Patients and carers share their experiences with the Parliamentary panel reviewing hospital complaints
I was very privileged to listen to people who had direct experience of the complaints process tell their stories last week. Three were seAp clients and three had gone through the complaints process without an advocate. All took the time to travel to the West Country and share their experiences for over 2 hours. Some of these experiences are still raw and painful to recount. What they all had in common was a desire to improve the NHS. As one participant said, 'it is our NHS, we want it to work'.
No one wanted to take legal action, they just wanted their concerns to be acknowledged, an apology and the reassurance that lessons had been learnt and that other people wouldn't have to go through what they had been through.
Here are some of the things they said
- I've advised people not to complain as you need to have the resilience of a horse to go through that process.
- Going through the process meant that I was unable to grieve
- I was met with active resistance, bordering on hostility. Everyone was so defensive
- The consultant didn't listen to me and my concerns. He was superior and patronising
- The subject of my complaint was protected from the process. He didn't apologise
- The whole process lacked warmth and compassion. No one asked me if I was ok at the local resolution meeting
- Apology was begrudgingly given, it was like pulling teeth and then it wasn't a real apology for the actions that took place but they were sorry that I felt aggrieved
- I felt deflated and emotional as I promised my partner that I wouldn't let them get away with it. In the end I gave up as I ran out of the time limit
- They turned it around to me, I was considered a difficult, challenging and abusive patient
- The investigation dragged on so long that I ran out of time to take the complaint to the next stage. It felt deliberate
- I was focussed on getting well--by the time I could make the complaint, I ran out of the time limit. It is too rigid and doesn't take into account the individual's circumstances
- I went to a meeting where I faced 5 NHS staff. You need to have a lot of stamina to go through that process. (this was everyone's experience)
- I had to chase up my complaint 3 times and when I asked for a meeting was told I didn't need one.
Sadly their experiences were similar and familiar. Most of those attending described themselves as confident and articulate people and yet they found the process unclear, complex and difficult to navigate. This was compounded when feeling emotional and vulnerable. They wondered what it would be like for those who lacked confidence.
The participants talked of the response they got when they raised a complaint and how the process seemed set to intimidate and discourage complaints. Very tellingly those still undergoing treatment at the hospital where they made the complaint asked to remain anonymous as they were concerned that any publicity would affect their care.
The main messages that I was left with are:
The NHS at every level needs to realise that patients, carers and the public want the NHS to succeed and work well.
They should be seen as partners in the NHS with invaluable information to share about how they experience the care that is being delivered.
Patients and carers recognise that mistakes happen, the NHS needs to be big enough to put their hands up and say sorry.
Encouraging feedback, both positive and negative and dealing with issues as early as possible, avoids entrenched positions. This message needs to come from NHS Boards.
The complaints system needs to be more open and transparent. The government should consider independent investigation of complaints.
None of the participants believed that their complaint was investigated objectively.
The role of the complaints manager was confused and they were not senior enough in the hierarchy to call people to account.
Continuous improvement - none of the participants believed that practice would really change as a result of their complaint. This is borne out by our experience of the types of issues that people complain about. They are frequently similar, year on year. However there is good practice and that needs to be shared.
Complaining is tough. People need support. Those who were not seAp clients didn't know about ICAS at the time.
All NHS bodies should inform all complainants about the existence of advocacy support.
Participants thought Independent Advocacy support should be available on wards and to those who do not have carers or others to speak up for them. This would enable people to raise concerns before they get to be a complaint.
Investigations took a long time, some having to follow up their complaint a number of times. All spoke of meetings where they would be facing 5 NHS staff, most found the responses they received as 'hugely patronising' and that the process lacked any warmth. There is a need for training in complaints handling.
The patients all felt they were fighting the system which was geared to defending those working within it. Going through the process compounded the initial complaint.
These comments echo the Healthwatch England report on complaints.
Participants were encouraged that Ann Clywd, MP was chairing the review as she had personal experience of complaining about the NHS treatment received by her husband. They were also encouraged by the message that both Ann Clywd and Patricia Hart are determined that their recommendations will be acted on and they will followed up progress.