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Improving complaint handling in a trust

Summary

A central London acute Trust asked us to help them identify why their outcomes for dealing with complaints were poor and what they could do to improve them. They then asked us to work together with them to implement our suggested improvements.

As a result of the ongoing hard work from Trust staff together with our input the percentage of complaints being dealt with within expected target dates has improved significantly. Staff dealing with complaints across the Trust have clearer guidance on what is expected and report having much more confidence in how to investigate and respond to complaints. Senior managers signing off response letters have told us that, as a result of the training and guidance we have provided, complaints response letters are being written more clearly and empathetically.

The issue

Shortly after coming into post a new Director of Nursing expressed concerns about the timeliness and the quality of the complaints responses which she was being asked to sign off. Commissioners targets on response times were frequently being missed and the Director of Nursing was spending an increasing amount of her time re-writing response letters which had already been “approved” and “signed off” by senior Divisional staff and the Complaints Team. There was very limited objective assurance available to her to demonstrate that complaints were being properly investigated.

Our approach

We carried out a thorough diagnostic of structures, processes and outcomes for complaint handling at the Trust.
This involved:
• process mapping of the complaints process as laid down in the policy versus what was happening across the Trust;
• auditing complaint files in detail and comparing them to local policy and best practice;
• interviewing key staff both within the complaints team and across the Trust to understand the reasons for poor practice;
• comparing Trusts current complaints staffing structures with other similar Trusts; and
• benchmarking on key outcome measures such as complainant satisfaction.

Our action

We made a number of clear recommendations as to how the Trust could resolve the issues identified and improve its approach to complaint handling. We were delighted when the Trust asked us to return to work with them over a six-month period to help to deliver these improvements. This phase of the work involved:

• producing detailed guidance for staff who have to write complaint response letters laying out clearly what is expected, examples of wording they can use, a suggested structure and a letter template;
• developing a planning document which lead investigators can use to plan and manage their complaints investigation and responses in order to ensure a better quality and faster process
• running well received training sessions for over 50 senior clinical and managerial staff who deal with complaints from across the Trust to ensure that they are clear about their role in dealing with complaints and of the good practice standards they are expected to work to.
• reviewing the Trust Complaints Policy and making recommendations for its improvement, ensuring that this was based on feedback from a wide range of clinical and managerial staff.

As a result of both hard work from Trust staff and input and guidance from Niche the percentage of complaints responded to within 25 days rose from 50% to consistently over 80%.

Staff undertaking lead investigator roles report they now feel much more confident about what is expected from them in dealing with and responding to complaints. Rather than letting staff get this wrong and then correcting it, the Trust has been able to train staff and give them clear guidance about what and how to handle complaints.

The Feedback

“Thank you. I will put this really informative training in place with the next complaint I receive”

“I wish I had had this training several year ago. I will definitely be using the good practice standards for complaint handling in future “

“Everyone dealing with complaints should have this”

As the work continues to be rolled out, we have confidence that the good practice which is already being delivered, will become more consistent across the whole Trust.

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