Written Statement - A Review of Concerns (Complaints) Handling within NHS Wales

Assembly Members will recall that in the latter part of last year, I signalled my intention to commission a review of the way in which the NHS in Wales responds to concerns and complaints from its patients and users. I write now to update you on the arrangements.

In April 2011 we introduced new arrangements for the management of concerns: Putting Things Right. The overall principles set out in Putting Things Right align very closely with the recommendations made by Robert Francis following the Mid Staffordshire Inquiry. It is now timely to review how well our arrangements in Wales are working and to build on the progress already made.

I am particularly keen that we take the opportunity to learn from good practice in other sectors. Therefore I am pleased to confirm Mr Keith Evans, who before his recent retirement was Chief Executive and Managing Director of Panasonic UK and Ireland, has agreed to lead this work. Mr Evans has a strong track record of leading a business which placed good customer care central to its continued success. He will be supported by Andrew Goodall, Chief Executive, Aneurin Bevan University Health Board. The Review will commence immediately and is currently expected to carry out its investigations over a 3 month period.

The full terms of reference for the review are set out in annex 1.

Annex 1

A Review of Concerns (Complaints) Handling within NHS Wales

Terms of Reference

Background

In April 2011 the Welsh Government introduced new arrangements for the management of concerns: Putting Things Right. These arrangements were underpinned by a comprehensive set of regulations and supporting guidance. They introduced a single more integrated approach bringing together the management of complaints, incidents and claims, based on the principle of ‘investigate once, investigate well’. It aimed to make it easier for patients and carers to raise concerns; to be engaged and supported during the process; to be dealt with openly and honestly; and for bodies to demonstrate learning from when things went wrong or standards needed to improve. The overall principles set out in Putting Things Right chime closely with the recommendations made by Robert Francis following the Mid Staffordshire Inquiry as well as the more recent report by Ann Clwyd MP and Prof Tricia Hart into the complaints process in NHS England.

Themes that constantly emerge from patients dissatisfied with the process, as well as other key stakeholders such as the Public Services Ombudsman for Wales, include:

• Not feeling listened to
• Timeliness in reporting and keep complainants informed of any delays
• Lack of clinical engagement in reviewing concerns – viewed as a management process
• A lack of openness and honesty
• Little evidence of learning
• Lack of accountability when things go seriously wrong.

Against this background it is timely to take stock and review the current arrangements to:

1. Review the current process to determine what is working well and what needs to improve. This needs to be considered from the perspective of: patients, their families and carers; staff; NHS organisations; and other stakeholders involved in the process including Community Health Councils and the Public Services Ombudsman for Wales. It will need to include the handling of concerns within primary and community care as well as hospitals.
2. Consider if there is sufficiently clear leadership, accountability and openness within the process.
3. Identify how the NHS in Wales can learn from other service industries.
4. Consider the wider cultural ‘patient’ service ethos and how staff are supported to deal with all aspects of patient feedback and address any concerns.
5. Identify how the NHS can demonstrate it is learning from patient feedback and demonstrate how it shares that learning.

The review should produce a report making practical recommendations for improvements in these areas in both the short and longer term.