Trust Board Meeting: Wednesday 14 January 2015
TB2015.08
Title
The Parliamentary and Health Service Ombudsman (PHSO)
report on complaints about Acute Trusts, and the review of Q1,
Q2 nationally for 2014-15.
Status
For information
History
This is a new report. It is being presented to the Trust Board
following the publication by the Parliamentary and Health Service
Ombudsman (PHSO) on 26 November 2014.
Board Lead(s)
Ms Catherine Stoddart, Chief Nurse
Key purpose
Strategy
TB2015.08 PHSO Complaints report
Assurance
Policy
Performance
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Executive Summary
1. The Parliamentary and Health Service Ombudsman (PHSO) published a report on 26
November 2014 entitled Complaints about acute trusts 2013-14 and Q1 and Q2 2014-15. The
report forms part of the national PHSO strategy to provide transparency in relation to enquiries
received and complaints investigated by the PHSO office. Trusts are encouraged to use the
PHSO data and insight to improve the care they provide.
2.
3.
4.
The PHSO report identified key questions to enable Trusts to better explore their approach to
handling complaints. These are:
•
Why are some Trusts more successful than others at resolving complaints locally?
•
What can account for the 15-fold variation in how Trusts handle complaints?
•
Why are some Trusts 11 times more likely to have their complaints investigated by the
PHSO than other Trusts, even after accounting for their activity levels?
•
And why are communication, diagnosis, and clinical care and treatment consistently
ranked as the top three issues people come to the PHSO to complain about?
The OUH Trust’s performance has been analysed accordingly against;
•
The five Trusts who have received the lowest number of complaints.
•
The five Trusts that have had the fewest complaints investigated by the PHSO.
•
The Trusts that have had the fewest complaints upheld by the PHSO.
•
The four Trusts within The Thames Valley area.
•
The Shelford Group.
The report has provided the catalyst for benchmarking, confirming the Trust’s activity in
relation to the PHSO’s concerns and identifying the next steps for analysis and development
of the complaints management process. The next steps are to build on complaints as part of
patient experience:
•
Consider the extension of the patient experience dashboard to include legal claims,
incidents, safe staffing and staff FFT.
•
The presentation of the divisional patient experience dashboard for ratification at the
Executive Directors’ meeting, Trust Management Executive (TME) and at the meeting
of the Quality Committee in February 2015.
•
The inclusion of the divisional patient experience dashboard at the quarterly divisional
performance reviews will enable alignment of the patient experience and quality
service improvements.
•
The PHSO report will be presented at the January 2015 meeting of the Trust Board.
•
A further progress update in relation to the Patient Experience Strategy will be
presented at the Quality Committee in June 2015.
5. Recommendation
The Trust Board is asked to note and approve the contents of the report.
TB2015.08 PHSO Complaints report
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Summary: The Parliamentary and Health Service Ombudsman (PHSO) report on
complaints about acute Trusts and an analysis of the complaints nationally for Q1,
Q2 in 2014-15
1.
Purpose
1.1. The report provides a summary of the key statistics collected regarding the
enquiries and the investigations of acute Trusts in England undertaken by the
PHSO. The PHSO report was published on 26 November 2014.
1.2. The report also reviews all complaints received from acute Trusts in Quarter 1
and Quarter 2 of 2014/15.
1.3. The PHSO has published this report in order to enable Trust Boards to examine
and benchmark their organisation’s performance in relation to others.
2.
Background
2.1. Dame Judith Mellor, OBE, the Parliamentary and Health Service Ombudsman,
has published her report as part of the strategy to provide transparency
regarding the enquiries received and complaints investigated by the PHSO.
2.2. The number and nature of complaints offer an insight into how Trusts are
performing. Any complaint that is upheld gives the Trust an opportunity to learn
from its mistakes. In the previous 18 months the PHSO has upheld 44% of all
complaints about Acute Trusts that they investigated.
2.3. There are many factors that influence the number of complaints received by
NHS Trusts. This includes the size of the organisation, the health specialisms it
manages, and patients’ demographics. If complaints data is to be useful and
enable learning, it is important that this context is taken into account.
2.4. The report reminds Trusts of the need for a more personalised approach to care
that welcomes feedback. This culture change is advocated to enable improved
healthcare services for everyone.
2.5. The PHSO does not intend this to be a measure of quality or performance. It is
intended that Trusts will use the data and insight drawn from the PHSO’s
casework as an opportunity to gain insight about and improve the care they
provide.
