/ Health, Parenting

Make your complaint count in public services

Make complaints count illustration

I asked if you’d ever complained about the service you’ve received from a healthcare professional. Your feedback and our research has prompted us to take action and we want to make your complaints count.

Many thanks to those who took the time to share their experiences of both good and bad practice in the healthcare sector. Take Beryl for example; she took action by complaining about an issue at her local GP. She told us:

‘I have nothing but praise for the reaction received from my Medical Practice. As a result of my letter of complaint I have received sincere apologies by phone by the Practice Manager, followed by very swift and prompt action by a member of the medical team which secured all the necessary treatment without delay.’

Beryl said that the timing of our discussions provided her with the impetus to write a letter of complaint which produced the necessary results.

Cause for complaint

But Beryl’s example isn’t always the case across the range of public services available to us. Our latest research reveals that a third of those who have experienced a problem with a public service didn’t complain. And often the reason for not doing so is because people don’t know who to complain to, or think it’s not worth the effort.

And even those who do complain aren’t always happy with the response. Four in 10 weren’t satisfied with the outcome of their complaint and half felt like their complaint was ignored.

While the Government has announced new measures to strengthen patient feedback in the NHS, we think there is still work to be done across all of the public services – from hospitals and GPs, childcare nurseries and care homes, and schools and universities.

Patient and parent champions

We want the Government to pledge to be the champion of patients, parents and all users of public services. We want you to have a role in triggering inspections by regulators by sharing your complaints and feedback. And with a unified public services ombudsman, you could have a simple single escalation point if your complaint is not resolved satisfactorily. Finally, Which? and other representative groups must be given the power to make super complaints in public services, just as we do in the private markets.

But we can’t do this without your help. We need your signatures and experiences of the public services sector to continue our work. Your experiences will help shape the direction of our campaign and prompt research into areas within the public sector which need more attention from politicians.

Public services are vital to everyone and if something goes wrong it’s crucial that people feel it’s worth speaking up to help stop the same thing happening again. Barriers to giving feedback must be removed if public services are to deliver the high standards that we all expect.

Allan says:
16 March 2014

I thought it might be interesting to comment from “the other side”. I am a retired hospital consultant and I acted for several years as a clinical director – that is an administrative chief in a medical department. It meant that I saw all the complaints about all medical staff, not just about me. Can I begin by saying that there are of course completely straightforward complaints, some of which are about events which are inexcusable like “I came for an appointment on Wednesday and was told the letter was wrong and I should have come on Thursday.”. Obvious, no excuse. Apology given. Others are less clear, such as “I had to wait over an hour to see the doctor”. Perhaps understandable if the doctor was unavoidably called to a major RTA in A&E. However all too frequent are extremely nasty complaints, which embellish perhaps justified grumbles with references to alleged defects of honesty and descend to racist and other abuse.
To illustrate I will briefly describe an incident in my personal past. A man came under my care with an infected heart valve. This was quickly diagnosed and appropriate treatment given. I discussed the case with a cardiac surgery centre who agreed the management plan. Arrangements were made for review of the case in the centre in a couple of days. Unfortunately the evening before transfer he abruptly deteriorated and could not be resuscitated. The family complained. Their complaint contained a littany of falsehoods and frankly unpleasant comments, including that I was English (I was working in Scotland). I was visited by the Chief Administrative Medical Officer for my region in Scotland, who told me “You are potentially in a lot of trouble, as someone in this case is clearly lying”. Fortunately I had kept meticulous records and the notes in the centre were crystal clear as well. I had done nothing wrong. The family were eventually told in a very bland way that there was “insufficient evidence to back their complaint”. No reference to the fact that they had lied and libelled. Without the meticulous record keeping I might have lost my job and career. It’s a disgrace that the public have no responsibility along with their rights.

It’s always helpful to hear an account from the other side and I am certain that the majority of medical staff do an amazing job under very difficult circumstances but occasionally things can go wrong with dire consequences. As a consultant I am sure you are also aware of the whole gamut of emotions relatives experience when suffering the loss of a loved one, ranging from complete denial to distress and anger, not to mention sometimes the need to apportion blame which I’m sure can make things very difficult for medical staff.

In my recent case [already posted] I failed to even get to see a GP. The fault clearly lay with the receptionist who failed to recognise the urgency of the case and the practice manager for failing to address the longstanding parking problem at the practice. As a result of my letter of complaint I received sincere ‘phone apologies with a follow up letter and an immediate emergency same day appointment with a consultant at my local hospital where I received the appropriate preventative treatment. The GP at the practice when made aware of the situation went to a lot of trouble to make sure I received the necessary treatment quickly and without delay.

