HSJ EXCLUSIVE New system is overwhelmed as unresolved cases continue to mount

Published: 03/02/2005, Volume II4, No. 5941 Page 5

The new NHS complaints system is buckling under massive pressure with the Healthcare Commission facing a backlog of more than 3,700 grievances, HSJ can reveal.

A private company will be brought in next week to help clear the backlog after the commission was deluged with 4,460 complaints about the NHS since taking over the second stage of the process in July last year. Some 3,711 have still to be dealt with, and only 526 have been declared closed.

The commission expects to receive 9,000 complaints by the end of its first year - almost double the number originally anticipated - while it has only employed half the staff it had hoped to take on. The commission now aims to clear the backlog by August.

Outsourcing provider Huntswood will send in a 45-strong team of case managers on Monday to help clear up to 2,000 complaints identified as 'low-risk' at a price of£500 per case.

Ten temporary members of staff have already been employed to screen the entire backlog - rating cases as low, medium or high risk - and a further 60 members of staff are expected to join the commission by April to help with the process.

Parliamentary and health service ombudsman Ann Abraham told HSJ she was growing increasingly concerned about the situation.

'People are not getting their complaints looked at in a timely manner. If you are concerned that your loved one actually did not receive the quality of care they should have and died needlessly, you are going to want that looked at pretty quickly.

'There are a whole range of issues in there about the way the system is bureaucratically driven, not patientfocused, not patient-centred.' Speaking to HSJ after giving the annual lecture to the Centre for Public Scrutiny last week, she said there were 'dangers of the new patient arrangements replicating all the problems of the old system'.

Ms Abraham will release a report to parliament about the NHS complaints procedure within weeks.

Under the system introduced in July, complainants unhappy with the way a trust or primary care trust has dealt with their concerns can ask the commission for a review of the case, a role previously played by health authorities. Complainants who do not agree with the commission's findings can turn to the health ombudsman as a final resort.

To date the commission has closed just 526 cases, while 223 are currently going through the investigation process. Of the closed cases, the vast majority were passed on to other organisations like the General Medical Council, forwarded to the ombudsman, sent back to trusts for local resolution or declared out of the commission's jurisdiction because they had not been originally reported to the local trust or PCT concerned.

Only four cases have made it to the panel stage. The three-person lay panel is used to examine the most serious complaints where there is a dispute about clinical evidence and experts are required.

Under the previous complaints system, 312 cases were referred to an independent review panel in 2000-01, the last year for which figures are published.

Patient and public involvement czar Harry Cayton said that now that Dame Janet Smith had published her final report on Shipman, the Department of Health expected to 'move quickly on a stream-lined process which will really focus on the outcomes that patients and their families want - not processes and bureaucracy.' Following Dame Janet's final report last week, chief medical officer for England Professor Sir Liam Donalson is leading a review into patient safety, which will recommend changes to the current role of the GMC.

www. the-shipman-inquiry. org. uk See Comment, page 3.