It gets a little dispiriting if you work with complaints and complainants to see the same old messages emerge in survey after survey as the years go by. If I was a complainant, I would be tempted to be very rude to the next person who wanted me to complete a survey about the experience I had with my complaint. The questionnaires or the questioner have a little spiel along the lines of “your experiences will help us greatly in improving the way we handle complaints”. Really? There seems to be little sign of that.
The National Audit Office has taken a look at complaint handling in both health and social care services in anticipation of the creation of a single complaints system in 2009. Our friends at the Customer Care Alliance and Surveylab have just published their annual look at the complainant experience across a variety of markets and providers based on a survey done during July, August and September 2008. 10,102 responses were received from a random sample of UK consumers and some 230 of them had their most serious problem with health care services.
The findings from the two surveys cannot be compared directly but some interesting common themes emerged – the same reason came top in the list of reasons why many did not bother to complain. Namely, the perception was that nothing would change as a result of voicing that complaint. The NAO survey which focussed exclusively on health and social care services asked more detailed questions about both the informal and formal processes. Young people were especially likely to drop the matter at the mention of a formal process. The people who persisted – this came through with the health care problems – were those who were looking after or complaining on behalf of someone else and there is an interesting suggestion with the social care data that readiness to voice dissatisfaction was linked to whether or not part at least of the service had been paid for. Class and age played their usual part in readiness to voice with ABC1s and 35-54 year olds the more likely to take the problem up.
Social care service problems are most often triggered by a social worker or home help and this personal flavour to the problem explains why people with a problem with for example the bad standard of treatment, worried about the effect of making a complaint, not wanting to damage a continuing relationship with the service provider.
What did complainants want? The CCA survey asked directly whether revenge would be nice. 7% of men said yes to that compared to only 1% of women. That same survey confirmed that what people wanted overwhelmingly was an apology (46%), an explanation (57%), and an assurance that the problem would not be repeated (40%). One of the most telling pieces of data in this study (the NAO did not ask the question) was that 54% of the people who were dissatisfied, shared that experience with friends/ colleagues.
Ministers despair that people do not believe what they are told about the health service. As we have said before, we listen to and more importantly believe our friends more when it comes to service experience. Service reputation lags well behind the public announcements – the speeches, the ads – because private user information (the wisdom of the crowd) discounts these official messages in favour of their word of mouth sources.
We will await the lessons from the early adopters programme for the new combined health and social care complaint handling arrangements and how well local providers put in place their own arrangements within the Making Experiences Count framework. The main pitfall to avoid when building new organisations is to push complaint handling to the back of the process building queue. This overlooks the fact that good complaint handling is an vital resource for users who have been dissatisfied by some aspect of the fledgling organisation’s service delivery. Bad first impression plus bad problem resolution equals poor reputation straight after launch – revisit our thoughts on who gets believed.
In the meantime, service process designers and commissioners need to look out for the user who is ABC1, 35-54 years old, responsible for someone else’s care. Lives in London and the South East and has lots of friends. Your reputation rests in their hands. Sort them out quickly with an apology and an explanation and just as most of those users do not want revenge, avoid giving any impression that vulnerable users still in the system will suffer for being cheeky and complaining. Worth perhaps repeating that stunning bit of data from the UK Customer Care study showing the rewards of good complaint handling that satisfies your users.