Thinking differently about complaints in the NHS

Editor – Dr Haxby sets out a refreshing call for managing complaints in the NHS more positively (Haxby E, FHJ October 2014 pp 103–7), citing the Francis report.¹

Though complaints may be an opportunity to bring patients and healthcare organisations (HCOs) closer together, they are often delegated to middle managers who are expected to synthesise replies from several consultants (who may not fully trust the complaints process) into a single Frankenstein letter linked with bureaucratic language. The language of such responses as well as the delay can further alienate patients or their relatives.

Trusts seem unlikely to move away from what they perceive as the safest medico-legal stance, but complainants could be engaged constructively by a senior medical professional acting as their advocate in parallel with the bureaucracy. Such a person could open a dialogue in the language (and medium) of the complainant, while assessing and investigating complaints on their behalf without admitting liability, pending and hopefully invigorating the eventual bureaucratic response. Such a dialogue would allow candour about the finite resources available in the NHS. If the advocate were sufficiently senior, perhaps someone either side of retirement, they could engage consultants and other health professionals effectively, driving improvement within the Trust. (One could even imagine a ‘chamber’ for different local HCOs.)

The drawback to any paradigm shift required to meet the requirements of the Francis Report would be the cost in the short term.

• © 2015 Royal College of Physicians