NHS Complaints
"An organisation that truly welcomes, values and uses complaints to inspire and
guide improvement will be more successful than one who does not"
Professor Alice Brown, Scottish Public Services Ombudsman
The NHS Complaints system can be a powerful force for making things better, both for individual complainants and for the wider NHS, thus creating a culture of learning from mistakes and putting things right - a key objective for the NHS in Scotland.
Complaints about the NHS are a valuable way of identifying issues in the service where change is needed. Acknowledging these issues and taking steps to rectify any problems is vital to create an open and honest NHS. Complaints should be welcomed with a positive attitude and valued as feedback on service performance, driven by the search for improvement in the organisation and not the appointment of blame.
The complaints system requires for the whole organisation to value and take ownership of complaints received. Front-line staff, managers and executive officers all need to have defined responsibilities in welcoming and learning from complaints, in order to make a complaints management process truly effective. It is crucial that complaints intelligence feeds directly back into service improvements.
Patients or perhaps a relative on behalf of a patient can make a complaint if they feel dissatisfied with any aspect of their episode of care or other factors such as facilities or the place they are seen in. There is an incredibly wide variation in the type of contacts that patients have with the NHS - such as treatment as an Inpatient, Outpatient, A&E attendance, donation of blood or transportation by ambulance, to name but a few. Each year, for example there are approximately 4.3m outpatient attendances1 and over 2m ambulance transportations2 in NHS Scotland.
Complaints received by the NHS are a relatively rare occurrence. In 2006/07, there were 7,347 complaints3 received about Hospital & Community Services - however putting this into context with the number of contacts4 with the NHS, this results in approximately 4 complaints per 10,000 patient contacts for Scotland. This compares with 5 complaints per 10,000 in 2005/06. For Family Health Services, there were 2,984 complaints received in 2006/07, resulting in approximately 2 complaints per 10,000 GP consultations.
NHS Boards and other NHS organisations submit summary information about complaints they receive to ISD Scotland. The data covers complaints received by Hospital & Community Services and Family Health Services . The data submitted to ISD includes all formal written complaints. Note however, that there is a variation in recording practice across Scotland and some NHS Boards / organisations also include telephone and other formal oral complaints in their submission to ISD. Further investigation into the consistency of recording practices in the NHS Boards and organisations across Scotland will be undertaken in future months.
The NHS complaints procedure was introduced in April 1996, with a subsequent revision in April 2005 - with the purpose of providing a simple, flexible, impartial and easily accessible system for the public as well as being fair to NHS practitioners and staff.
Current Complaints Procedure
Scottish Public Services Ombudsman
Citizen's Advice Scotland (CAS)
Review of the NHS Complaints Procedure, 2005
Current Complaints Procedure
The NHS complaints procedure was revised with effect from 1 April 2005. The most noticeable change is the removal of the Independent Review stage. This was removed to enable a faster process and to allow the introduction of independent scrutiny at an earlier point. This is provided by the Scottish Public Services Ombudsman. The new system also makes provision for those wishing to complain about their GP without initially having to contact their GP. In these circumstances, they may contact their Board complaints officer in the first instance. These changes are in line with the recommendations made in the research carried out in 1999 by System 3 Research and York Health Economics Consortium.
Further details on the current Complaints Procedure can be found at:
"Can I help you? Learning from comments, concerns and complaints"
Scottish Public Services Ombudsman
If a complainant remains dissatisfied with the response from the normal complaint process, there is recourse to the Scottish Public Services Ombudsman who provides a 'one-stop-shop' for individuals making complaints about organisations providing public services in Scotland. 
www.spso.org.uk
Citizen's Advice Scotland(CAS)
In March 2006 it was announced that CAB services would be assuming a new role in providing advice and support to NHS patients and the public, including help in taking forward any complaints they may have about the treatment they received in the NHS. Citizen's Advice Scotland
CAS press releases
www.cas.org.uk/pressrelease332006.aspx
www.cas.org.uk/pressrelease192006.aspx
Review of the NHS Complaints Procedure, 2005
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An evaluation of the NHS Complaints Procedure, established in April 1996, was carried out. This was a thorough UK wide project led by the Department of Health in England with a Scottish Advisory Group of complaints personnel and patients' representatives set up to oversee the Scottish evaluation. The evaluation report has been published and can be found at the Scottish Executive web site at : www.scotland.gov.uk/library3/health/nhscomplaints.pdf
The Scottish Perspective pre-consultation document can also be found on the Scottish Executive web site at: www.scotland.gov.uk/library3/health/nhscomplaints_summ.pdf
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Overall, the aims of the research were to provide an evaluation of how the NHS complaints procedure is operating across all parts of the NHS - hospital, community and Family Health services - and meet the information needs of policy makers and managers concerned with the future development of the system. It was not intended to be an academic project, but a practical and realistic analysis based as far as possible on the actual experiences of those using and operating the procedure. This is now being used as a tool to further refine the process so that it better meets its original aims and principles.
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An advisory group was established to develop proposals for a revised NHS complaints procedure that will be 'credible, easy to use, demonstrably independent and effective'. The group developed these proposals and issued a pre-consultation paper. From this, further work was carried out to develop the ideas.
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A consultation paper was issued following the results from the pre-consultation document. This exercise lasted three months and the results were analysed independently by Scottish Health Feedback. The Scottish Executive responded to the Scottish Health Feedback report. All of these documents can be found atwww.show.scot.nhs.uk/complaints
1 Outpatient Attendances : Data Source ISD(S)1, New and Return attendances, 2006/07
2 Scottish Ambulance Transportations : Scottish Ambulance Service (SAS), Patient Transportation Service and Emergency and Urgent responses, 2006/07
3 Complaints : This is the number of complaints submitted to ISD. This includes all formal written complaints. In some Boards / organisations, telephone and other formal oral complaints are included in their submission to ISD.
4 Patient Contacts : Data Source for selected activity ISD(S)1, includes Inpatient episodes, Daycases, Day patients, Outpatient and A&E Attendances, Psychiatric episodes, Ward Attenders, Allied Health Professional and other technical department episodes, Haemodialysis attendances. Note that activity from other areas such as Maternity and Community contacts (such as Health Visitors) are not included.
5 Number of Consultations: Estimates from PTI (Practice Team Information) data show that there were approximately 15.6 million face-to-face contacts between patients and General Practitioners (GPs) in Scotland in 2005/06. Please note this figures excludes other staff members of the practice team i.e. practice and district nurses, health visitors.
Santiago Nieva
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