Hospitals need to do more to show patients how the NHS is learning from mistakes, says Sir Robert Francis QC

  • New research finds fewer than half of NHS hospitals in England (38%) are reporting on any action taken in response to complaints raised by patients and loved ones. 
  • Analysis of publicly available documents suggests just 1 in 8 hospital trusts are compliant with statutory complaints regulations.
  • To have confidence in the NHS complaints system, people need to see how their views are making a difference. 

There has been some positive change in the years following the Mid Staffordshire Inquiry to improve openness and transparency in the NHS. Yet when it comes to complaints, many hospitals are too focused on process rather than demonstrating how they’ve listened.

A review of NHS trust complaints reporting for 2018 has revealed that just 16% of hospitals published stand-alone complaints reports which the current regulations require them to produce.

Healthwatch England’s review took other sources of reporting into account, including annual reports and quality accounts, but based on this publicly available information only 12% of trusts could be considered to be fully compliant with the regulations.

Reporting on learning from complaints was not always obvious, with reports often stating simply that changes had been made but providing no detail on what precisely or how complaints have led to improvements.

Hospitals, indeed the NHS more broadly, need to shift the mindset on complaints. Reporting needs to look beyond the numbers and response times and focus more on how to effectively demonstrate to patients and the public what has been learnt. This is the only way to give the public confidence that their concerns are being listened to and acted on.

Complaints help hospitals to quickly spot and tackle issues, but our evidence shows that people will not complain if they lack confidence that NHS services will listen. Four in five people have told Healthwatch that seeing how other people’s complaints have had an impact would encourage them to make their own voice heard. Yet recent research from the Care Quality Commission reveals that over a third of people currently believe nothing would change even if they complained.

Everyone was too busy. Nobody had the time to co-ordinate my care. I don’t want to complain formally – just to tell someone, so this does not happen to anyone else” – Patient speaking to Healthwatch Northumberland

Healthwatch is calling for national leadership to support hospitals effectively communicate how they are learning from complaints. Recommendations include empowering a single national organisation to act as a ‘complaints standards authority’, tasked with promoting good practice on learning from complaints and monitoring how well the complaints system is working to improve care for people.

Healthwatch England Chair, Sir Robert Francis QC, and former head of the Francis Inquiry into the failings in care at Mid Staffordshire NHS Foundation Trust, said:

Lots has changed about the health service since the Mid-Staffs review concluded, but there is still so much to do if the NHS is to become truly transparent.

“Complaints in particular has been an area of slow progress. The public expects the NHS to learn from mistakes and to be honest about what needs to change, but to know this is happening people also need to see the evidence.

“Hospitals and national health organisations need to demonstrate greater leadership and show how they are learning from incidents. Without this, we cannot hope for people to feel their feedback is valued and acted upon. 

“I shall be writing to every trust in the country about this report and the need for leaders to shift their focus from counting the number of complaints, to reporting on the people behind them and the actions they are taking to improve services. 

“By sharing learning locally and empowering people to speak up about the changes that they’d like to see we can improve care for everyone. This is integral to the success of our health and social care system as a whole.”

Click here to read the full report online.