Written Statement - A Review of Concerns (Complaints) Handling within NHS Wales – “Using the Gift of Complaints”

In April 2011, the Welsh Government introduced Putting Things Right – the new arrangements for the management of concerns and complaints in the NHS. This aimed to make it easier for patients, relatives and carers to raise concerns; to be engaged and supported during the process; to be dealt with openly and honestly and for organisations to learn from concerns.

Almost three years on from the introduction of Putting Things Right, in February 2014, I commissioned a review of the way in which the NHS in Wales responds to concerns and complaints to consider how effectively these arrangements are working.

The  review was led by Keith Evans, the former chief executive and managing director of Panasonic UK and Ireland.

I would like to thank Mr Evans for his comprehensive report and the significant public and stakeholder engagement which has taken place as part of the review process. This is a subject on which people hold strong views and Mr Evans has reflected those in his report.  

He is to be commended for the thoroughness of his engagement and for being able to reach and engage with such a breadth and diversity of people in such a short period of time.  The Report takes full account of other relevant work in this field, including the review of the NHS complaints system in England carried out by Ann Clwyd, MP, ensuring that the issues Welsh patients raised in her review have been addressed in this review.  It also takes into account  the findings of the recent Trusted to Care Report which, independently, highlighted concerns about the NHS complaints process.

Among the many personal observations he makes in his report, I was particularly struck by Mr Evans’ comments about how difficult it can be for staff working in the NHS when they feel constantly under “siege” . The  report illustrates the impact this has upon them and their ability to do the jobs which are so important to us all.  

We know the vast majority of patients are happy with the overall care they receive but when things go wrong the right mechanisms need to be in place to address concerns. As Mr Evans points out, with the very large number of patients whom the NHS treats each and every day,  if even a very small fraction have concerns about their care this can amount to thousands of people.

As part of his review, I asked Mr Evans to suggest improvements, which could be made to Putting Things Right. He has made a large number of key recommendations.

However, his overall message is that Putting Things Right is the right approach for managing complaints and concerns, although there are variations in the way it is implemented across Wales. This needs to be addressed. His review finds Putting Things Right has been successful in generating complaints but it has not had the accompanying infrastructure to keep pace with this. There are also suggestions about how the process should be refined to keep it simple, standard, slim and speedy and, above all, easy for patients and relatives to access and navigate.  

The NHS needs to be open and honest and accept feedback from patients and staff as a “gift” which should be embraced and acted upon. The report indicates some organisations may not always be – or be perceived to be – open, which can lead to needless and repetitive complaints. This needs to change. Staff must also be empowered to deal quickly with concerns and at source.  He makes it clear that staff need to have the necessary training and support to deal with complaints effectively.

The key for everyone, whatever their particular job, Mr Evans says, is to put themselves in the shoes of the patient – to see the experience through their eyes, and to respond accordingly.

The NHS must carefully consider Mr Evans’ review and his recommendations. While there are some immediate actions for health boards, NHS trusts and partner organisations to take forward, I want  them and the public to have the opportunity to consider the review and its recommendations and put forward their views. 

For example, Mr Evans suggests that a more national approach towards complaints and concerns should be considered to ensure greater consistency. He puts forward a number of ways about how this could be taken forward. I am particularly interested to hear views on some of these more wide-reaching recommendations.

Following a period of wider engagement over the summer, I will make a further statement in the autumn.