Complaints Up – Good or Bad News?

Complaints up! Shock horror! I can imagine what tomorrow’s press will make of the NHS Information Centre report on English written complaints showing a 13.4% year on year rise, breaking through the 100,000 barrier. The accompanying comments from Tim Straughan the chief executive try to put this in context by offering some evidence of increased NHS activity in England e.g. GP consultations up by 44% between 1998 and 2008.

Does More Really Mean Worse?

That may help but I doubt it. More in the eyes of most people means worse when it comes to complaints. But this is to ignore the most important aspect of complaint statistics – especially those dealing with written complaints. The statistics reflect the process where written complaints remain a big part of the business. They also give a clue about such things as the emotional impetus of  the user decision to persist and sit down and write and of course the age of the complainant – oldies write more. The numbers tell us little about whether or not the complaint system is doing its job of improving patient satisfaction and raising the standards of service.

It’s the Process, dummy

The clue here is the 10,020 complaints under the heading of ‘communication’ cited in Table 5.  When I see the problem heading of communication being one of the biggest numbers as always, I see a failure to understand root cause – if the process does not facilitate good communication, it is a poor process.What gets labelled  as ‘poor communication’ are the difficulties in making a process work. People try and fail to resolve problems or to explain what is going on to others.

No Satisfaction Data, No Sense

Poor communication is therefore a topic that can be addressed not through asking people to write better letters or go on courses about defusing righteous anger but by focusing on the achievement of outcomes that satisfy and improve. Equally the MAC rule and recommendation is that statistics about complaint incidence must never be published without accompanying data on satisfaction and impact. We also need to have more useful ’cause’ headings than ‘All aspects of clinical treatment’ which accounted for 42,727 complaints – the highest single figure. Where do you start to improve quality? The category is so broad as to defy useful analysis.

Best outcomes – more voice, less letter – better

The best outcomes for complaint handling are more complaints better handled without the need for correspondence at all. By that we mean fewer written complaints across the board – certainly in areas like appointments delay and cancellation where timely, complete and empathic explanation on the day makes letter writing a thing of the past.

Then we can look forward to headlines like ‘Health Chiefs win satisfaction battle with more complainants satisfied than ever before. My confidence in the Health Service has been restored after they dealt with my problem so well’ says Mr MAC of London SW’ Until this happy day, stand by for the usual reaction.