Intended for healthcare professionals


Complaints proposals for NHS welcomed

BMJ 1994; 308 doi: (Published 21 May 1994) Cite this as: BMJ 1994;308:1322
  1. J Warden

    A new and simpler complaints procedure for the NHS produced by a review committee has been welcomed by the health professions and by patients' organisations in Britain (see also editorial on p 1315). The health secretary, Virginia Bottomley, said that she accepts the broad thrust of the report, Being Heard; she has begun a three month consultation period before introducing legislation.

    The proposals would mean that all complaints would be handled under a common system, with no distinction between clinical and non-clinical complaints or between family practice and hospitals. The same procedures would apply to all parts of the health service. General practitioners would be required by contract to operate their own internal complaints process.

    The review committee's chairman, Professor Alan Wilson, the vice chancellor of Leeds University, said that the response that patients get when they make a complaint is a fundamental test of the NHS as a public service. He wants to replace the adversarial approach with a system that is friendly, prompt, and local as well as fair to patients and staff.

    The committee of 12, drawn from the health service, professions, and consumer interest groups, recommends a two stage procedure for dealing with complaints. At stage one, complaints would be handled internally on the spot, or within 48 hours, by front line staff or a named complaints officer, who could be a senior partner or hospital manager. The aim is to offer an oral apology or explanation. If the complainant remained dissatisfied investigation and conciliation would follow, with a written response within three weeks. After that the complaint would be put in the hands of the most senior official - a chief executive or, in primary care, a specially appointed complaints executive. Professor Wilson expects the vast majority of complaints to be handled by stage one procedures near to the point of origin.

    Stage two provides the back up of independent screening and arbitration by a panel with three or five members, with a lay majority and chairperson - following the principle of the jury system. The larger panel would consider issues of professional judgement. If it found that professional codes of practice had been breached it would inform the relevant regulatory body. Panels would be expected to deal with complaints within five weeks. All stages of a complaint should be completed within three months. If still dissatisfied the complainant could approach the health service ombudsman. Professor Wilson believes that a good complaints procedure “bringing logic and order to bear” would reduce the volume of litigation. The cost of running it would be no greater than at present and, while he emphasised the need to train staff to handle complaints, he said that the cost could be absorbed in current training programmes.

    For the BMA, Dr John Chisholm said that the report went a long way to meeting the needs of doctors and patients for a fair and speedy complaints system. The report was also welcomed by medical royal colleges, health authorities, and the Patients Association.

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