2.6. The report identifies key questions to enable Trusts to better explore their
approach to handling complaints. These are;
•
Why are some Trusts more successful than others at resolving complaints
locally?
•
What can account for the 15-fold variation in how many complaints Trusts
handle?
•
Why are some Trusts 11 times more likely to have their complaints
investigated by the PHSO than others, even after accounting for their
activity levels?
•
Why are communication, diagnosis, and clinical care and treatment
consistently ranked as the top three issues people come to the PHSO to
complain about?
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2.7. The PHSO records the two distinct aspects of patient experience for each
complaint it investigates
•
The local resolution undertaken: This provides insight into why
complainants are dissatisfied with the local resolution offered by Trusts.
•
The elements of the health care service that led people to complain.
2.8. The main issues cited with the local complaints process of acute Trusts related
to an inadequate apology and a poor explanation of a decision. The additional
issues were:
•
No acknowledgement of mistakes.
•
Complaint response is wrong and/or incomplete.
•
Unnecessary delay in handling complaints.
•
Inadequate financial remedy.
•
Inadequate systemic remedy.
The first three of these can be improved internally. OUH Trust’s activity in
response to the questions raised by the PHSO is outlined in Appendix 9.
2.9. A comparison of the number of complaints investigated by the PHSO with the
number of written complaints made at the local level provides some insight into
the effectiveness of complaint handling at each acute Trust.
2.10. On average, the PHSO investigated 2.2 complaints for every 100 written
complaints received by each acute Trust.
2.11. This varied considerably. The PHSO identified that the 10 Trusts with the
highest number of complaints investigated averaged 5.95 investigations per 100
written complaints. This compared with Trusts with the lowest proportion of
investigations to written complaints that averaged 0.41 investigations per 100
written complaints.
2.12. The PHSO also compared the investigated complaints with clinical activity data.
This was labelled as clinical incidents within the report. The Trust has clarified
that the report is referring to clinical activity and not investigated clinical
incidents.
2.13. The PHSO has included complaints involving multiple Trusts. This is the first
time this information has been included in any reports.
2.14. The PHSO noted that those Trusts with effective local complaints processes
would expect to have fewer enquiries and investigations by the PHSO. However
the report notes that some Trusts openly give complainants information about
how to escalate their complaint if they are not happy with the local investigation.
This in turn may lead to a higher proportion of enquiries to, and investigations
by the PHSO.
2.15. This Trust was commended by the CQC in the inspection in February 2014, for
its transparency and openness with complainants and other agencies.
3.
Overview of complaints about acute Trusts
3.1 The PHSO has listed information relating to all the acute Trusts in England. The
following information has been included;
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•
The number of complaints made to Trusts.
•
Enquires received by the PHSO.
•
Enquires accepted for investigation.
•
PHSO investigations fully or partially upheld.
•
PHSO enquires per 100 complaints to Trusts.
•
Investigations per 100 written complaints to Trust.
•
Enquiries per 10,000 clinical incidents.
•
Investigations per 100,000 clinical incidents.
•
Total number of clinical incidents recorded by Trust.
TB2015.08
3.2. The PHSO has not included the number of complaints upheld or partially upheld
by individual Trusts. This information is available to the PHSO and is submitted
to the Health and Social Information Centre (HSCIC) in the annual KO41a
complaints return to the Department of Health. Please note from 1 April 2015
the KO41a complaints data will be submitted to the HSCIC on a quarterly basis.
3.3. The PHSO recorded the number of complaints to OUH Trust as 890 between
April 2013 and September 2014. OUH Trust’s performance has been analysed
against;
•
The five Trusts who have received the fewest complaints.
•
The five Trusts that have had the fewest complaints upheld by the PHSO.
•
The Trusts with the most complaints, compared to OUH Trust.
•
The five Trusts within the Thames Valley area.
•
The Shelford Group.
•
The Trusts also with two PHSO investigations upheld.
•
The Trusts with a similar number of complaints.
•
Trusts with a similar level of clinical activity as the OUH Trust.
3.4. The tables relating to the Trust’s performance are presented in Appendices 1-8.
3.5. The five Trusts who have received the fewest complaints. The complete
PHSO data for the five Trusts that have received the lowest number of
complaints is presented in Table 1 and Chart 1 in Appendix 1. These Trusts,
with the exception of the OUH Trust, are solely specialised Trusts. The Trusts
have all received significantly fewer complaints than the OUH Trust. Despite
this, OUH Trust compares favourably due to only two complaints being upheld
by the PHSO in 2013/14.
