Published: 19/08/2004, Volume II4, No. 5919 Page 21

The NHS complaints system has in the past been accused of bias - something the Healthcare Commission intends to remedy, says Marcia Fry

It is time the NHS took a leaf out of the commercial sector's book and viewed complaints as a valuable source of feedback on what the public expects and where we get it wrong.

Some trusts make the most of the information they gather from complaints, but too often patients have been failed by a system that has been over-lengthy, unclear, inconsistent and perceived to be lacking in independence.

To address some of these issues, and to help drive broad, crossNHS learning from complaints, the Healthcare Commission now delivers the second tier (or independent review) stage of the NHS complaints procedure in England.

The NHS Complaints Procedure National Evaluation report in March 2001 found that almost three-quarters of those interviewed who had experience of the old process believed it to be either unfair or biased. Even those operating the system recognised there was a need for greater independence.

The commission aims to deliver a fair, consistent and timely process. Feedback we have received shows that people want a fair system for both the complainant and the complained against. We will give both parties the opportunity to put their side of the story, to agree the terms of reference of any investigation and to have access to all relevant documentation.

Under the old system, the experience of the person making the complaint and the complained against appeared to differ depending on the trust, the convener or the lay chair involved. The Healthcare Commission's staff and lay panel members are being trained to secure more consistency in process and in the application of criteria when making judgements. Our quality assurance processes should mean that inconsistencies or further training needs are picked up quickly.

The Healthcare Commission will investigate further when information indicates that not all issues have been addressed, but likewise, it will tell people when there is nothing further we can do for them. We will adhere to the tenets of the concordat between bodies inspecting, regulating and auditing healthcare on reducing the burdens of inspection to ensure we monitor rigorously but without requiring organisations to fill in yet more forms.

The commission is also now responsible for assessing performance against the recently published national standards, including the requirement that all healthcare organisations have systems to ensure patients, their relatives and carers have suitable access to information about formal complaints and feedback on the quality of services. The standard also requires that people are not discriminated against when complaints are made, and are assured that organisations will make changes when appropriate.

The commission is in a unique position to view how healthcare organisations respond to patients' concerns. I hope that by taking over the independent review of complaints, the commission can give a much-needed boost to the attention given to this invaluable feedback on care for patients. We will be working to ensure that the information extracted from complaints is translated into improvements in services. We will be looking to NHS bodies to do the same.

Marcia Fry is head of operations of the Healthcare Commission.