A major overhaul of how complaints are handled by the NHS and a culture of greater openness in the health service has been demanded by MPs in a report today.
Significant variation in how complaints to NHS providers were handled was discovered by members of the House of Commons Health Select Committee during their inquiry into complaints and litigation.
The report recommends the health service ombudsman be given the power to review complaints rejected by providers, calls for a single point of access for complaints and advice and recommends HealthWatch England be charged with “maintaining an overview of complaints handling in the NHS”.
Model commissioning contracts should mandate the provision of comparable complaints data and NHS management should be tasked with improving patient awareness of the Independent Complaints Advocacy Service, it said.
The committee discounted suggestions that the Patient Advisory and Liason Service (PALS) should be independent of the NHS, considering it would lose its “insider” access, and rejected proposals that PALS officers should have a set pay grade.
Committee chair Stephen Dorrell said: “We attach importance to the individual process changes which we recommend, but we believe the most fundamental change which is required is a change of culture within the service. We look to both the NHS National Commissioning Board and HealthWatch England to monitor progress in delivering this fundamental change in the direction of a less defensive and more open culture.”
On litigation, the report warns the government to be wary of proposals to reduce legal aid for most clinical negligence cases but recommends a strengthening of the regulations governing claim management companies.
So called “claims farmers” advertise legal services to members of the public who have suffered an injury. When people sign up the claims are sold to law firms and can sometimes even be auctioned off to the highest bidder.
The MPs are concerned that the companies’ methods encourage people to go straight to litigation rather than use the complaints system and push up the cost of litigation through charging the NHS exorbitant costs when successful.
The inquiry heard evidence from the NHSLA that claims management companies were responsible for the 10 per cent year on year rise in litigation against NHS organisations in 2008-09 and 2009-10. They predict the increase for 2010-11 will be even higher.
The report recommends the Government “review the regulatory structure within which these businesses operate in order to ensure that patient and taxpayer interests are properly safeguarded”.
Senior policy manager at the NHS Confederation, Frances Blunden said she shared the commitee’s concerns on complaints management companies.
“A regime of regulation to keep their activities from continuing to create excessive costs for the health service and reduce the amount available for patient care is needed,” she said.
“We all want to see legal claims given due process but we also need to ensure that the first remedy for every problem with NHS care is not legal action.”