Supporting information on the Complaint Standards Framework for the NHS

Stage 2 - Detailed look into the issues: Key points

18. When a quick resolution is not possible or suitable, or if the individual remains dissatisfied, NHS organisations should ensure that a member of staff trained in complaints handling carries out a detailed look into the issues raised.  This will always involve taking a detailed and fair review of the issues in hand to determine what happened and what should have happened.

19. Complaints staff should be trained in advanced dispute resolution skills to empower them to seek a mediated resolution to the concern or complaint at any time during the detailed look at the issues.  

20. NHS organisations should ensure complaints staff carrying out a detailed look are properly trained to do so, have the appropriate level of authority and autonomy to carry out an impartial review of the matter.  NHS organisations should ensure such staff have the right resources, support and protected time in place to carry out this work in accordance with the complexity of each case.

21. The staff member carrying out the detailed look should always make sure they engage with the person raising the concern or complaint to ensure they fully understand the key issues and what outcomes they seek before they carry out their detailed look.  Complaints staff should ensure that they have signposted the person to support and advice services, including independent advocacy services, at an early stage.

22. NHS Organisations should ensure that any staff members subject to a complaint are made aware at the earliest opportunity.  Staff subject to a complaint should be given an opportunity to comment on the events complained about and see how their comments are used in any response to the complaint.  Staff complained about should be given advice on how they can access support within their organisation, as well as external representation. 

23. Depending on the complexity of the complaint and what is required to carry out a thorough review, complaints staff should discuss with the person a suitable timeframe for how long it will take and keep the person (and any staff subject to the complaint) regularly informed and engaged throughout. If these timescales cannot be met complaints staff should ensure this is communicated to the person, and any other parties involved, at the earliest opportunity. 

24. Complaints staff should always explain how they intend to carry out the detailed look into the complaint and make clear upfront who will be responsible for the final decision and how the response will be communicated.

25. Complaints staff should be trained in investigative techniques and evidence gathering and must be able to give a clear, balanced explanation of what happened and what should have happened with reference to relevant standards, policies and guidance to clearly identify if something has gone wrong.

26. Staff should always be open and honest when things have gone wrong.   NHS organisations should empower and train their staff to identify suitable ways to put things right for people when mistakes have occurred, which can include providing apologies, service improvements and/or compensation. Staff should ensure the apologies and explanations they give are meaningful, sincere, and openly reflect what impact the mistake has had on the individual. 

27. NHS organisations should also make sure all staff identify what learning can be taken from feedback and complaints, regardless of whether mistakes are found or not. 

28. Senior staff in every NHS organisation should take an active interest and involvement in feedback and complaints and what insight and learning can be taken to improve their services for other users.

29. NHS organisations should maintain a record of all complaints outcomes and action taken in response to complaints. They should monitor complaints over time, looking for trends and areas of risk that may be addressed.

30. NHS organisations should report publicly on their complaint handling performance. This should include reporting how complaints have led to a change in services, policies or procedures.

31. NHS organisations should ensure any complaint that involves other organisation(s) (including cases that cover health & social care issues) are investigated in collaboration and co-ordination with those organisations.  These organisations should agree who will be the ‘lead organisation’ and who will be responsible for overseeing and coordinating the look into what happened.  The lead organisation will be responsible for ensuring the individual receives a single, joint response.