Search tips
Search criteria 


Logo of bmjThis ArticleThe BMJ
BMJ. 2007 October 13; 335(7623): 738.
PMCID: PMC2018804

Many trusts fail to monitor whether complaints have any effect, says watchdog

NHS trusts in England are failing to act on and learn from the complaints they get, says the national healthcare watchdog.

Results from the Healthcare Commission's first ever audit of complaint handling in the NHS show that the way in which complaints are followed up varies greatly.

The commission identified the 10% of trusts that were most at risk of not meeting the core standard set down by the government on handling complaints. These 32 trusts, together with 10 others selected because they handled complaints well, were inspected by the commission in February and March this year.

The core standard requires trusts to make complaints procedures accessible, to act on concerns and make changes where appropriate, and to ensure that complainants are not discriminated against.

The inspectors found that only two of the 32 poorly performing trusts had adequate arrangements in place across all standards, 12 had areas for improvement, six were at risk of not complying with the core standard, and 12 had a significant lapse that could affect their rating in the commission's annual health checks.

The commission could have issued a total of 96 notifications to the 32 poor performing trusts: one for each of the three standards. However, overall the commission issued 25 notifications to 18 trusts. Most of these (14) related to discrimination against complainants.

The main concern was that no system was in place to monitor whether complaining had had a detrimental effect on patients' subsequent care.

The report says, “Processes can be fragmented and applied inconsistently within trusts and across the NHS. While the basic elements of a complaints handling system were evident, the emphasis remains on the process rather than focusing on the outcome. It is the outcome that counts for patients.

“Complaints are an excellent source of information about customers' experiences and should therefore be an integral component of an organisation's performance management system.”

The NHS receives 140 000 complaints a year, 8000 of which are referred to the commission because patients are dissatisfied with how they have been handled locally. The commission sends a third of these back to trusts for further

figure news1310f2

The commission recommends that trusts do more to make complaints systems more accessible, especially to people with special needs and from ethnic minorities. It also says that staff need to be told about trusts' commitment to complaints and that those working directly with patients need training in handling complaints.

Anna Walker, the commission's chief executive, said, “When someone does complain, trusts need to respond well. Patients want complaints resolved quickly and locally. Trusts need to show they can respond to the individual's concern and learn as an organisation. If they do not, it could seriously damage people's faith in the NHS.”

Peter Walsh, chief executive of Action against Medical Accidents, a charity that campaigns for safety and justice for patients, warned that the government's proposal to remove the independent review function from the Healthcare Commission, as laid out in the consultation document Making Experiences Count, “could leave many complainants with nowhere to go.”

Mr Walsh said, “The ombudsman [who would take over this role from the Healthcare Commission] must be given significantly more resources to deal with complaints than she currently has, and the transition must be carefully managed.

“Access to independent review should be safeguarded until there is evidence that the promised improvements to local resolution are having the desired effect.”


Is Anyone Listening? A Report on Complaints Handling in the NHS is available at

Articles from The BMJ are provided here courtesy of BMJ Publishing Group