Learning, Improving and Accountability


Service User feedback, including complaints, is a valuable source of information on how well services are doing. A key objective of the revised policy is to ensure that there is long term learning across the hospital and community health sectors from analysis of all Service User feedback. 

It is clear that there is a necessity to learn and improve as a result of feedback and complaints. There must also be a focus on implementing the recommendations from complaints, and making meaningful service improvements as a result. Such a focus on organisational learning is a vital way for Hospital Groups and Community Healthcare Organisations to encourage a culture of welcoming feedback and complaints and using these as a positive driver for service improvement and delivery as well as informing resource allocation.

Managers at all levels should encourage and assist all staff in understanding and using feedback as essential information to support on-going improvements to services. To support this, valuing feedback is a cornerstone of the newly revised policy and process.

Linking complaints with learning and improvement is an important way of assuring the safety and quality of care.  As Don Berwick, an international leader in patient safety and healthcare quality, “in the discovery of imperfection lies the chance for processes to improve”.  Berwick also said: “the best way to reduce harm is to embrace wholeheartedly a culture of learning”.

Mid-Staffordshire Trust hospital

The Mid-Staffordshire Trust hospital incident concerned poor care and high mortality rates at the then Stafford Hospital, Stafford, England. In November 2010, a public inquiry opened, chaired by Sir Robert Francis QC, which examined the causes of the failings in care. Amongst the inquiry’s findings was that hundreds of complaints were made about the care provided at the hospital but these complaints were not investigated or were simply ignored.

The inquiry identified key themes in relation to the handling of complaints.  These included the low priority given to feedback and learning from complaints.

“A health service that does not listen to complaints is unlikely to reflect its patients’ needs. One that does will be more likely to detect the early warning signs that something requires correction, to address such issues and to protect others from harmful treatment” – Sir Robert Francis QC.

  • Information about feedback is regularly reported to senior management via the Complaints Manager.
  • Staff responsible for investigation and resolving complaints are trained in complaints handling.
  • Information on trends identified through feedback is publicly available.
  • Lessons learned from complaints are used for system wide learning and improvements.
  • Findings from complaints are regularly communicated to staff.
  • Recommendations made and accepted following the investigation of complaints are implemented fully and all relevant persons have been informed of this.

Every complaint is an opportunity to learn