Review of NHS Complaints Pathway

Complaining about an NHS service

The right to complain about unsatisfactory service is a key consumer right. The NHS constitution makes a promise to encourage and welcome feedback on health and care experiences and to use this feedback to improve services.

Healthwatch has an important role, set out in the legislation, to promote and strengthen the voice of local people in the design of health and social care services and in monitoring the quality of those services.

How easy is it to complain about an NHS service in Wiltshire?

In 2014, Healthwatch Wiltshire carried out a review of the NHS complaints pathway in Wiltshire. We spoke to Patient Experience and Patient Advice and Liaison service (PALS) managers from the Royal United Hospital, Salisbury Hospital and The Great Western Hospital as well as the acute ambulance service, the 111 service and the out of hours service. Most importantly, we listened to local people and heard from many, that sadly, their experience of navigating the system was often negative. People were unclear where to turn to when they have a concern of complaint and they have little trust or confidence in the system to deliver a satisfactory result or deal with the concern effectively.

What did we do to try and make things better?

We wrote a report based on what we had found. This is called: ‘NHS and social care services in Wiltshire: Pathways to making a complaint or raising a concern’. In this report we made recommendations for NHS providers and ourselves that included changes to process, practice and information provision that would bring about an overall improvement in the local NHS complaints system and therefore people’s experience of using it. The report was presented to the Wiltshire Health and Wellbeing Board in September 2014 and all of the recommendations endorsed.

Our recommendations

Provision of information

  • Dedicated feedback page with clear link from homepage: to include leaflets and policies.
  • Leaflet explaining in more detail the complaints pathway and roles and responsibilities of those involved.
  • Up-to-date and clear easy read documentation.
  • Use of infographics and flow charts.
  • Downloadable information in PDF format.

Learning Disabilities

  • Link to, or embed information from Parliamentary Health Services Ombudsman site: ‘Complain for Change’.
  • A dedicated resource to encourage those with LD to raise concerns.

Children & Young People (CYP)

  • Produce dedicated CYP friendly information to include leaflets and posters.
  • Provide more innovative avenues to encourage CYP to give feedback on the services that they access.

Sharing Good Practice

Providers to share examples of good practice in complaints handling by the formation of a ‘Health and Social Care Liaison group’. To include representation from acute hospital, mental health and ambulance trusts, CCG, Wiltshire Council. The group to be chaired initially by HWW. Other groups may be involved as appropriate – e.g. SEAP, other local Healthwatch, Medvivo and CareUK.

Innocent Bystanders

  • Record and take seriously, concerns from innocent bystanders (other patients and non-relatives).
  • Volunteers on wards to encourage and assist patients in giving feedback.

Sharing Information

Routine sharing of anonymised, thematised data relating to complaints, concerns, friends and family tests (FFT) from all providers.

What’s happening now?

We have carried out a further review of NHS complaints system to see if things have changed. Although some improvements have been made, with hospital Trusts making information a little easier to find, there is still a lot more work to be done.

Working with local providers and Commissioners

One of the recommendations we made was that providers of NHS services come together regularly as a complaints liaison group so that they could share good practice. Healthwatch Wiltshire organised the first of these meetings in November 2015. The meeting was well received by all who came along.

At first, the members of the group are the PALS and Patient Experience managers of RUH, GWH, AWP, SFT and NHS Wiltshire Clinical Commissioning Group. The group will to meet on a quarterly basis with the purpose of:

  • Sharing good practice in complaints handling.
  • Discussing local issues arising in complaints handling.
  • Bringing in different groups e.g. other local Healthwatch, advocacy providers or GPs etc. to discuss specific issues, inform and build relationships.
  • Building supportive relationships.
  • Creating a local peer-support network.

At the request of PALS/Patient Experience Managers who attended the group, Healthwatch Wiltshire has agreed to run two learning workshops for PALS/Patient Experience staff from the acute hospital Trusts. This will give them the opportunity to meet with patients who have experienced the complaints system and with PALS staff from different Trusts.

Healthwatch Wiltshire’s involvement in the national work on NHS complaints.

Healthwatch England believe that we need wholescale reorganisation and culture change to make a system that is ‘simple, seamless and stress-free from people’s perspective and offer meaningful resolution’. Therefore, they have developed a 7-point action plan that has been sent to the Secretary of State for Health.

One of the things that they want to do is to put together a complaints Toolkit to make it easier for local Healthwatch to easily assess complaints systems in their area. Healthwatch Wiltshire is one of three local Healthwatch actively involved in this work.

One of the people we spoke to summed up using a simple acronym what he would like a complaints system to look like:


NHS and Social Care Services in Wiltshire: Pathways to Making a Complaint or Raising a Concern

Download the full report

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