Support . Empower . Advocate . Promote

seAp's response to the Review of NHS Hospital Complaints System

Posted: 1st November 2013

The long awaited publication of the Clwyd Hart review into NHS Hospital complaints has set out a number of key recommendations to improve the complaints system. 

seAp was pleased to contribute to the report by sharing our decade of experience supporting clients to raise concerns and make complaints to NHS bodies.  We  brought together clients who gave their experiences directly to the panel in one of its focus groups.  More details are as outlined in our blog.

The findings of the panel is not a surprise to anyone who has had an interest in improving quality in the NHS, there have been many reviews in the past, all coming to the same conclusions.

We are pleased that the report reflected the concerns expressed by our clients and the need for accessible, independent support at a vulnerable time for most people. 

There are many recommendations in the report but I want to focus on those which have addressed the issues raised by our clients and advocates. We particularly welcome the following: 

  • Raising complaints handling high up on the agenda for hospital trust boards and CCG’s and making the whole process more transparent.  This will go some way to making the public confident that the complaint is being dealt with properly and that the complainant’s views are valued.
  • There should be greater independence in the complaints system and that independent investigation should be offered in line with theFrancis recommendations. 
  • Complaints handling staff should be adequately trained, supported and of sufficient seniority to investigate complaints. seAp would be pleased to offer training to staff highlighting the complainants point of view
  • We also support the closer alignment of complaints advocacy with local Healthwatch.  Our experience has shown that where there is a close relationship with LHW, there is a greater understanding in the community about the benefits of raising concerns and complaints and the support available to do so.  The Advocacy service will also provide LHW with trends and information about services which could steer LHW work and support it to develop its strategic plan.  As a member of the Health and Wellbeing Board, LHW can highlight complaints handling and challenge poor practice with commissioners.  Of course LHW are newly developing organisations locally focussed on their communities.  seAp believes there need to be national standards and support to enable LHW to meet their full potential.
  • We fully support the need for a national brand for complaints advocacy.  This is all the more important as patients travel the country to access health services.  Access to advocacy support to make complaints needs to be easy and accessible through a ‘one stop’ consumer champion. 
  • Our clients and advocates tell us that most people would like the opportunity to raise concerns with their healthcare professionals before they become complaints.  The current system means that they will only receive support if they complain.  We welcome the report’s focus on support on the wards to raise concerns; however we believe that volunteers should be recruited, trained and supported by independent voluntary organisations, preferably advocacy providers.  There are several reasons for this:  they will be independent of the hospital (an important matter already raised in the report), raising issues with professional health providers on a busy hospital ward is not easy, especially if the volunteers are not trained and haven’t got the right back up and support.  seAp is currently working with LHW inEast Sussexto pilot such a programme
  • Providing NHS complaints advocacy across the South of England has provided us with a unique insight into the variety of complaints handling approaches across NHS service providers and the impact that this has from a complainant’s perspective. If a complaint has been lodged there are benefits to early acknowledgement/intervention meetings.  A number of Trusts have adopted an ‘acknowledgement by meeting’ approach to their complaints handling (Avonand Wilts MHPT and Royal Bournemouth Hospitals NHS FT). This has proved to be a positive approach to the early and effective resolution of NHS Complaints, has reduced complaint time, increased customer and staff satisfaction with the added benefit of cost efficiencies for both provider and commissioning bodies on the ward.


As the report admits, there have been many previous reports that have highlighted the same issues, the implementation of its recommendations is key.

We support the proposal to empower and adequately resource the consumer voice and would like to work alongside those organisations to represent the voice of those we support both locally and nationally

We also support the proposed role for the CQC to prioritise the handling of complaints. seAp has had discussions with the CQC on how we could assist it in hearing our clients’ stories and sharing information on complaints.  We are able to highlight trends as well as outcomes and client satisfaction.  Many of our clients tell us that they are not always able to share their complaint with others because they feel too emotional or because they fear that it may adversely affect any future care.  It will take a long time for people to trust that the system will not close ranks.  In the meantime they would like their advocate to represent their views or they would be prepared to share them in a confidential arena with support from their advocate.  This is what we are discussing with the CQC. 

We are also encouraged by the pledges from the stakeholder organisations and we would like to offer them support and training to enable them to deliver on their pledges.

Finally this report has the opportunity to create the culture change required.  This must come from the top.  It may mean that complaints increase but as long as they are handled appropriately and lessons are learnt--this will be a good thing.  Ann Clwyd’s own experience reached out to many of our clients.  They knew she understood what they were going through.  It is an opportunity to restore confidence in the complaints process and the claim that the NHS is patient centred or as I heard at a recent conference, patient-powered.

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