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NHS must learn from patients' complaints

The Healthcare Commission is urging NHS trusts to do more to learn from patients' complaints and to handle the issues raised "quickly, efficiently and locally".

It will today publish a report on the recurring themes in some 16,000 complaints sent to the Commission between July 2004 and July 2006.

With poor complaints handling among the top issues patients raise, the watchdog will launch the first national audit of how NHS trusts deal with people's concerns. It will look at good and poor practice, inspecting some 50 trusts after analysing performance indicators covering all trusts in the country. 

Inspectors will check whether trusts give complaints handling sufficient priority and learn from the issues raised. They will consider whether complaints systems are accessible and understood by people using services. If trusts are not up to standard, this will be reflected in their annual performance rating.

The report highlights some common themes of complaints:

  • Safety - 22% of total. Often the most serious type of complaint, issues included a mix up over names leading to a child having the wrong injection and a failure to properly manage when things went wrong after childbirth. 

  • Nursing - around 7% of total. Nurses provide a large proportion of patient care so the total number is unsurprising but the themes are concerning. Complaints about nutrition were most prevalent including low-quality or inappropriate food and lack of help with eating. There were also complaints about staff attitudes and the dignity of patients. 

  • Discharge from hospital and service coordination - around 5% of total. Some cases were about the lack of notice given to families before the discharge of a relative from hospital. More serious cases involved the discharge of vulnerable patients including children and the elderly without any support or at inappropriate times of the day.

  • Cleanliness and healthcare-associated infection - around 5% of total.

  • Removal of patients from GP lists - some 15% of complaints about GPs. This was a recurring theme despite clear requirements on the topic. Some GPs did not warn patients that certain behaviour could lead to them being taken off a list or explain to people why they had taken action.

  • Record-keeping - 3% of all complaints. In a number of cases involving GPs, it was found that patients' records had been misplaced. The transfer of records was also frequently a source of problems.

  • Clinical care and treatment, including delays in referral or diagnosis - 66% of complaints about GPs. Concerns raised included alleged failures by GPs in making accurate or timely diagnoses.

  • Out-of-hours GP services - about 2.5% of total.

Anna Walker, the Commission's Chief Executive, said: "Complaints represent the raw feelings of patients and the NHS must listen and learn from them. At the centre of each one is an individual who often has genuinely suffered. Too often, this was not just because of what went wrong but because of the way people were dealt with. 

"Many of people's concerns are about the basic elements of healthcare, such as good communication. These are not things that cost a lot of money to solve. They are about management and staff working together to ensure they treat patients as they would like to be treated themselves."

Looking at what complainants wanted, 33% said a better explanation of what went wrong, 23% service improvements, 10% an apology, 9% the event acknowledged, 8% action against staff, and 8% for the same thing not to happen again.