount of service activity and issues within healthcare settings and are outside the organisation, thus providing an independent assessment.
The HSE collates complaints regionally and nationally and uses this data as a source of learning across the entire system.
Unlocking the potential of healthcare complaints requires both a feedback process that facilitates complaint reporting and systematic procedures for analysing the complaints received.
HSE People Strategy (PDF)
Learning from Complaints
The importance of learning from all Service User feedback and complaints cannot be underestimated. In a recent survey within the NHS, the majority of NHS Hospital Trust leaders believe that they are failing to use and utilise the information from complaints. (Health Service Ombudsman for England, 2013)
- Only 20% review learning from complaints and take resulting action to improve services.
- Less than half measure patient satisfaction with the way complaints are handled.
- Less than two thirds use a consistent approach to reviewing complaints data.
- Around a fifth said that the information they received was ineffective in identifying and reducing risk to patient safety.
Lessons learned from complaints are used for system-wide learning and improvements.
“There are many encouraging signs in the research we are publishing to indicate that the NHS recognises the value of complaints information to patient safety. However, the results of our research suggests that too many Trusts are not considering the kind of analysis they need in order to understand patient experience and use information from patient complaints to improve safety and care.
From Ward to Board level, learning from complaints needs to improve.”
(Julie Mellor, Health Service Ombudsman for England, 2013)
The HSE and Service Providers must ensure that organisational improvement is a key objective of their feedback processes. All feedback must be viewed as an opportunity for quality improvement and risk management. It is important to assure Complainants that all valid feedback will be used by the organisation to identify corrective actions that need to be taken to ensure that the action about which the complaint was made, will be remedied.
To achieve this objective, all HSE staff and Service Providers must accept and recognise complaints as a means of improving the services provided by the organisation. The HSE and Service Providers must ensure that there is cultural acceptance of Service User feedback throughout the organisation.
The pathway for handling complaints that have both clinical and non-clinical aspects to them has been addressed. See Complaints Management Pathway (Link).
It is important to recognise that feedback generated organisational improvements must be addressed in conjunction with the relevant Quality and Risk Personnel in the relevant services, if the complaint relates to both clinical and non-clinical issues.
Complaints Managers Governance and Learning Forum
The Complaints Managers Governance and Learning Forum is a formal network of Complaints Managers and other professional bodies, for example, Office of the Ombudsman, Ombudsman for Children, designed to ensure learning and best practice are shared throughout the organisation.
The Forum is a member driven networking group made up of all Complaints Managers and supported by QAV staff.
The Forum supports the Complaints Managers role of ensuring that lessons learned from complaints are used to improve the service and that those lessons are shared with peers.
The Forum is required to meet on a quarterly basis with resulting minutes and actions published. Each Community Healthcare Organisation Chief Officer and Hospital Group Chief Executive Officer must ensure that a representative Complaints Manager attends and feeds back any learning through relevant management channels locally.
The Forum gives Complaints Managers access to;
- peer learning,
- a platform for involvement in wider quality driven projects,
- an arena for best-practice thinking to solve challenging issues through the examination of complaints handled in each area, and
- a venue for sharing experience in local learning from complaints handling and form analysis of complaints data.
The aims of the Forum include;
- promoting and guiding a consistent approach to the management of complaints within each Hospital Group, Community Health Organisation and corporate HSE, which will reflect Your Service Your Say, The HSE Management of Service User Feedback Policy for Comments, Compliments and Complaints 2017 and the requirements of the National Standards for Safer Better Health Care.
- providing a leadership role within the individual Community Healthcare Organisation and Hospital Groups, ensuring that learning and improvement is a key priority in the management of all Service User feedback.
- providing clear guidance on each step required as part of a robust complaints management process.
- promoting governance, leadership and accountability as part of the effective utilisation of Service User feedback.
The objectives of the Forum include:
- To drive a more integrated approach within the HSE regarding the management analysis and reporting of Service User feedback, enabling better collaboration and problem solving.
- To promote a focus within each Community Healthcare Organisation and Hospital Group regarding the use of Service User feedback for improved service planning and strategy development.
- To develop and implement a process which will enable and support the sharing of learning within and across the health services, locally, regionally and nationally.
- To provide support and share information among members.
- To provide a forum for professional networking of members.
- To promote a systematic approach to translating recommendations identified as part of the management process of Service User feedback into action and to embed a framework of tracking and monitoring with a focus on benefits/outcomes of the transformation.
- To provide and share first-hand patient journeys/experiences for the purposes of learning across all services.
Casebook
Each Complaints Manager has a responsibility for the development of casebooks within their respective Community Healthcare Organisation and Hospital Group.
Each Community Healthcare Organisation and Hospital Group must publicise via the development of complaint casebooks received and dealt with within their respective areas. These casebooks should contain brief summaries of complaints received and how they were concluded/resolve (including examples of resulting service improvements) and should be made available to all medical and nursing staff, as well as senior management.
Casebooks will be published by the NCGLT online to ensure maximum circulation and sharing of learning from these anonymised complaints. (Link)
Complaints Officer Governance and Learning Forum
Subsequent to the publishing of the Learning to Get Better report, the Ombudsman has requested a further recommendation regarding the establishment of a Complaints Officer Governance and Learning Forum.
This forum will be supported by Consumer Affairs. Members should include representatives;
- of Complaints Officers from CHOs and HGs
- of Complaints Officers from Service Providers
- from Consumer Affairs
- from Complaints Manager Governance & Learning Forum
- from QAV
- from other relevant professional or regulatory bodies, as appropriate
The Forum supports the Complaints Officers’ role of ensuring that lessons learned from complaints are used to improve the service and that those lessons are shared with peers.
The forum is required to meet on a quarterly basis with resulting minutes and actions published.
The forum gives Complaints Officers access to;
- peer learning,
- a platform for involvement in wider quality driven projects,
- an arena for best-practice thinking to solve challenging issues through the examination of complaints handled in each area, and
- a venue for sharing experience in local learning from complaints handling and form analysis of complaints data.