3.6. The five Trusts that have had the fewest complaints upheld by the PHSO.
The 19 Trusts with no complaints upheld by the PHSO are presented in Table 2
in Appendix 2. The Trusts in this category received between 12 and 692
complaints. The number of enquiries to the PHSO ranged from two to 67. The
PHSO received 67 enquires from OUH Trust complainants. The number of
enquires accepted for PHSO investigation ranged from zero to 14, and although
this Trust’s number of complaints were the highest, the proportion accepted for
investigation compared to other Trusts was low.
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3.7. The Trusts with the most complaints, compared to OUH Trust. The
complete PHSO data for the five Trusts who have received the highest number
of complaints are presented in Table 3 and Chart 2 in Appendix 3. The
proportion of OUH Trust’s complaints upheld by the PHSO was 0.22%. The
range of upheld complaints in this category was between 0.07% (Mid Yorkshire
NHS Trust) and 0.49% (St Bartholomew’s NHS Foundation Trust). When
compared with Trusts in this category, OUH Trust was the third best performing
Trust.
3.8. The five Trusts within the Thames Valley area. PHSO data for the five acute
Trusts within the Thames Valley area are presented in Table 4 and Charts 3-10
in Appendix 4. OUH Trust has the highest level of clinical activity and also
received the highest number of complaints compared with the other Thames
Valley acute Trusts. The proportion of OUH Trust’s complaints upheld by the
PHSO was 0.22%. The range of PHSO upheld investigations ranged from 0%
(Royal Berkshire Hospital) to 0.37% (Buckinghamshire Health Care NHS Trust).
OUH Trust was the second best performing trust in this category.
3.9. The Shelford Group. The PHSO data for the 10 Shelford group Trusts are
presented in Table 5 and Charts 11-18 in Appendix 5. OUH Trust was sixth in
terms of the number of complaints received. However, OUH Trust was third
best performing in relation to the number of PHSO upheld investigations.
3.10. The Trusts also with two PHSO investigations upheld. The PHSO data is
presented in Appendix 6. The PHSO upheld two complaints investigations for
39 Trusts including the OUH Trust. The number of complaints received by
Trusts in this category ranged from 65 (Royal Brompton and Harefield Hospital
NHS Foundation Trust) and 2034 (University Hospitals of Leicester NHS Trust).
3.11. The Trusts with similar number of complaints. The PHSO data for trusts
with a similar number of complaints to OUH Trust are presented in Appendix 7,
Table 7 and Charts 19-26. The number of complaints ranged from 860-895. The
number of investigations partially or fully upheld ranged from 2-6. OUH Trust
was the best performing on partially or fully upheld investigation as it had the
lowest proportion in relation to overall number of complaints.
3.12. Trusts with a similar level of clinical activity as the OUH Trust. The PHSO
data for trusts with a similar level of clinical activity as OUH are presented in
Appendix 8, Table 8 and Charts 27-35. The total number of complaints ranged
between 890-1192. The number of PHSO investigations partially or fully upheld
ranged between two and 11. OUH Trust was the second best performing on
partially or fully upheld investigation as it had the second lowest proportion in
relation to overall complaints.
3.13. The PHSO’s four questions have not been answered by this data analysis;
however, it does provide an indication of the success of OUH Trust’s
investigation and resolution complaints process. The work undertaken by OUH
Trust to address the PHSO’s concerns is presented in Table 9 in Appendix 9.
3.14. This report has provided the catalyst for benchmarking, to gain assurance of
OUH Trust’s activity in relation to the PHSO’s concerns and identify the next
steps for analysis and development. The next steps in terms of linking
complaints to patient experience are:
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4.
TB2015.08
•
Consider the extension of the dashboard to include legal claims, incidents,
safe staffing and staff FFT in order to provide a more comprehensive
report.
•
The presentation of the divisional patient experience dashboard for
ratification at the Executive Directors meeting, TME and at Quality
Committee in February 2015.
•
The inclusion of the divisional patient experience dashboard at the
quarterly divisional performance reviews to review patient experience and
quality service improvements.
•
A further progress update in relation to the Patient Experience Strategy will
be provided at the June 2015 meeting of the Trust’s Quality Committee.