I recall one occasion when I suffered a fractured fibia. The doctor who initially treated me was very pleasant and compassionate but on returning 6 weeks later I met with a most disagreeable individual who seemed unable or unwilling to carry out the necessary follow up treatment. I ended up advising HIM what I felt was appropriate in the circumstances which amazingly he agreed to! I regret now that I didn’t report him at the time. [I wasn’t a member of Which? then!]

The simple fact remains it does little to bring about changes and improvement if people fail to make their grievances felt.

NHS Professional says:
17 March 2014

I am so incensed by this petition, I am cancelling my membership of 24 years.
I am very disappointed that Which? has joined the NHS smear campaign being run in this country; a back door way of privatisation of the NHS.
Most people today cannot remember what it was like without an NHS, and you know what they say, you don’t know what you have until it is gone.

I think what I find most shocking is that despite all the adverse publicity and the findings in the Francis Report some NHS Trusts are still behaving in a shocking & inhumane manner. I have been complaining about a vulnerable neighbour’s “care” for 4 years and counting now – letters/emails/ telephone calls & meetings. Eventually we got to the stage of a Local Resolution Meeting in February 2014 and 3 of us (me, an advocate from SEAP and a friend of mine) travelled 35 miles to meet with senior personnel from the Trust. On arrival the meeting was effectively shut down by the Chairwoman before it began on very spurious grounds.
All the correspondence I have received from this Trust is littered with inaccuracies, blatant misrepresentations of what I’ve asked/said and/or omissions. The whole experience has made me ill and cost me a fortune in both personal and financial terms and despite the fact they are a MHS the only positive suggestion they have made to me is that I “should take a step back”. I have asked them repeatedly how I am supposed to “take a step back” when they fail/refuse to intervene in a crisis, but they haven’t answered this point.
All the other services now involved in my neighbours care (police, ambulance service, GP’s etc.) believe that my neighbour would be dead had I not become involved, but the NHS repeatedly tries to make me feel as though it’s my fault for being involved. Meanwhile, whilst they procrastinate, my neighbour has remained very vulnerable, at very high risk and her already fragile personal relationships have been fractured immeasurably. On top of this she has been arrested on more than one occasion (and has had a taser pulled on her), Sectioned, allowed to leave hospital in the middle of the night to walk 20 miles home in her nightclothes (based on the fact that she was deemed to have the “capacity to decide”), had her personalised Case Presentation uploaded onto the internet and a member of her Crisis Team told the Police she was “attention seeking” minutes after the police had just cut her down from a rope. She has had 26 ambulance call outs in a 3 year period as opposed to 6 in the preceding 3 years when she had a Care Plan that worked for her and as a result of the frequent high risk suicide attempts she has made and her general inability to cope with life on a day to day basis now, her physical health has also diminished.

The Care Plan that she had before and that worked so well for her fundamentally cost the Trust one week’s respite care every 6-8 weeks in an Acute Care Hospital! If they did a cost comparison there can be no justification for the “care” she has received over the last 4 years on financial grounds alone, let alone the human costs. The irony is that she has had an increase in non-scheduled respite admissions to the same Acute Care Hospital for longer spells solely due to the fact she has been allowed (through non-intervention) to make repeated very high risk suicide attempts and has ended up needing far more intensive care.
Over the last few months the Trust have begun to intervene in a slightly more timely manner, however she still needs a high level of support from me because her life is far more chaotic than previously and because the lack of an holistic approach to her care has resulted in her having even less to live for.
Sadly for her what I have described above is just the tip of a very large iceberg and it is still ongoing. I know she isn’t the only person in this situation and I also know that changes are being made in MHS (and in Crisis Care particularly), but they can’t come soon enough. In the interim we must find a way of safeguarding people like her when they are most at risk and it has to be an organisation (other than the police and ambulance service) who can intervene 24/7 and who can address/remedy the problem at source. At the moment there doesn’t appear to be anyone to turn to when someone’s life is at great risk, because it seems to be outside the remit of the organisations that these Foundation Trusts report to in order to gain compliance. Frighteningly this fundamentally makes these Trusts self-regulating!
Whilst I am aware that I can take the case to the Parliamentary Ombudsman I can only do this after I have exhausted the process at local level, which is not as easy as it sounds when you are dealing with a Trust that either won’t answer your complaint or that persists in misrepresenting what you say. To cite a prime example of what I have been up against I asked this question at the Local Resolution Meeting I attended in February:-
Do you think it’s acceptable to send someone home to an empty house in the middle of the night hours after she was 30 seconds away from successfully hanging herself, where the noose would still be hanging from the skylight had I not asked the police to take it down?
This was translated back to me by the Professor who chaired the meeting as:-
You asked whether (her) care plan could include the need for someone to sit with her after discharge from hospital.
So whilst this culture still persists within the NHS it is impossible to believe that any improvements will be made at all and it is increasingly difficult to persuade my neighbour that her life counts for something. Over the last 4 years she has come to believe that it will be better if she kills herself, because as she puts it, “if I die it will be cheaper for them and they can concentrate on people with real problems”. She never said that once in the 3 years I knew her when she had a Care Plan that worked. In response I have to lie to her and defend the very Trust that is making her feel like that in first place.
On the upside the police and ambulance service have been fantastic throughout. And for anyone who is experiencing difficulties in getting answers find an Advocacy Service asap because the one I am now using (SEAP) are excellent too.

