When complaint handling becomes risk analysis it has missed the point.

I was informed that the Cabinet Office are carrying out pilot studies into ‘best practice complaint handling‘.  It involves using technology to transfer the number of complaints lodged to senior managers within public services so that they can identify trends and presumably take appropriate action.

To me this smacks of complaint handling as risk analysis and misses the point that each complaint represents someone’s personal trauma.  It matters to them, even if no-one else has suffered in a similar way.  Will only those complaints whose numbers cross an arbitrary threshold be delivered remedy?   Surely the value of using complaints as feedback is to prevent trends, not to monitor them?

One complaint should be enough to trigger remedial action.

The problem is that those in charge of the system work in a vacuum.  In marketing the consumer is placed at the centre of the task.  They are consulted on tiny detail and their preference monitored via sales.  Alterations in consumer behaviour are investigated and remedied.  The consumer is a partner and their needs are central to good delivery.  If you don’t satisfy your customer, they go elsewhere.  In public services the consumer is the citizen and the ones to consult are those with experience of the service; most likely previous complainants.  In relation to health care the consumer’s voice has been heard via the Francis inquiry, the Morecambe Bay inquiry and the sterling work of campaigners such as Julie Bailey, James Titcombe and Katherine Murphy from the Patients Association.   There is now a consensus view that complaints are not taken seriously, not reviewed thoroughly, lessons are not learned and as a consequence others suffer.

The Cabinet Office review of ‘best practice’ is part of a response to address the issue of poor complaint handling across all public services, not just health.  Commendable; but where is the consumer voice, helping to provide a complaint system which works for those receiving as well as those delivering?  Where is the ‘gold dust’ voice of experience once lauded by Oliver Letwin, the minister in charge of these improvements?

As the Cabinet Office moves forward with its review of the Ombudsman landscape they use public consultation as bookends to the process.  You can comment at the start and you can comment at the end, but we don’t want you at the table interfering with due process as we draft the new legislation.  Of course consumers of public services can’t vote with their feet.  We will be forced to put up with whatever Ombudsman reform the powers that be decide is good for us.  If we don’t agree with the model, we can always join the 66% who don’t bother to make a complaint in the first place because they don’t think it will make a difference. Basically the only choice we have is to enter the labyrinth of public sector complaint handling with hope in our heart or walk away and suck it up.

Steve Hilton says in his book ‘More Human’ that when he was advisor to the government a new ‘open policy making team’ was introduced.

“It’s fundamental re-orientation of policy making, from a focus on bureaucratic needs and priorities to the real lives of the real people government is supposed to serve.”

So where are all the ‘real people’ sitting round the Cabinet Office table?  Nothing but ‘insider experts’ as far as I can see.  Where, for that matter, is the patient voice on the new IPSIS committee? Sadly absent.   https://www.facebook.com/ParliamentaryOmbudsmanCampaign/posts/489612051195433

Insider experts talking to other insider experts in closed conference bubbles, such as that provided by ‘Westminster Briefing’.  At £220 per delegate the real people are left on the outside with their noses pressed against the window.  When approached by the PHSO Pressure Group to supply two places at a reduced rate to their upcoming NHS complaint handling conference the request was denied.  http://www.westminster-briefing.com/home/event-detail/newsarticle/nhs-patient-complaints-improving-your-response-to-support-patients-staff/

When asked how many complainants might be attending the conference in order to give the perspective of the service user and work in partnership with service providers the reply from Bruce Reilly was;

“Whilst I’m not able to completely second guess the audience that will attend, I expect much of the audience will be those in the NHS that deal with patient complaints and therefore engage with many complainants. Our conference will touch on a ‘partnership approach’ with the patient, with agenda points on “providing patients with clear information”, “people’s responses to their complaints experience” and “improving the effectiveness of PALs services”.

 “As I expect much of the audience to be those staff involved in the complaints process, they will a lot of experience in the complaint process in their organisations. We are also looking to have speakers who are also experts in this field. Unfortunately though, I’m simply not able to offer you registration at a reduced rate. There are costs involved, such as hiring the room, providing materials for the day and staff costs etc.”

So plenty of ‘experts’ here and no consumers required.  NHS money will pay the £220 fee in most cases.  For that they will get coffee and a biscuit, a networking lunch and a ring bound folder.  What they won’t get is any real understanding of a complaint as personal trauma, with life changing consequences for those who speak out and are denied justice.  These kind of closed talking shops don’t move anything forward, they just move round in circles, collecting money every time they pass go.

So will Mr. Letwin and the Cabinet Office make good his promise of 2013?

” Instead of viewing them as a “danger,” complaints should be seen as a vital “mine” of information, the Cabinet Office minister told MPs.”  http://www.bbc.co.uk/news/uk-politics-24548731

Well, what do you think?


Editorial update 28.9.15:  since this blog was posted it has been revealed that a number of NHS campaigners, including Will Powell who has campaigned fiercely for Duty of Candour, have been invited to join the IPSIS panel. This is a very positive step forward and the structure of this new investigation body will benefit greatly from the insight of their first hand experience.

Equally, members of the PHSO Pressure Group have been invited to meet with Oliver Letwin to discuss the PHSO Bill before the official public consultation.  Our message to Mr. Letwin will be that when we talk of British values ‘justice’ is high on the list.  The new Ombudsman service must deliver justice to the people and must be accountable when it does not.  Time to ditch the ‘whitewash’.








  1. Colin

    …and how about a radical new approach…send the complaint back to where it came from, back to the local area with public access by the local media and internet so that the complaint becomes visible and the eventual judgement known by all …

    • phsothefacts.com

      Local resolution is the most valuable as the people who can make the changes need to be the ones to understand what went wrong. When complaints are put in the hands of complaint managers the main aim is to ‘dispose’ of them. I’ve even heard this word use by a professional at a conference.

      • Colin

        Transparency is the key word that we must never lose sight of…..in the case of a complaint against the NHS this means full and total access to all medical documents, the right to know the names and positions of all those involved and the roles they played……without transparency accountability doesn’t stand a chance …

  2. Pingback: Turn Up The Volume – Bristol Conference 16.10.15 | phsothefacts
  3. Paul Trummel

    Risk management stratagems deny legitimate access to information using a bizarre court finding (now subject to appeal in UK Supreme Court) to accommodate gagging and abuse of process (arbitrary decisions and entrapment) by police officers and bureaucrats who frequently use dumb insolence as an important part of their disingenuous stratagems. As sociopaths, they often encounter legal difficulties, which include criminal activity, by disregarding societal standards and the rights of individuals. Devoid of moral and ethical compass, they do not experience a full range of human emotions which explains their lack of empathy and the suffering that they cause. Generally, they remain indifferent to the possibility of physical pain or punishment and show no remorse or fear; this may also explain their apparent disregard for the consequences of their actions. . . . Full Text at:

    • phsothefacts.com

      I believe that most people who work within systems are good and have sound values, but gatekeepers exist at different levels who have no hesitation to use any means possible (legal or otherwise) to close down perceived threat.

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