Wednesday, 8 September 2010


It was recently reported that the number of NHS complaints has gone up, rather a lot.

The details are unfortunately numbers, giving us data, rather than information. I was taken, for example, by the increase in complaints across Primary Care that increased by 4.4%. Does this mean anything? In my corner there's been a LES that's increased a lot of clinical activity in Primary Care. They've also started undertaking a slew of activities that the acute Trust used to provide. A number of exercises in partnership working with the voluntary sector (eg in promoting breastfeeding with baby bistros, in dementia cafes, in osteoporosis prevention) ramped up health visitor and midwifery and GP activity. Activity in Primary Care has increased. Is an increase in complaints of 4.4% in keeping with an increase in activity of 4.4% and therefore of no real interest? Is it less than the increased activity, therefore the proportion of patients complaining is actually going down?

Sadly I do not know, since it was reported without such refined deliberation. Ho hum.

In parts of my service, activity has increased by over 400%, another team is overperforming at 200%, but despite activity increasing strikingly over the last financial year the number of complaints haven't quadrupled/doubled. If our activity goes up by 400% but our rate of complaints in Secondary Care went up by 13.4% in those teams, it'd suggest a profound reduction in total proportion of patients experiencing poor satisfaction and complaining.

The data doesn't really tell me much. It piqued my curiosity, though. Although this year, as fortunately is typically the case, I've had written compliments and no complaints, I pulled all the formal complaints for our directorate that were investigated and our Chief Exec responded to, over the last few years. Interestingly, across the Trust, the majority of complaints are upheld, fully or partially, with the patients' being found to have valid cause for complaint in at least one aspect of their complaint.

In older adults' services, almost no complaints were upheld.

Not only do we have few complaints, but those who do complain have investigation and, unlike other services (so it's not an organisational bias) aren't found to be at fault.

It was noted that written opinion in clinics and visits were frequently sought, with a high rate of return. In-patients are surveyed on discharge too, so there's systematic attempts to solicit patients' opinion.

Locally we've therefore lots more patient feedback, lots more clinical activity, yet few complaints. I wonder if that's in keeping with the national picture. Are the numbers crude data, without the context of activity levels and service redesign and expansion into riskier areas, really showing more complaints? Or is it, as may well be the case, as we're finding locally, that the rate of complaints is actually going down?

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