It isn’t news that NHS complaints management needs to be improved

The NHS, the government, medical professionals and patients, have known this for over 20 years.  Bundles of money has been spent on reviewing the issues – from “Being Heard: The report of a review committee on NHS complaints procedures” (DoH, 1994);  “Making things better? A report on reform of the NHS complaints procedure in England” (2005) right up to the 2013 “Putting Patients Back in the Picture” (Parliamentary and Health Service Ombudsman) review, post-Francis report into Mid Staffordshire.

Ten years ago, the then Labour Government announced it would overhaul the NHS’s complaints procedure.   The then Minister of State for Health Rosie Winterton said “Patients deserve a robust, effective complaints system. All patients should expect a thorough investigation, a comprehensive response, and effective action in response to their concerns.”  Yes, they do.

But they didn’t get it, because 10 years’ later, and with the Mid Staffordshire scandal in the papers, Jeremy Hunt, Secretary of State for Health for the Coalition, was saying “I want to see a complete transformation in hospitals’ approach to complaints, so that they become valued as vital learning tools. There can be no place for closing ranks or covering backs when patient safety is at stake.”

That’s 20 years, with every review and report finding the same issues and making the same recommendations.

So what’s gone wrong? Why is the NHS where it is?  My lasting impression, from my exhaustive research, is that managing complaints in the NHS is like a dog chasing its tail: how do we stop this endless circling around and around, going nowhere?   Clearly whatever it is that is being done, it aint working.   And this is no criticism of the NHS employees individually – I’m an NHS supporter and believe that the cuts they’re working around are insupportable.

But this matters to me, professionally and personally, so what can CMP bring to the table in addition to the work we already do with the NHS, investigating complaints and training managers?

Is managing an NHS complaint different?

Making a complaint is basically needing to have a difficult conversation that arrives at an outcome.   In the workplace we do this all the time, with colleagues, clients, and suppliers. It’s where CMP’s expertise lies.  So let’s apply the principlas of a ‘good’ difficult conversation, to responding to NHS complaints.

The principles of good complaint handling

There are three guiding principles (see also our Courage to Manage: Having essential conversations at work) which are Courage, Benevolence, and Honesty.

1. The Courage to show leadership, to have the difficult conversation, hear the tough feedback, say the tough things, to make changes in yourself
2. Benevolence to show empathy, to listen, to assume good intentions
3. Honesty in owning your feelings and behaviours, your failings, your part in matters, to say what you need clearly and without blame.

How it would help the NHS to adopt these principles

I’ve looked at the key findings of the Parliamentary and Health Service Ombudsman “Designing Good Together” report 2013 which show that, in the main, the system doesn’t work because:

1. People don’t listen
2. Trusts react, they don’t respond
3. Any improvements or learning is kept to a small body of people, not shared.

So how would bringing Courage, Benevolence and Honesty into your trust make a difference?

How Courage will help

Your staff, managers, policies, senior leadership and Board would:

• welcome complaints without defensiveness
• benchmark yourselves against other Trusts
• share the learning from the complaint with the complainant and with your stakeholders from top to bottom
• give a clear, honest explanation of what happened
• tell employees where they need to improve
• speak up to people in senior positions and give them real information not deference

How Honesty will help

Your staff, managers, policies, senior leadership and Board would:

• acknowledge personal, professional, organisational shortcomings, failures, weak areas
• be realistic and frank about what is possible
• give honest and understandable explanations to complainants
• tell employees where, how and when they need to improve
• have access to accurate, comprehensive and reliable data

How Benevolence will help

Your staff, managers, policies, senior leadership and Board would:

• invite complaints knowing they are well intentioned or coming from a place of pain and distress
• welcome conversations with complainants as a way of helping them simply to feel heard and supported emotionally
• listen to each other from an open non judgemental place

It’s not enough to keep reviewing the problem

It’s got to be time to do something different and new.  Come and meet us at the Health Care complaints conference on 19 September; or if you’re not going, then contact me to talk through how we might be able to work with you to bring those key ingredients into your complaint-handling.