This week there has been lots of talk about the way complaints about healthcare are handled in the UK.  There have been calls to expand the role of the Health Service Ombudsman to allow more claims to be examined as part of an appeals process when patients are unhappy.

A report published earlier this week found that in 2009/10 complaints about NHS services increased by 13.4 per cent to 101,077. This demonstrates the biggest rise for 12 years. The reasons behind the rise could be a decline in the standard of NHS care but could also be down to increased demand for healthcare, better awareness of optimum healthcare standards and also better awareness of the complaints process. Personally I think awareness of the complaints process may be the biggest drive for the number of complaints.

The controversy comes with the way these complaints are being handled. The vast majority were dealt with by hospital trusts. The remaining 15,579 were referred to the ombudsman, of which only 346 were investigated. The criteria for investigation is that the ombudsman has to believe there is a prospect of 'a worthwhile outcome'.  However a Health Select Committee who investigated the complaints handling procedure were "not convinced that all complaints were properly reviewed". In one instance the ombudsman declined to investigate because missing medical records meant the family were unlikely to get a "worthwhile" response.

From our experience in a clinical negligence environment we know that the NHS complaints procedure is invaluable for patients. Firstly it can highlight which areas of complaint are simply not appropriate for legal action by identifying that protocol/guidelines have been followed or that no injury has occurred. This can give 'closure' to patients. Secondly the complaint response can often educate patients about their treatment. Doctors and nurses seem to forget that some people do not have in depth medical knowledge and patients can feel that things have 'gone wrong' when in fact they simply were not educated about realistic outcomes.

However, in my experience of reviewing hundreds of complaint responses I have rarely come across a complaint that has been reviewed by the Ombudsman. I can appreciate that they can only investigate a limited number of cases based on the criterion. However patients do often become frustrated when their complaint has not been resolved. Maybe there is scope for a 'middle step' similar to what the Healthcare Commission used to provide. Or perhaps the ombudsman needs to explain why they can not investigate each case on an individual basis. Or indeed simply investigate more cases.

We will have to wait and see what solutions are implemented. For now, at least this coverage does serve as a reminder to all who are dissatisfied with the standard of healthcare they have received; there is a complaint process which can help - use it!