Conclusion
4.1. The PHSO has published her report as part of the strategy to provide
transparency about the enquiries received and complaints investigated by her
office. The report highlights the need for a culture change to a more
personalised approach in healthcare that welcomes feedback and improves
services for everyone.
4.2. The report is not intended to be a measure of quality or performance. Trusts are
encouraged to use the PHSO data and insight in order to improve the care they
provide. The PHSO report identified key questions to enable Trusts to better
explore their approach to handling complaints.
5.
Recommendation
5.1 The Executive Directors are asked to note and approve the contents of the
report.
Catherine Stoddart
Chief Nurse
Report prepared by:
Caroline Heason, Safeguarding Adults and Patient Services Manager
Rachel Taylor, Public Engagement Manager
January 2015
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Appendix 1: NHS Trusts in England with the fewest complaints, compared to OUH
Trust, April 2013 – September 2014
Complaints made to
trust
Enquiries received by
PHSO
Enquiries accepted for
investigation by PHSO
Investigations fully or
partly upheld
Enquiries per 100
complaints to trust
Investigations per 100
written complaints to
trust
Enquiries per 10,000
clinical incidents
Investigations per
100,000 clinical
incidents
Total number of clinical
incidents recorded by
trust
Royal National Hospital
For Rheumatic
Diseases NHS
Foundation Trust
12
2
0
0
16.7
0.0
2.32
0
8607
The Clatterbridge
Cancer Centre NHS
Foundation Trust
19
2
2
0
10.5
10.5
1.42
14.19
14092
Papworth Hospital NHS
Foundation Trust
48
9
2
0
18.8
4.2
2.09
4.63
43165
Liverpool Heart and
Chest Hospital NHS
Foundation Trust
59
11
4
0
18.6
7
4.75
17.29
23141
Royal Brompton and
Harefield NHS
Foundation Trust
65
14
4
2
21.5
6
2.66
7.59
52686
Oxford University
Hospitals
890
67
13
2
7.5
1.5
1.76
3.41
381294
Table 1: A comparison of OUH with the trusts with the fewest complaints comparison Source: PHSO
TB2015.08 PHSO Complaints report
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NHS Trusts in England with the fewest complaints compared
to OUH Trust: April 2013 – September 2014
1000
900
800
700
600
500
400
300
200
100
0
890
12
19
48
59
65
Royal
The
Papworth
Liverpool
Royal
Oxford
National Clatterbridge Hospital NHS Heart and
Brompton University
Hospital For
Cancer
Foundation
Chest
and Harefield Hospitals
Hospital NHS
NHS
Rheumatic Centre NHS
Trust
Diseases NHS Foundation
Foundation Foundation
Foundation
Trust
Trust
Trust
Trust
Chart 1: A comparison of OUH with the trusts with the fewest complaints comparison Source: PHSO
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Appendix 2: NHS Trusts in England with the fewest PHSO upheld complaints,
compared to OUH Trust, April 2013 – September 2014
Total number of
clinical
incidents
recorded by
trust
Investigations
per 100,000
clinical
Enquiries per
10,000 clinical
incidents
Investigations
per 100 written
complaints to
Enquiries per
100 complaints
to trust
Investigations
fully or partly
upheld by PHSO
fully or partly
Enquiries
accepted for
investigation
Enquiries
received
Complaints
made to trust
Royal National Hospital
For Rheumatic
Diseases NHS
Foundation Trust
The Clatterbridge
Cancer Centre NHS
Foundation Trust
Papworth Hospital NHS
Foundation Trust
The Christie NHS
Foundation Trust
Queen Victoria Hospital
NHS Foundation Trust
The Royal National
Orthopaedic Hospital
NHS Foundation Trust
The Walton Centre
NHS Foundation Trust
Taunton and Somerset
NHS Foundation Trust
South Warwickshire
NHS Foundation Trust
South Tyneside NHS
Foundation Trust
Salford Royal NHS
Foundation Trust
Royal Berkshire NHS
Foundation Trust
The Hillingdon
Hospitals NHS
Foundation Trust
Royal Surrey County
NHS Foundation Trust
Poole Hospital NHS
Foundation Trust
Surrey and Sussex
Healthcare Trust
Western Sussex
Hospitals NHS
Foundation Trust
University Hospital of
South Manchester NHS
Foundation Trust
12
2
0
0
16.
