Last reviewed 5 November 2013

Commissioned by the Prime Minister following the Francis report into failings at the Mid Staffordshire NHS Trust, a new report has proposed systems to overhaul the NHS complaints handling procedures.

Robert Francis QC reported earlier in the year that problems in Mid Staffordshire NHS Trust could have been detected earlier if staff had listened to the concerns of patients and relatives.

A Review of the NHS Hospitals Complaints System: Putting Patients Back in the Picture, which looked at 2500 accounts of poor care and lack of compassion, was co-authored by Labour MP Ann Clwyd and NHS chief executive and former nurse Professor Tricia Hart. They have called for a revolution in the way the NHS handles complaints, after receiving emails and letters from patients, doctors and nurses that revealed an NHS culture of “delay, deny and defend”. They said too many patients found the current approach to complaints unresponsive and confusing, and put the health service on a year’s notice to improve accountability and transparency.

Complaints needed to be taken seriously at the very top of the NHS, it said, with chief executives responsible for signing off the complaints and trust boards scrutinising and evaluating them. It also said that staff must be better trained to listen to patients and act on what they hear. The authors also called for “better, safer, kinder care so that fewer patients feel like they want to complain”.

The authors obtained commitments from 12 key NHS organisations including the Royal College of Nursing, the General Medical Council, the Care Quality Commission (CQC) and Monitor. These included pledges that:

  • the Nursing and Midwifery Council would include new duties over complaints handling in its code of conduct

  • Health Education England will develop an e-learning course to improve training

  • NHS England will work with local managers to hold hospitals and other providers to account

  • the CQC will place a strong focus on complaints in its new hospital inspection regime.

Recommendations also included appointing a board member with special responsibility for whistleblowing and making basic information such as who is who on a ward easily available to all patients. Hospitals will be expected to publish annual reports in “plain English” on complaints.

Health Secretary Jeremy Hunt welcomed the report and said a full response to the Stafford Hospital inquiry and the reports that have followed would be made before the end of the year.

Shadow Health Secretary Andy Burnham said: “The NHS has an unfortunate tendency to push complainants away and pull down the shutters. That has to change.”

The report comes as Health Service Ombudsman Dame Julie Mellor calls for a 24-hour advice service for dissatisfied patients. Her report, NHS Governance of Complaints Handling, found that only a fifth of NHS boards reviewed learning from complaints and then took action to improve services. She said she hoped the new review of NHS complaints would help tackle the “toxic cocktail” of reluctance by patients to complain, and the defensiveness of NHS organisations.