31st March  2015

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Dame Julie Mellor, Parliamentary and Health Service Ombudsman in conversation with Roy Lilley

Is the PHSO fit for purpose?

King's Fund 15th April Details here

No that we've got
News and Comment from Roy Lilley

When it all goes wrong, what do you do? Well, there's the warrantee, maybe a money back guarantee? Or, 'take it back and change it'. Marks and Sparks built a business on the idea.


There is the little known Sec75, 'connected lender', legislation; buy something on your credit card and it all goes wrong, the bank should give you your money back and it's for them to sort out the suppler.


Nothing is perfect but consumers are probably in a better place now than they have ever been; trading standards, health and safety, rules and regulations all designed to protect the customer.


What about the health service?


In the real world handling complaints is fairly straightforward. Listen, Sympathise, Don't justify, make Notes, agree a Course of Action and Follow Through. Follow the six simple steps and most of your complaints will turn into compliments.


Well run businesses will tell you, complaints handling and the analysis of why people are disgruntled is a top-of-the-shop task.  They want to know, fix and learn.  Complaints are the grit in the oyster; you can't have the pearls without the grit.


The NHS? The complaints 'procedure' is explained here; if you find it reassuring tell me what tablets you're taking. I want some! We start with the NHS Constitution with its weasel worded promises and finish with the Parliamentary and Health Service Ombudsman.


In between we have; informal chats, formal complaints, complaints procedures, 'tips on how to complain', Trust's procedures, PALs (open Mon-Fri, 9-5), CCG procedures, call-centres, the GMC, the NMC, emails, letters, on-line forms, templates, lawyers and the PHSO. There are timescales, timelines and time to respond; three days, 25 days or none of the above.


The CQC tell you they don't 'do' complaints but they do 'do' a leaflet. Oh, and they 'do' have a phone line where you can complain to your heart's content but they won't 'do' anything to rectify your issue... so go back into the loop of Local Authorities, Local Government Ombudsman and the NHS or the PHSO.


Got a complaint? It might be better to give it a blast on social media, or write out your complaint, tie it to a brick and lob it though the Secretary of State's window. You could try a bill-board, a brass band or perhaps some aerial advertising with a banner towed by a drone?


The Health and Social Care Information Centre do what they can to collate data on written complaints but I doubt it's the total picture.  Doctors attract the biggest numbers of complaints, nurses, midwives and HVs come next. Inpatient services are the most complained about with paramedics facing the biggest increase in complaints.


All up there are +3k complaints a week... bear in mind more than a million people are looked after, one way or another, in the NHS, every day.


That's about all I can tell you. Other than (Page 20); 'staff attitudes' are high on the list for complaints topics, as are communication and delays in discharge and transfer arrangements. Food is complained of far less than you might imagine. Complaints about complaints handling are up by 8.1%!


If this sounds clunky, it's because it is. If this sounds like the NHS counts complaints but doesn't count on them to improve services, you might be right.


PHSO is the last port of call. In 2012-13 they claim to have 'resolved' 26,358 complaints. I think we might need to define 'resolved'. They include; not investigated, 'gave support', took no action, informal intervening and in 467 cases they actually investigated. Mmm...


The PASC are non-too-pleased with how incidents of clinical failure are investigated and are calling for an airline style of immediate no-blame investigation and learning.


NHS complaints, that need the bright light of candour to be seen and learned from, are dragged into the shadows by the pull of damages, busted careers, the toxicity of whistle-blowing, bullying, lawyers, fear, blame and guilt.


Complaints are gold-dust; savvy managers go prospecting for them, mine them and treasure them.


When we make it:

  • easy to complain,
  • with complaints freely heard,
  • considered with respect,
  • resolved promptly
  • and the lessons learned, implemented...

...we'll have a complaints system worth the name.


Right now, I'm not sure that's what we've got...


Come and join my HealthChat evening with the head of the PHSO, Dame Julie Mellor,

in conversation with Roy Lilley 

Details here 

Let's find out about complaints.

Book Now


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Dame Julie Mellor
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Come and hear Dame Julie in conversation with
Roy Lilley
Just what impact has the PHSO had on better care?
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15th April 2015
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