7
0.0
2.32
0
8607
19
2
2
0
10.
5
10.5
1.42
14.1
9
14092
48
9
2
0
4.2
2.09
4.63
43165
66
4
2
0
18.
8
6.1
3.0
1.20
6.02
33201
80
3
0
0
3.8
0.0
0.49
0.00
61269
14
6
9
3
0
6.2
2.1
2.65
8.83
33979
18
0
18
2
19
0
22
1
38
3
41
1
42
3
12
1
0
6.7
0.6
2.25
1.87
53430
33
5
0
2.7
2.06
3.13
159942
15
7
0
18.
1
7.9
3.7
1.39
6.49
107903
21
6
0
9.5
2.7
3.17
9.07
66162
26
4
0
6.8
1.0
1.32
2.03
197375
31
7
0
7.5
1.7
1.33
3.01
232909
54
12
0
12.
8
2.8
4.57
10.1
6
118077
43
0
46
7
48
2
52
2
27
3
0
6.3
0.7
1.59
1.77
169588
15
1
0
3.2
0.2
1.15
0.77
130412
37
5
0
7.7
1.0
2.27
3.06
163321
65
14
0
12.
5
2.7
2.86
6.15
227564
62
2
52
11
0
8.4
1.8
3.28
6.93
158670
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Investigations
per 100,000
clinical
Total number of
clinical
incidents
recorded by
trust
Enquiries per
10,000 clinical
incidents
Investigations
per 100 written
complaints to
Enquiries per
100 complaints
to trust
Investigations
fully or partly
upheld by PHSO
fully or partly
Enquiries
accepted for
investigation
69
2
89
0
47
13
0
6.8
1.9
1.74
4.82
269930
67
13
2
7.5
1.5
1.76
3.41
381294
Enquiries
received
Complaints
made to trust
Portsmouth Hospitals
NHS Trust
Oxford University
Hospitals
TB2015.08
Table 2: The trusts whom have had the fewest complaints upheld by the PHSO
Source: Complaints about acute trusts 2013-14 and Q1, Q2 2014-15 Parliamentary and Health Service Ombudsman (PHSO)
TB2015.08 PHSO Complaints report
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Appendix 3: NHS Trusts in England with the most complaints, compared to OUH
Trust, April 2013 – September 2014
13
2
7.5
1.5
Brighton and Sussex
University Hospitals NHS
Trust
Central Manchester University
Hospitals NHS Foundation
Trust
Colchester Hospital University
NHS Foundation Trust
Mid Yorkshire Hospitals NHS
Trust
Barts Health NHS Trust
112
6
81
20
3
7.2
1.8
119
2
120
17
2
10.
1
125
7
140
5
245
1
66
18
5
67
15
289
43
Total number of
clinical incidents
recorded by trust
67
Investigations per
100,000 clinical
incidents
890
Enquiries per 10,000
clinical incidents
Investigations per 100
written complaints to
trust
Enquiries per 100
complaints to trust
Investigations fully or
partly upheld by
PHSO
Enquiries accepted
for investigation by
PHSO
Enquiries received by
PHSO
Complaints made to
trust
Oxford University Hospitals
1.7
6
3.6
4
3.41
1.4
3.1
3
4.44
38299
9
5.3
1.4
9.96
1
4.8
1.1
12
11.
