A MATTER OF PERSPECTIVE

The almost defunct Healthcare Commission has issued one of its last documents, this one is entitled:

“Report highlights that patients remain concerned about how trusts deal with their complaints, as well as the same basic aspects of healthcare” ” Healthcare Commission
And contains the usual stats:

The way trusts handle complaints is still the number one issue raised by complainants, accounting for 19% of cases reviewed, up from 16% last year.

In almost half of complaints reviewed, the Commission either upheld the complaint or sent it back to the trust for further work because the trust's initial response to the complainant was not good enough.

Patients and the public also continue to raise issues about the same basic aspects of healthcare such as: poor communication (12% of cases, down from 17% in 2006/07), standard of treatment (11% up from 6% in 2006/07), delay or failure to diagnosis a condition (9%), and delays in accessing care (8% up from 4% in 2006/07).

The Commission upheld 30% of the cases reviewed in this period, up from almost 20% last year. In a further 17% of cases (down from 26% in 2006/07), the Commission found the trust's response to the complainant was not sufficient and it was sent back to the trust for further work. This means almost half of complaints reviewed required further work by the trust.

Twenty-seven percent were out of the Commission's jurisdiction, mostly because the complainant had not raised their concerns locally first. This is up from 24% last year, suggesting that some trusts are not making the complaints procedure clear enough for patients and the public or that people do not have faith in the independence of the local procedure.

Eighteen percent of cases were found in favour of the trust as it was found that the NHS had handled them appropriately. Most of the remaining cases were either withdrawn by the complainant or referred on to the Parliamentary and Health Service Ombudsman.

The report shows there were an equal number of complaints reviewed by the Commission about both primary and hospital care (both 43%). The remainder were about mental health trusts (10%), strategic health authorities (1%), ambulance trusts (0.9%), prisons (0.8%) and other trusts (2%).

Yawn, yawn.

Here is the Analysis of the complaints reviewed by the Commission which reveals the following themes:

Hospitals (43% of total)The majority of complaints about hospitals were concerning nursing care. Of these, 43.5% were about general care, highlighting issues such as nutrition, falls and observation of patients.

GP practices (11% of total)Complaints about GPs were the most common type of complaint about the primary care sector. Twenty-five percent of complaints about GPs were in relation to a delay or failure to diagnose a condition or illness.

Dental surgeries (4% of total)The majority of complaints about dental services related to treatment (36%). This included issues such as delays in accessing services and incorrect or unsuccessful treatment.

Accident and emergency care (3% of total)The main issues complained about were related to treatment (24%). There were concerns about ambulance response times and incorrect treatment.

Maternity services (2% of total)Thirty-one percent of complaints about maternity services were about treatment. These include complainants' concerns about the standard and timeliness of treatment they received.

Mental health services (5% of total)The main concerns were in relation to general care (47%), such as the appropriateness of treatment, care review meetings and the use of control and restraint.

Learning disabilities (0.3% of total)These were not primarily complaints made about learning disability services, but healthcare services for those with learning disabilities. Recommendations to the trust were made in over half of cases.

No stats on Hospital doctors I see.

This is where the different perspectives come in:- Anna Walker, the Commission's Chief Executive, said: "Considering that millions of treatments are delivered by the NHS each year it is perhaps encouraging that we only receive around 8,000 complaints a year. However, it is concerning that around half of complainants received an inadequate response from the trust when they first complained and we required further work to be done on the complaint.

“Each year the NHS delivers 380 million treatments and receives around 135,000 complaints.”

The Commission reviews cases where the patient is unhappy with the response from the trust. The report, the third of its kind, covers the 8,949 complaints reviewed in the year to 31 July 2008.”

The healthcre Commission’s perspective is that 135,000 complaints, 8949 which were not resolved at local level by the Health Trusts is “encouraging”.

My perspective is that 135,000 complaints is a damning indictment of the NHS management, this is not about percentages, if we were talking about cars, and only 135,000 out of 380 million were defective then OK.

But we Are talking about 135,000 people that were unhappy with their own or their loved ones’ treatment, that is the population of South Cambridgeshire or more than the population of Colchester, which is “enouraging” to the Healthcare Commission.


I accept that we are all human (well most of us anyway), and that mistakes happen, and we have the right to complain, which we did 135,000 times to July 2008, what I don’t think acceptable is the scrotum twisting way the firkin NHS managers deal with our righteous complaints.

These complaints all 8,949 of them were bollocksed up by the management, by ineptitiude, lack of care and worst of all not listening.

Somewhere out there in NHS neverland there are thousands of piss poor top Knobs causing people stress and anguish because they can’t get their act together to resolve complaints made by people who have been hurt, emotionally and physically by their lack of care.

And what happens to these so called “managers” ?

Bugger all, once the initial comnplaint is received and acknowlegded they are allowed to take as long as they like to deal with these 8,949 cases, yes there are guidelines on how long to take in replying, and the supposedly full and complete reply, but they are treated as a license to delay, deny and dither about with the minutia of the complaint rather than the core problems.

The healthcare Commission send back the complaint to the Trust, sometimes they uphold the complaint, sometimes they do nothing, but have you ever heard of any action taken against the people responsible, the CEOs, the Medical Directors, or the boards of these trusts being sacked or fined?

No, because the HcC is only interested in stats and “learning”, we all want the NHS to learn from mistakes, but they don’t seem to, the same old complaints keep coming up, year after year, the Trusts give the same old answers, the complaints move to the HcC and they do the same old thing-send it back to the Trust who………..ad infinitum.

The CEOs of trusts are like a rat up a drainpipe when it comes to blaming “system failures” to excuse their poor treatment, and that is the problem: the system, the complaints procedure to be exact, we hear about the “new” system for complaints, with the demise of the Healthcare Commission the complaint will be dealt with by the Trust first, then if you are not happy it will go to the Health Ombudsman, who will either uphold the complaint or refer it back to the Trust.

So where have we gained?

It may be marginally faster to bounce the complaint back but it will still be in the hands if the CEOs, what is the outcome of the Ombudsman upholding a complaint? Will there be any punitive action taken against those Really responsible? Of course there won’t.

The real problem of the complaints procedure still hasn’t been addressed, the Hospital CEO and complaints dept, until the complaints procedure is taken away from “in house” and a truly independent body is given the powers to investigate, put forward solutions and take action against the management, the lack of justice for complainants will continue.

“The habit of analysis, the ability to get under the surface of things and at the vital essentials, gives a man a tremendous advantage.” Anon


Angus

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