Public Information: Comments, Compliments and Complaints

Service Users want to be able to access safe, effective and high quality care and treatment.  (See HSE National Healthcare Charter ~ You and Your Health Service and the HIQA Standards for Safer, Better Healthcare)

Expressions of complaint by patients and their advocates reporting poor healthcare experiences represent a valuable data source for learning (see Trends below ) and improving the analysis of complaints is a priority for service providers. This data can facilitate service monitoring and organisational learning. Service users are valuable sources of data as they observe and experience a huge amount of service activity and issues within healthcare settings and are outside the organisation, thus providing an independent assessment.

The implementation of an effective and efficient feedback process will allow lessons to be learned both from individual complaints investigations and from data analysis of complaints. These can be used to inform service change and to create an environment the delivery of high quality and safe healthcare services.


Data analysis plays an essential role is assessing the culture of an organisation.

By analysing and aggregating feedback (comments, compliments and complaints) obtained from informal observations of external stakeholders who have interacted with the system we can attempt to measure the culture of the HSE.

Aggregating feedback that reflects both positive and negative Service User feedback gives an independent perspective into the functioning of organisational culture.

In order to make sense of the complex data reported by Service Users specifically in relation to complaints the HSE has a complaints taxonomy based around 8 central themes with 243 sub-categories. This thematic breakdown of complaints received will help identify trends allowing complaints officers to systematically label each issue and its sub-category. This systematic labelling can be used to gauge culture.

Analysing these trends helps management draw conclusions for promoting service quality and best practice amongst all staff. Data will be aggregated from each local service, Community Health Organisation or Hospital Group in order to assess the culture of that institution. This is used to identify strengths and weaknesses, and to benchmark services nationally.

Stage 1

  • Categories of each issue in a complaint and its sub-category
  • Complaints resolved at Stage 1 (HSE Point of Contact Resolution)
  • Complaints not resolved at point-of-contact and escalated to Stage 2 (HSE Formal Investigation Process)

Stage 2

  • Categories of each issue in a complaint and its sub-category
  • Stage 2 complaints resolved within 30 working days
  • Stage 2 complaints upheld
  • Stage 2 complaint investigations that result in a review request
  • Stage 2 complaint investigations that result in an Independent Review request

Stage 3

  • Stage 3 (HSE Internal Complaint Review) upheld
  • Stage 3 internal reviews that result in an Independent Review request

Additional Data Analysis

In addition the HSE’s taxonomy, complaints can be analysed using an internationally recognised complaints categorisation system called the Healthcare Complaints Analysis Tool (HCAT).

The Healthcare Complaints Analysis Tool, developed by the London School of Economics, is the first standardised tool for analysing complaints in a rigorous and conceptually meaningful way.  It is also the first tool that can reliably assess problem severity.

HCAT has primarily been designed for use in Acute settings.

Results from HCAT can be used to:

  1. Systematically categorise the general and specific problems reported by Service Users within a particular healthcare setting.
  2. Differentiate between high and low performing health services, e.g. in terms of the severity of the problems reported.
  3. Identify healthcare services with a specially high risk profile, e.g. in terms of services users reporting severe safety problems.
  4. Encouraging learning and the sharing of information at local, regional and national levels.
  5. Provide longitudinal data on complaint trends, e.g. to test the effect of an intervention to improve Service User experience.


HSE Annual Report

In accordance with the Health Act 2004, the HSE must submit to the Minister for Health, as part of the Executive’s Annual Report, a general report on the performance of its complaints management processes containing such information considered appropriate by the Executive or as the Minister may specify. This report will be co-ordinated by the National Complaints Governance and Learning Team.

HSE Service Provider Annual Report

A service provider who has established a complaints procedure by agreement with the Executive must provide the Executive with a general written report on the complaints received by the service provider during the previous calendar year. This report is to include:

  • The total number of complaints received
  • The nature of the complaints
  • The number of complaints resolved by informal means
  • The outcome of any investigations into the complaints

Further information may be required at the discretion of the National Quality Assurance & Verification Division, who will inform Service Providers of data required.