It still comes down to culture

Learning for legal regulators, as NHS launches complaints review

Elisabeth DaviesWhen the Francis Report first came out I wrote a blog about the learning for the legal services sector and the crucial importance of looking at culture, asking the question ‘How can the regulators shape the culture of providers?

At the risk of sounding like a stuck record, this week I’m back on this, prompted by the announcement by the Secretary of Health of a review aimed at ensuring that all hospitals listen to and act upon the concerns of patients. In launching the review Secretary of State for Health Jeremy Hunt said:

‘Complaints can be the earliest symptom of a problem within an organisation and the NHS should use them to learn from and improve their service’.

Nobody can argue with that. Complaints have long been seen as an essential means of raising standards but post Francis there could be an even greater emphasis on using complaints to close the quality loop. It’s got to be worth looking at the review and comparing where we are with complaints in legal services.

The review will engage with patients, their carers and representatives, staff and managers and other organisations involved in handling patient complaints to hear how Trusts currently act when concerns and issues are raised.

It will also consider:

  • what common standards can be applied to the handling of complaints;
  • how intelligence from concerns and complaints can be used to improve service delivery, and how this information can be made available to service users and commissioners;
  • the role of the Trust Board and senior managers in developing a culture that takes the concerns of individuals seriously and acts on them;
  • the skills and behaviours that staff need, to ensure that the concerns of individuals are at the heart of their work; how complainants might more appropriately be supported during the complaints process through, for example, advice, mediation and advocacy; and
  • the handling of concerns raised by staff, including support for whistleblowers.

The review will identify existing best practice for handling complaints, and make recommendations for a set of common standards by which all NHS hospitals will be assessed and held to account.

Does any of this resonate with legal services? It does for me. Back in October 2012, the Consumer Panel released research we’d commissioned from the Legal Ombudsman that exposed these very issues.

We all know that you can only make a complaint if you’re fully aware that you have the right to make a complaint; if you understand how to make it; who to make it to and how it should be handled. But this report showed more than this. It showed that people believe they won’t get a fair hearing; that they fear upsetting their lawyer could have repercussions for their case; and then just as bad, a quarter of those that do complain rate their experience as one out of ten.

Just as I suspect the NHS complaints review will do, our report showed the clear gap between what regulation is supposed to be delivering and what is actually happening in reality. But, this is about more than improving compliance with the rules of signposting and communication. Our report was about the more fundamental cultural issues which need to be addressed in the legal services sector. Issues that still need to be addressed.

I’ll be watching the NHS complaints review with interest – I hope others in the legal services sector will be as well.