NHS should welcome 'citizen whistleblowers'

Hospital ward The NHS should welcome reports from 'third parties', Ms Bradley says

People who see something going wrong in the NHS should be able to report their concerns, even if they haven't been directly affected, according to Anna Bradley, the chair of patients' group Healthwatch England.

In this week's Scrubbing Up, she says the NHS often doesn't let witnesses file complaints - an omission akin to preventing people reporting an abandoned bag at an airport because they don't have the owner's permission.

We know that patients are reluctant to make a fuss when standards slip on hospital wards.

Many simply don't know how to make a complaint, others are actually scared of the consequences.

Yet we often hear complaints referred to as 'gold dust' by hospital bosses in terms of improving services.

You would think then that health and care organisations would be eager to hear from anyone who wanted to report a concern or complaint.

However, our research suggests that tens of thousands of incidents are slipping under the radar because those who witness poor care and try to report it are being told, in one particular case, to "mind their own business".

'Civic-minded individuals'

Responding to a Freedom of Information request, a third of hospitals across England told us that they don't record complaints from "third parties", ie those that witness rather than personally experiencing poor care.

Many of the hospital trusts that replied incorrectly stated that such complaints cannot be investigated without the permission of the patient.

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If a passer-by reports an abandoned bag in an airport, the staff don't say: "I'm sorry sir, but do you have the permission of the bag owner."”

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Others said they record such incidents as informal feedback only, with no follow-up provided to the courageous and civic minded individuals complaining on behalf of vulnerable patients.

In the worst cases some hospitals just flat out said they don't record these complaints.

Even where these reports are recorded, they are often not included in formal stats allowing hospitals so their complaints data doesn't tell the true story.

For me this is symptomatic of a much bigger problem around complaints handling in the NHS and social care services.

The fact that doctors and nurses would rather tell one of these "citizen whistleblowers" they can't complain because they don't tick the right box or have the permission to make a complaint is just wrong.

If a passer-by reports an abandoned bag in an airport, the staff don't say: "I'm sorry sir, but do you have the permission of the bag owner." Rather they are thanked for their vigilance.

If the policy makers and politicians are serious about driving culture change in the NHS then more needs to be done to wipe out this 'compute says no' attitude and encourage staff to welcome feedback - positive and negative.

'Long hard look'

With the secretary of state for health's update on progress against the recommendations of the Francis inquiry expected in the next few weeks, I implore him to take a long hard look at the complaints question.

In our report, 'Suffering in Silence', we set out a vision for streamlining and refocusing the complaints system around what people want.

Firstly, the system needs to make it easier for people to complain, including institutions understanding that everyone, including third parties, has the right to raise concerns.

Secondly, every case should be dealt with compassionately, with a speedy, personalised response that actually addresses the poor experience and includes an outline of what happens next.

Lastly, those who fail to up their game must be held to account by being put into "special measures" by the regulators, issued with financial penalties and ultimately being shut down and replaced.

In short, it's time for the health and social care sector to get serious about complaints, and stop finding loopholes to avoid having to face up to their mistakes.

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