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Complaints handling must improve in UK trusts
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     The UK Healthcare Commission has warned NHS trusts that they could lose out in their annual assessment if they do not improve their handling of patients?complaints. Since the commission took over the independent second stage of the complaints process last August, the number of unresolved complaints has trebled from less than 3000 a year under the old system to an estimated 9000-10 000 this year.

    A progress report from the commission抯 head of complaints says that in its first 10 months the commission received nearly 7000 requests to review complaints, of which only 2164 have so far been resolved. It hopes to clear the backlog by the autumn. More than a quarter of these complaints were sent back to NHS trusts because the investigators did not feel that enough had been done to resolve the issue at local level. Of those complaints reviewed in detail, only 8% were resolved in the complainant抯 favour and 38% in the NHS organisation抯 favour. Ten per cent were referred to the ombudsman.?

    Most complaints were about poor communication, poor clinical practice, an unsatisfactory patient experience, poor staff attitude, and poor complaints handling. Case managers also highlighted a substantial number of complaints about poor handling of bereavement and patients being removed from GP抯 lists.

    "The NHS has got to get better at handling complaints, which are an important tool for improving services," said Marcia Fry, the commission抯 head of operational development. "In the coming months we will be working with the NHS to improve handling of NHS complaints. However, if the situation doesn抰 improve, trusts will feel the effect in their annual rating."

    The commission had expected an increase in second stage complaints because some patients distrusted the old system but the size of the increase had been a shock, she admitted. One reason was that some trusts had hung on to cases until the new system was in place. There were also a number of inappropriate referrals, including complaints about car clamping and getting the wrong chocolate bar from the vending machine.

    The commission was developing new guidance for all trusts on good complaints handling. It also planned to visit the 10 trusts with the highest number of unresolved complaints to offer training and support.

    Ms Fry was particularly concerned that complaints about communications, staff attitudes, and the patient抯 experience amounted to 40%-50% of all the cases they were seeing—more than for patient and clinical safety. "That is high and ought to be eradicated in the majority of cases."

    About 60% of all unresolved complaints come from the acute sector and 15% from primary care providers. The biggest area of complaint in acute trusts relates to treatment in emergency departments. Most of the complaints referred on by primary care trusts are about general practice.(Andrew Cole)