Failing NHS complaints system needs overhaul, MPs say

The complaints system can be difficult to navigate

The NHS complaints system in England is failing patients and needs an overhaul in order to ensure justice, according to a committee of MPs.

The health select committee says a "more open culture" is needed when handling complaints and criticises the Health Ombudsman's role as too narrow.

The cross-party group says too few complaints are officially investigated by the ombudsman.

The Department of Health says new plans will make the NHS more accountable.

The ombudsman's office insisted it can review cases that merit it.

It is only relatively recently that NHS patients in England have been able to take their complaints direct to the Health Ombudsman.

Before April 2009, any complaints not settled locally between the parties involved were reviewed by the Healthcare Commission and referred up to the ombudsman if necessary.

In a bid to simplify and speed up resolutions, the Healthcare Commission stage was scrapped.

But some critics are concerned that the streamlined system now means some complaints are falling by the wayside. In 2009-2010, the ombudsman investigated 3% of about 15,000 health complaints it received, although many more were examined unofficially.

There appears to be something of a "black hole" into which the many complaints which would have been reviewed by the Healthcare Commission and upheld have fallen, Action Against Medical Accidents said.

The committee of MPs agreed.

Chairman Stephen Dorrell said the ombudsman's current remit excluded a number of cases sent for review.

"Patients should feel entitled to an independent review. That mismatch between patients' expectations and what the ombudsman does in practice needs to be closed," he said.

A complaint is accepted for formal investigation or intervention by the ombudsman only if the person has suffered injustice or hardship as a result of poor service or maladministration, and only if there is the prospect of "a worthwhile outcome".

In one instance the ombudsman declined to investigate because missing medical records meant the family were unlikely to get a "worthwhile" response.

'Complex' system

The committee also wants healthcare providers to be more open and adhere to a "duty of candour", which requires them to publish information about the complaints they receive and the progress they make.

Action Against Medical Accidents chief executive Peter Walsh said: "We are very pleased that the committee has accepted our and other participants' calls for better access to independent review of complaints.

"Only a fraction of people who had independent reviews under the old system can get the ombudsman to investigate."

A spokeswoman for the Health Ombudsman said: "Where our assessment reveals clear evidence of maladministration or injustice, we consider whether we can resolve the issue quickly and effectively through our intervention rather than a full investigation."

She added: "The system for handling NHS complaints is a complex one. We welcome the report's endorsement of the current system's design and potential, its emphasis on listening to patients and support for advocacy and the committee's call for a greater focus on complaints data and learning from complaints."

A Department of Health spokesman said: "The revised plans we set out last week, in response to the independent NHS Future Forum, will safeguard the future of the NHS and put patients at the heart of our health service.

"Under the plans, patients will have a stronger voice and the NHS will be more accountable for the quality of care it provides for patients.

"In addition, Local HealthWatch will champion the views and experiences of patients, helping to drive improvements in the quality of health and social care services."