Speaking up: Resolving NHS complaints and preventing problems from recurring

When a patient or their loved ones are dissatisfied with a health care experience, they can make a formal complaint. But the process can be daunting and frustrating, the NHS’s response is too often defensive, and there is little attempt to use complaints constructively as a driver for improvement.

The Speaking Up project aimed to transform the complaints system at Mid Staffordshire NHS Foundation Trust, enabling patient voices to be heard and translated into genuine improvements in care.

The project involved a range of interventions designed to create greater transparency, scrutiny and independence, and build closer links with the local community.

Resolved complaints were examined by peer review panels made up of clinicians, complaints managers, magistrates and members of the community, to provide data on the effectiveness of the complaints system. Independent advocates were trained to support individuals making complaints and the team introduced a survey to measure satisfaction among complainants. The team also produced ‘digital stories’ about people’s experiences of the complaints system.

Outcomes:

• The trust made significant progress in some areas of complaint handling, including providing complete responses, good quality explanations and a named contact for the complainant to liaise with.
• There were also improvements in how complaints were investigated.
• However, performance in other areas was static and fewer complaints were dealt with promptly, which brought down overall performance.
• The complainants survey, peer review methodology and scorecard, and good practice standards for complaints handling developed by the project have the potential to be used across NHS organisations.

Challenges faced:

• Changes made to the complaints survey and the peer review system during the project – to improve data collection – made it difficult to compare data over the lifetime of the project.
• The team struggled to recruit patients and staff to share their experiences through digital stories.
• They realised that transforming complaints handling requires improvement across a very wide range of areas, which can only be achieved with consistent engagement and support from a large number of staff.