I have just written to several bodies about my total frustration (and fear) at the way the NHS and GP services are going.
Since the 1950s I have been under the care of what was a fantastic NHS both specialist hospital teams and GP practices.
I have a very long and complicated history made up mostly by side affects from very strong prescribed drugs. I suffered total hearing loss, loss of balance and Tinnitus along with arthritis and skin cancers in my early twenties. The good part was the kidney transplant!
Over the years from a very young child I saw the NHS change in front of my eyes. As a child staff in hospitals couldn’t do enough for you. Even the very strict matrons and sisters – a latter one of whom practically adopted me when I was in hospital for 6 months, when I was seven years old.
Then came the changes to how wards were run and GP practices. Nobody talks to us anymore and there is a distinct attitude problem which has absolutely nothing to do with money.
Specialist teams are no longer allowed to refer patients to a relevant team. You have to go to your GP. The latter then gives you 10 minutes but knows nothing about you because they haven’t read the notes or asked you. You see a different one every time. They quite frequently tell you they don’t have time.
In April I requested a referral to a different area of the health service on the advice of the specialist team. So the locum GP wrote a letter to the original specialist team! When I had not heard any further a couple of weeks ago, I asked the specialist team member if they had received a letter about it from the GP. They said they had not.
I had an appointment to see a GP around the same time. The type of appointment where you phone at 8 in the morning and keep redialling until you get through. This was for a different problem yet still related. But you are only allowed one problem per appointment. But I asked if there was any evidence a letter had been sent. The Dr said there was but didn’t have time to talk about it and to wait until the appointment this week.
When I arrived this week, the Dr had both the letter that had been sent in April to my specialist team and the reply. Yet no one had made a referral or let me know.
Then the Dr went on to ask my why I wanted the referral (it was for a Cochlea implant). As I have been totally deaf for over 40 years I thought this was weird. So I had to explain it all. He then asked if I wanted to try hearing aid. When you have no hearing there is nothing to ‘aid’, I explained again. Again confirmed in 1974.
He examined my ears – wonder if he thought I had 40 years worth of wax in there???
However, coming to the referral Dr tells me he needs to refer me to ENT first then they will refer me to the cochlear implant team if they deem it necessary. Back full circle since April. How long this will now take I wonder I shall still be alive!
No time to discuss a previous referral problem that had come unstuck. All the time the Dr is writing everything, rather than make the effort to speak.
So we have rules changed about referrals at hospitals, GPs who don’t have time and say so. The attitude of staff on wards is incredibly unkind sometimes. I was in for a knee replacement and the whole team treated me as if I was making it all up as I go along. Asked to speak clearly they say “I am” How would they know? You have to see something to lip read it. black looks even when on the way to theatre and being roughly pulled about doing post ops etc. On the the 4th day I saw a new sister so I asked to go home and she got me signed off and discharged that day. She was setting up an investigation and said she would meet me at my next appointment. I received a letter in reply to my complaint telling me ‘all the staff have been advised to speak clearly and face a deaf patient’!! So another circle of nothing. The sister nor her apparent representative showed up at the appointment. That is just one event. I am not the patient from hell, but I do like to know what is going on around me and in that case the attitude went through day and night staff. I honestly think they believed I was making the deafness up. Probably due to my speech. Why would you make up something like that? Obviously there had been no checking on my historical notes, which do have an effect on the treatment you are having.
So, my feelings are very fragile on the NHS as there does not appear to be any real care left.