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Icebergs and seas of the NHS

November 9, 2012

Coverage today of the NHS ombudsman’s report regarding the ever-increasing number of complaints received from patients across the UK. But the shock shouldn’t be that the number of issues handled by the health service ombudsmen is so high, rather it should be that it is so low.

When one considers that over 10% of NHS patients say they are not happy with the service they receive (consistent finding across national patient surveys), the number of complaints being received should be much, much higher. Unless either people can’t be bothered to complain and/or the systems to do so are just too complex.

I’d suggest that the complaints system (indeed the whole feedback system) for the NHS is totally broken and inadequate. It is a relic of the last century – if NHS care was as out-dated as the systems for listening and learning from patients, then we’d still have gas-lamps on the ward and be using ether as an anaesthetic.
With respect to volume of feedback, we are only capturing a tiny fraction of comment, feedback and patient issues. The real number of issues and concerns is at least 100 fold the number actually received.
Each of these pieces of user feedback and comment is a chance for the NHS to learn – missing these insights condemns the NHS to repeatedly make the same mistakes year after year.
It is also unacceptable that we still lack transparency on these comments and feedback. Patients and their families should – when they wish to do so – be able to put their concerns on the internet just as they can with any other service industry, and Trusts should reply there in a fully open way (whilst respecting confidentiality).

Leading hospitals are beginning to do this – and it works. Patients are happier, confidence and trust in organisations increases, and such transparency is linked to reduced costs of litigation.

But it is also vital to capture compliments and examples of excellence, thank-yous and recommendations. Making it easy for patients to “rate and review” their doctors, nurses, hospitals and clinics always gives huge numbers of positive compliments and helps us identify and remember what excellence looks like through the eyes of patients.

So, if the number of complaints being received about the NHS is just the tip of the ice-berg, that ice-berg is floating in a huge ocean of compliments and thank-yous. It is this sea as much as the few ice-bergs floating in it that shows the way forward, that puts pressure on low performers, which builds the morale of staff, and which shared publicly will provide informed choice for those needing care.

94% of feedback on iWantGreatCare is positive. Grateful patients saying thank you for excellence, and recommending the best for the next patient

 

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