8
1.8
3.6
5
2.3
3
4.9
9
18081
3
28726
7
57927
1
9.00
5.22
7.42
38129
4
22227
6
Table 3: The five trusts who have received the highest number of complaints Source PHSO
NHS Trusts in England with the most complaints , compared to OUH
Trust: April 2013 – September 2014
3000
2451
2500
2000
1500
1000
890
1126
1192
1257
1405
500
0
Oxford
University
Hospitals
Brighton and
Central
Colchester Mid Yorkshire Barts Health
Sussex
Manchester
Hospital
Hospitals NHS NHS Trust
University
University University NHS
Trust
Hospitals NHS Hospitals NHS Foundation
Trust
Foundation
Trust
Trust
Chart 2: The five trusts who have received the highest number of complaints Source PHSO
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Appendix 4: PHSO data in the Thames Valley area acute Trusts’ complaints, April
2013 – September 2014
Enquiries per 10,000
clinical incidents
1
8.6
0.8
1.97
1.80
167104
411
31
7
0
7.5
1.7
1.33
3.01
232909
548
73
17
2
13.3
3.1
5.10
11.87
143223
Buckinghamshire
Healthcare NHS Trust
613
52
9
4
8.5
1.5
2.61
4.51
199365
Oxford University
Hospitals
890
67
13
2
7.5
1.5
1.76
3.41
381294
Total number of
clinical incidents
recorded by trust
3
Investigations per
100,000 clinical
incidents
33
Investigations per
100 written
complaints to trust
382
Enquiries per 100
complaints to trust
Enquiries accepted
for investigation by
PHSO
Enquiries received
by PHSO
Investigations fully or
partly upheld by
PHSO
Complaints made to
trust
Frimley Park Hospital
NHS Foundation Trust
Royal Berkshire NHS
Foundation Trust
Heatherwood and
Wexham Park Hospitals
NHS Foundation Trust
Table 4: Thames Valley Complaints Comparison Source: PHSO
Thames Valley Trusts: Enquiries Received by the
PHSO
Thames Valley Trusts: Numbers of Complaints
1000
900
800
700
600
500
400
300
200
100
0
890
382
411
548
613
80
70
60
50
40
30
20
10
0
67
73
52
31
33
Chart 3: Thames Valley Trusts:
Chart 4: Thames Valley Trusts:
Numbers of Complaints: Source PHSO
Enquires received by the PHSO: Source PHSO
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18
16
14
12
10
8
6
4
2
0
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Thames Valley Trusts: Enquiries accepted for
investigation by the PHSO
13
4
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
9
7
Thames Valley Trust Investigations fully or
partly upheld by the PHSO
17
3
Chart 5: Enquiries accepted for investigation by the PHSO
2
1
0
Chart 6: Investigations fully or partly upheld by the PHSO
Thames Valley Trusts: PHSO Enquiries per 100
complaints to trust
Thames Valley Trusts: Investigations per 100
written complaints to trust
13.3
14
12
10
8
6
4
2
0
7.5
7.5
8.5
8.6
1.5
1.5
1.7
0.8
Thames Valley Trusts: PHSO investigations per
100,000 clinical activity
5.1
1.33
3.1
t
Thames Valley Trusts: PHSO enquiries per 10,000
clinical activity
6
5
4
3
2
1
0
3.5
3
2.5
2
1.5
1
0.5
0
Chart 8: PHSO: Investigations per 100 written complaints
Chart 7: PHSO Enquiries per 100 complaints
t t
2
1.76
1.97
2.61
Chart 9: PHSO Enquiries per 10,000 clinical activity
TB2015.08 PHSO Complaints report
14
12
10
8
6
4
2
0
11.87
1.8
3.01
3.41
4.51
Chart 10: PHSO investigations per 100,000 clinical activity
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Appendix 5: PHSO data on Shelford Group Trust Complaints, April 2013 –
September 2014
Enquiries received by
PHSO
Enquiries accepted for
investigation by PHSO
Investigations fully or
partly upheld by PHSO
Enquiries per 100
complaints to trust
Investigations per
100,Y000 clinical
incidents
Enquiries per 10,000
clinical incidents
Total number of
clinical incidents
recorded by trust
465
68
19
2
14.6
4.1
2.65
7.40
256771
University Hospitals Birmingham
NHS Foundation Trust
664
70
14
2
10.5
2.1
3.21
6.43
217769
The Newcastle Upon Tyne Hospitals
NHS Foundation Trust
702
97
29
3
13.8
4
1.95
5.83
497003
University College London Hospitals
NHS Foundation Trust
788
108
19
2
13.7
2.4
3.12
5.48
346409
Imperial College Healthcare NHS
Trust
