Maximising the learning from complaints: What can we learn from the Surrey Independent Health Complaints Advocacy (IHCA) Service?

Healthwatch Surrey felt a deep dive into Surrey’s Independent Health Complaints Advocacy (IHCA) cases could contribute some fresh insight in the drive to share best practice relating to complaints. Surrey Heartlands Integrated Care System (ICS) are developing a new Network of Complaints and Patient Experience Leads to develop best practice, and we hope that our reflections may inspire further collaborative working.

Key findings:

Not all NHS provider websites offer a link to complaints processes. Healthwatch have not checked every provider website but have noted in particular that GP Practice websites are inconsistent and some have no link to their complaints processes. There is also often confusion between “feedback” and “complaints”.

While many provider complaints website pages signpost IHCA under “If you need help making a complaint”, it is often very low down on the page, and less likely to be found by those daunted by processes and complex text.

What people mostly want from their complaint is:

• Acknowledgement: for the provider to respond with care and sympathy;
• Reassurance that it will not happen again to other people – that lessons have been learned or changes made.

The main reasons people don’t complain are:

• It’s too difficult
• They don’t believe it will result in improvements or change
• They are concerned about repercussions for their future care.

There is a disconnect between what people want their complaint to achieve, and what providers measure and report. Providers sometimes report outcomes but these tend to be individualised, not measured or tracked. Measurement focusses on:

• Whether a complaint is upheld or not
• How quickly a complaint is managed and resolved
• Broad/generic categories of complaint.

The complaint areas Healthwatch Surrey’s Advocates manage most often are:

• Quality of care; access to care
• Patient-provider partnership and teamwork; staff attitude
• Administration, paperwork and referrals
• Complex mental health cases.

The report contains three recommendations about improving complaints handling processes.