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Making Complaints Count: Supporting complaints handling in the NHS and UK Government Departments (Executive Summary)

Issues for Parliament to consider

The progress we have achieved to date is substantial, but more needs to be done. Coronavirus has radically transformed public life and will give rise to far-reaching changes to how public services can and will be delivered and accessed. This should not be ignored. There is a need to ensure we do not lose the momentum to develop a more effective, more open public sector complaints system.

The Public Administration and Constitutional Affairs Select Committee may wish to consider the following issues as part of any inquiry it launches in response to this report.

Reform of existing legislation on complaints handling in the NHS

The Department for Health & Social Care should review the 2009 NHS Complaint Regulations with a view to amending them to better reflect modern best practice in complaints handling. These regulations are outdated and lack detail on what is required from NHS organisations when handling complaints, which have contributed to the variability in approach evidenced in this report.

The development of the Complaint Standards Framework provides an opportunity for any reform of the 2009 Regulations on several key expectations, particularly ensuring that every NHS organisation reports in a standardised way that places focus on what learning they have identified from handling complaints.

Similarly, the Regulations must outline requirements for NHS organisations to signpost complainants, particularly the most vulnerable, to the support that is available to them locally if they want to make a complaint.

We ask Parliament to explore this proposal further. This should cover the role of the regulations if or when the Ombuds service is granted statutory Complaints Standards Authority powers, as well as how a system of reporting on the Standards works in practice in the interim.

Strengthening oversight on complaints handling and learning from complaints

There is currently no single organisation that has overall responsibility for developing complaints standards in England and overseeing how these are embedded. Instead, such responsibility is spread across a wide circle of organisations, causing overlap and confusion.

We agree with Healthwatch England’s conclusions in their recent report “Shifting the Mindset” that there needs to be a single organisation empowered in law to act as a national complaints standards authority, responsible for not only setting the standards expected, but also for overseeing how organisations within its jurisdiction perform against these standards.

Devolved nations across the UK have addressed this point by empowering their national Public Services Ombuds offices with complaint standards authority powers. This core element remains missing from the complaints landscape in England and at the UK level, which means citizens making complaints at these levels are at a disadvantage compared to those elsewhere.

Both PACAC and PHSO have repeatedly called for the UK Government to facilitate a Joint Committee to conduct pre-legislative scrutiny of the Public Service Ombudsman Bill. This would have been the natural place for Parliament to consider whether PHSO should be given statutory responsibility to become a Complaint Standards Authority.

In the absence of this scrutiny taking place, an inquiry into this report would be a natural time for PACAC to explore the merits of how we can best catch up with the rest of the UK in this area.

While more fundamental reform may take more time to deliver, we would welcome PACAC’s views on whether now is the right time for PHSO to be granted statutory complaint standards powers through any other relevant legislative vehicle into which it could be incorporated. To achieve this, a sector by sector approach may be necessary, most likely starting with the NHS.