NHS complaints system not working, say MPs

Clinical commissioning groups must play a 'substantial role' in ensuring the NHS handles complaints correctly, MPs have said after they found that the current system is 'not working'.

The House of Commons health select committee's inquiry into the complaints and litigation processes in the NHS found ‘unwarranted variations’ in how the complaints system works across England.

It said commissioners must play a key role in strengthening the complaints procedure and also said NHS Choices could offer 'real time feedback', such as 'patient bedside technology'.

Health select committee chairman Stephen Dorrell said patients expect rightly that if they make a complaint it will be taken seriously, with the health service acting ‘openly and quickly’. But he said the current system means patients’ grievances are ‘exacerbated’.

Mr Dorrell said patients are often forced to side-step the NHS complaints system and go straight to litigation procedures, which makes the process more stressful for doctors and patients.

The report said commissioners have the potential to be the ‘engines that drive improvement in the complaints system’.

It said service agreements between commissioners and provides should include a ‘contractual duty of candour to the commissioner’.

When commissioning bodies are authorised by the NHS Commissioning Board they should also be placed under a contractual duty of candour to their populations and to their local Healthwatch organisations, it said.

Mr Dorrell said:  ‘The complaint system varies far too much from one part of country to another. In the areas where it doesn’t work well enough the system is felt by patients to be too defensive and not sufficiently open.’

‘We are arguing that it is really core that the commissioning process within the health service reduces this variation and puts a greater emphasis on openness and being less defensive.’

Meanwhile, the health select committee said it ‘strongly supports’ the use of tools that allow patients to give anonymous feedback, such as NHS Choices.

It said the government must pilot how ‘real-time’ feedback could be captured, for example patient bedside technology that could lead to an immediate response and feed into analyses of ‘broader complaints trends’.

It added that role of the Health Service Ombudsman needs a complete overhaul if it is to provide an effective appeals process for the complaints system.

It said: ‘The current terms of reference prevent her [the Health Service Ombudsman] from launching a formal investigation unless she is satisfied in advance that there will be a 'worthwhile outcome'.

‘We have concluded that this requirement represents a significant obstacle to the successful operation of the complaints system.’

Frances Blunden, senior policy manager at the NHS Confederation, said the increased cost of legal claims in the NHS and the growing sense claims were being actively generated by some claims management companies made a fresh look at the way they are regulated necessary.

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