London hospitals are the subject of more serious patient complaints than any other type of secondary care trust, a review by the Parliamentary and Health Service Ombudsman Ann Abraham reveals.

Of the five hospital trusts that the ombudsman received most complaints about in 2009-10, four were large London hospital trusts (see box 1).

Barts and The London Trust was the subject of most complaints, with 146, followed by Guy’s and St Thomas’ Foundation Trust and Imperial College Healthcare Trust, both with 112.

NHS Devon was the primary care trust with the most complaints, 84, followed by West Sussex (see box 2). Mental health trusts and specialist hospital trusts tended to be the subject of the least complaints.

This is the first time the health service ombudsman has published an annual review of the complaints it has received in England, detailing previously unpublished data on which organisations received the most complaints.

It follows the introduction in April 2009 of a simplified complaints handling system based on local resolution and the ombudsman as the final step, with neither the Healthcare Commission nor its successor the Care Quality Commission involved. 

Overall, 14,429 complaints were received by the ombudsman in 2009-10, of which the majority were about clinical care and treatment, followed by the attitude of staff.

In most cases where complaints were investigated and upheld, the ombudsman instructed the trust to either apologise or “put things right”, for example by booking a further clinical appointment. In 30 cases, an organisation was instructed to pay compensation.

The report said it was “unclear” why there were more complaints made about trusts in London. The report noted high numbers of recorded complaints could be the result of “good signposting” to the ombudsman.

Ms Abraham highlighted that, where the mistake was not in dispute, organisations could often avoid the involvement of the ombudsman through a simple apology to the patient.

She said: “An apology can be a powerful remedy; simple to deliver and costing nothing.”

She noted, however, that inadequate record keeping commonly prevented trusts offering a “full and thorough explanation of what went wrong”.

National Voices chief executive Jeremy Taylor said this year’s report set a benchmark on which to gauge the longer term impact of the new complaints procedures, and whether it would lead to systemic change. He said the high number of complaints still going to the ombudsman was “depressingly familiar”.

A spokeswoman for Barts and The London Trust said only three of the complaints made against it had led to formal investigation by the ombudsman and that it was focused on resolving problems as quickly as possible at local level. 

A spokeswoman for Guy’s and St Thomas’ said the number of complainants referring their case to the ombudsman about the trust had increased, but the number investigated had decreased. She said: “We believe this is in part due to patients failing to realise they can only go the ombudsman once the local investigation has been concluded. We are working hard to make this clearer.”

Charles Wellington, complaints manager at Barking, said: “We have met with the Ombudsman to discuss this report.

“It is important to note that we are an extremely large organisation, and we would expect a proportionately higher number of complaints than smaller trusts. They also informed us that an unusually high number of people – around 75 per cent – had complained directly to the Ombudsman rather than coming to the trust first.”

Meanwhile a spokeswoman from Imperial said the trust had significantly reduced the number of formal complaints it received last year by 10 per cent. She said: “We place great importance on providing an open, honest reply and strongly sign post the ombudsman in our complaints process.” 

A spokesman for Leeds Teaching Hospitals said: “Leeds Teaching Hospitals is one of the very largest trusts in England, seeing well over a million patients each year. The number of our complaints referred to the ombudsman should be seen in that context.”

NHS Devon director of corporate affairs Venessa James said the “main theme” of complaints had involved dentistry, which the PCT had acted to rectify by improving access.

NHS West Sussex customer service unit manager Maureen Vallon said the PCT had launched and publicised a customer services unit last year.  She said: “As a consequence of this we have seen a rise in the number of complaints we receive.”


Box 1: Top five hospital trusts by complaints received: 
Barts and The London Trust146
Guy’s and St Thomas’ Foundation Trust 112
Imperial College Healthcare Trust  112
Leeds Teaching Hospitals Trust  102
Barking, Havering and Redbridge University Hospitals Trust 93


Box 2: Top five PCTs by complaints received:          
NHS Devon84
NHS West Sussex81
NHS Hampshire 79
NHS Surrey75
NHS Leeds    71