Promoting a learning and improvement culture
A learning and improvement culture is vital for addressing and learning from feedback and complaints. An effective system – led from the top - demonstrates its commitment to promoting a learning culture that values complaints and feedback. When done well, every member of staff knows their role in promoting a ‘learning from complaints’ culture.
Despite the recognition over many years that a learning culture is vital, our review has found that there remains a defensive culture around the handling of complaints in some public service organisations which must be addressed.
Effective and inclusive leadership is key to developing and maintaining a positive culture for complaints. If leaders are not visibly committed to engaging with feedback and complaints, no learning culture can survive or thrive. This can lead to repeated mistakes and avoidable harm to future service users.
Complaints teams told us that they lack status in their organisations. We also heard that complaints teams are not always regarded with sufficient respect, authority or ‘gravitas’ from their colleagues compared to other teams and functions. As a result, they are in a weaker position to ensure that colleagues engage with complaints and provide robust and meaningful responses on behalf of the organisation. Advocacy organisations also shared their concern that complaints staff do not often appear able to challenge clinicians.
As well as supporting and investing in staff who handle complaints, it is essential that organisations provide support to staff who are complained about. Research in this area highlights the clear need for staff to be treated with the same empathy and sensitivity as complainants. This includes greater transparency and engagement in any investigation that concerns them. Our draft Complaint Standards Framework reflects established guidance for how organisations can better support their employees in this area.
NHS organisations will benefit from doing more to proactively capture and learn from complaints. This will help them monitor services and spot emerging trends that could affect the quality of care. These learnings should then be reported publicly and shared with other organisations.
The Complaint Standards Framework we have developed for the NHS sets out clear expectations as to how organisations can demonstrate a learning culture, report on learning from complaints, and share best practice with others. It places a strong emphasis on leadership, with the clear expectation that senior staff must demonstrate commitment to capturing and acting upon all learning.
This will be developed further through the creation of detailed guidance, as well as creating a standardised method of reporting on learning from complaints that can be used nationally. We will develop it further for the parliamentary bodies in our jurisdiction.
Particularly in the context of the COVID-19 crisis, learning from the response of public service organisations will be crucial to understanding how they can be strengthened in future.