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Complaints and Investigations

Why do people make complaints about health and care?

People may complain about health and care services if they have difficulties accessing care, there are delays in access, or they have been refused an assessment or service. They may complain about the quality of care or service they receive, including a lack of communication or information, how staff have treated them, poor quality care assessment or delivery, or reductions in care. Complaints may be made by the person needing care, or their representative, usually their carer or family.

It is important to recognise, however, that many people who have these concerns do not complain because they do not know how to complain, because the complaints system is too difficult to navigate, or because they fear that there will be a negative impact on their care.

People need to know how to complain, and we must make it easy for them to raise concerns without fear of the possible consequences.

What do people want when making a complaint?

When people make a complaint (on their own or someone else’s behalf) they want:

  • Sensitivity from the person receiving their complaint and from the investigator.
  • A transparent and independent complaints process and investigation.
  • To make their complaint once, even if it encompasses several teams, organisations or services.
  • To feel someone is on their side and supportive to them.

People want timely and full response, directly addressing the issues they have raised. They need recognition of what happened and the impact on them – an apology, and where appropriate, a remedy. People want the problem to be put right, for example to have access to the service they need, to have a voice and choice in their care and treatment, or for policies and practice to be improved. Crucially, people want to know what went wrong and why, and to be assured that no one else will be affected in the same way again.

Complaints give us the opportunity to put things right, and to learn, change and improve.

How should we respond to complaints?

“Complaints matter in health and social care and for too long they have not been taken seriously enough. Too often complaints are met with a defensive culture instead of a willingness to listen and learn.” Care Quality Commission

The Francis Inquiry identified how the culture of an organisation can impact on how it manages complaints and serious incidents. Negative cultures were characterised by:

  • A lack of openness to criticism, secrecy and defensiveness.
  • A lack of consideration for patients and acceptance of poor standards.
  • Looking inwards and not outwards, and misplaced assumptions about people’s judgements and actions.
  • A failure to put the patient first.

The Inquiry recommended a culture of openness and candour to ensure people know when things go wrong, can raise concerns and have their questions answered.

To respond positively to complaints, and to investigate when things go wrong, we should:

  • Co-produce complaints processes with people who use services.
  • Encourage positive and negative feedback and complaints as part of continuous improvement.
  • Listen to complainants and families, accept and seek to understand their experience.
  • Provide access to support and advocacy where needed.
  • Carry out high quality investigations by trained investigators.
  • Cooperate with other services and organisations included in a complaint or investigation.
  • Be open and honest about what has happened and how we will prevent it happening again.
  • Agree an appropriate remedy with the complainant and take prompt action.
  • Audit and report to boards, commissioners and inspectors to evidence how complaints and investigations have been managed and acted upon.
  • Share learning across teams and with relevant partner organisations.

Complaints procedures

Complaints about providers of health or care services should initially be made to the provider, but people can also contact the Care Quality Commission about any services they regulate, the local Integrated Care Board or the local council about services they commission, or the regulatory body of any specific professional.

To learn more about making complaints about the NHS click here

To learn more about making complaints about health or social care providers click here

To learn more about making complaints about local authority social care in Essex click here and in Suffolk click here

References and Further Reading

References & Further Reading

Section description goes here

Last Updated on 2 July 2024

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