Learning from complaints

Complaints data and individual complaints can provide important insight into how services are being delivered within an organisation. This can lead to learning for individual services as well as the organisation as a whole.

Sharing learning

Organisations should look at incorporating feedback from complaints as part of their internal communications strategy with staff. This includes learning from complaints handled by the organisation as well as complaints dealt with by the Ombudsman.

In some cases, learning will only be relevant to specific services, however organisations should look for opportunities to share wider learning across organisations where possible.

The following are some possible ways of sharing learning from complaints:

• Regular discussion of complaint outcomes and learning at meetings of directors or other senior officers.
• Briefings delivered in staff meetings. These should briefly highlight learning from complaints and provide a reminder of accepted standards. Time should also be given for questions and discussion, especially where serious failings have been identified or there has been a serious adverse impact on an individual or the wider public as a result of any fault by the organisation.
• Updates on complaint outcomes and learning shared within regular staff communications.

Root cause analysis

Organisations should look beyond individual actions to identify wider factors that may have contributed to failings in how a decision was reached or in service delivery. A detailed analysis of these factors is not necessary in every case where fault is identified. However, a more detailed analysis of systemic issues which may have contributed to failings may be appropriate where serious failings have been identified or there has been a serious adverse impact on an individual or the wider public as a result of any fault by the organisation.

This approach set out below is based on the NHS Patient Safety Incident Response Framework. The framework focusses on understanding how incidents happen and systemic factors which may contribute to them. Taking this approach supports organisations to move away from a culture of blame to a culture of accountability by analysing wider factors which contributed to any fault rather than attributing these to individual error.

Front line staff involved in the issue complained of and the individual who raised the complaint can play an important role in providing feedback through this process to help organisations understand different factors that may have contributed to any fault. Encouraging individuals to engage in this process can demonstrate the organisation is taking the issue raised seriously and is committed to learning from their complaint.

Organisations should consider the following issues when looking at factors which may have contributed to any fault:

Technology & tools: Did the complainant and staff dealing with the issue have access to relevant technology and tools to help resolve the issue? Were they aware of how to access and use these? Were these available and working as expected?

External influences: What outside factors influenced the action taken by the organisation? Did the actions of the individual or third-party organisations contribute to the fault? Could this have been addressed at the time? Did other factors outside the organisation’s control contribute to the fault? How could this be mitigated in future?

Organisational factors: Does the organisation have clear policies and procedures in place for dealing with the issue? Were staff able to access and understand these? Are policies and procedures in line with legislation and guidance? Are staff made aware of changes to policies and procedures? What training is provided to staff and is this regularly reviewed?

Job tasks: Did other work pressures affect staff capacity at the time either individually or collectively? Did staff have knowledge to carry out their role? Did staff have access to support to deal with the issue?

Person factors: Did individual members of staff have appropriate training? If newer members of staff were involved in dealing with an issue, did their induction prepare them for dealing with the issue complained of? Did individual members of staff feel supported by line managers? Were individual members of staff affected by personal situations which may have affected their performance? Were they able to access support at work to help manage their capacity?

Physical environment: Were there any issues with the location where the issue occurred which contributed to the fault (e.g. layout)? Could this have been anticipated and mitigated against? If services are regularly delivered in the same space, were adequate, regular health and safety checks in place?

Effective use of complaint data

Individual complaints can provide important learning for organisations, however consideration of wider data can provide insight into how services are being delivered and provide an early warning of potential serious failings in an organisation.

In this guide we have provided recommended key performance indicators (KPIs) for organisations and how these should be interpreted. Consistent recording of data allows organisations to track variations in performance over time and compare performance against other similar organisations who have adopted the same KPIs.

Organisations should avoid setting targets for performance. This can result in unintended consequences as service areas and officers focus on meeting targets rather than providing a quality response to complaints. Instead, organisations should look to benchmark performance against others and previous reporting periods. Over time this will help to establish expected performance levels allowing organisations to analyse performance more closely when organisational, service level or individual performance deviates from expectations.

The KPIs are set out under four categories. These categories should not be analysed in isolation as comparing data in two areas may provide useful information about particular issues. For example, a sudden increase in complaints received with no corresponding increase in upheld complaints may indicate that dissatisfaction is being caused by how a service is being delivered rather than whether the organisation is at fault. Analysing data in this way may support service improvements that prevents similar complaints being raised in future.

Organisations should not aim to reduce the number of complaints received. However, a reduction in complaint numbers may be a helpful indicator of the success of any service improvements put in place alongside other relevant performance information.