884
106
16
2
12.0
1.8
2.79
4.20
380584
Oxford University Hospitals
890
67
13
2
7.5
1.5
1.76
3.41
381294
Guy's and St Thomas'
926
93
17
4
10.0
1.8
2.74
5.01
339436
Sheffield Teaching Hospitals NHS
Foundation Trust
949
101
19
1
10.6
2.0
2.20
4.13
459675
King's College Hospital NHS
Foundation Trust
980
178
24
5
18.2
2.4
4.80
6.47
370820
Central Manchester University
Hospitals
119
2
120
17
2
10.1
1.4
3.13
4.44
382999
Investigations per
100Y written
complaints to trust
Complaints made to
trust
Cambridge University Hospitals
Table 5: Shelford Complaints Comparison Source: PHSO
Shelford Group Trusts: Numbers of Complaints
1400
1192
1200
980
884 890 926 949
1000
702 788
664
800
600 465
400
200
0
Chart 11: Numbers of complaints
TB2015.08 PHSO Complaints report
Shelford Group Trusts: PHSO enquiries
200
180
160
140
120
100
80
60
40
20
0
67
68
70
93
108
97 101 106
Chart 12: PHSO enquiries
Page 15 of 29
178
120
Oxford University Hospitals
TB2015.08
Shelford Group Trusts: Enquiries accepted for
Investigation by the PHSO
Shelford Group Trusts: Investigations fully or
partly upheld by the PHSO
6
35
29
30
24
25
20
15
13
14
16
17
17
19
19
4
4
19
3
3
2
2
10
5
1
0
0
Chart 13: Enquiries accepted for Investigation by the PHSO
Shelford Group Trusts: Enquiries per 100 complaints
to trust
20
18
16
14
12
10
8
6
4
2
0
5
5
10 10.1 10.5 10.6
12
13.7 13.8
7.5
Chart 15: Enquiries per 100 complaints to Trust
TB2015.08 PHSO Complaints report
2
2
2
2
1
Chart 14: Investigations fully or partly upheld by the PSHO
Shelford Group Trusts: Investigations per 100
written complaints to trust
18.2
14.6
2
4.5
4 4.1
4
3.5
3
2.5
2
1.5
1.4 1.5
1.8 1.8
2 2.1
2.4 2.4
1
0.5
0
Chart 16: Investigations per 100 written complaints to Trust
Page 16 of 29
Oxford University Hospitals
Shelford Group Trusts: Investigations per 100,000
clinical incidents
TB2015.08
Shelford Group Trusts: Enquiries per 10,000
clinical incidents
6
4.8
5
7.4
8
6.47
6.43
7
5.48 5.83
6
5.01
4.13 4.2 4.44
5
4 3.41
3
2
1
0
Chart 17: Investigations per 100,000 clinical incidents
TB2015.08 PHSO Complaints report
4
3
2
2.2
1.761.95
3.123.133.21
2.652.742.79
1
0
Chart 18: Enquiries per 10,000 clinical incidents
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Oxford University Hospitals
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Appendix 6: Trusts also with 2 PHSO investigations upheld
Complaints made to trust
Enquiries received by
PSHO
Enquiries accepted for
investigation by PSHO
Investigations fully or
partly upheld by PSHO
Enquiries per 100
complaints to trust by
PHSO
Investigations per 100
written complaints to trust
Enquiries per 10,000
clinical incidents
Investigations per 100,000
clinical incidents
Total number of clinical
incidents recorded by
trust
Barnsley Hospital NHS
Foundation Trust
279
19
3
2
6.8
1.1
1.66
2.62
114526
Birmingham Children's
Hospital NHS Foundation
Trust
110
20
2
2
18.2
1.8
2.64
2.64
75868
Calderdale and Huddersfield
NHS Foundation Trust
564
63
7
2
11.2
1.2
2.86
3.17
220513
Cambridge University
Hospitals NHS Foundation
Trust
465
68
19
2
14.6
4.1
2.65
7.40
256771
Central Manchester
University Hospitals NHS
Foundation Trust
119
2
120
17
2
10.1
1.4
3.13
4.44
382999
Chelsea and Westminster
Hospital NHS Foundation
Trust
356
40
9
2
11.2
2.5
2.99
6.72
133910
Chesterfield Royal Hospital
NHS Foundation Trust
805
32
9
2
4.0
1.1
2.27
6.40
140706
Croydon Health Services
NHS Trust
705
62
5
2
8.8
0.7
4.62
3.73
134184
Derby Hospitals NHS
Foundation Trust
681
48
10
2
7.0
1.5
1.94
4.03
247954
Ealing Hospital NHS Trust
223
21
1
2
9.4
0.4
2.49
1.19
84381
East Sussex Healthcare NHS
Trust
521
57
17
2
10.9
3.3
2.96
8.83
192541
George Eliot Hospital NHS
Trust
326
28
7
2
8.6
2.1
3.42
8.56
81778
Great Ormond Street
Hospital For Children NHS
Foundation Trust
123
23
6
2
18.7
5
3.30
8.61
69688
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Oxford University Hospitals
TB2015.08
Complaints made to trust
Enquiries received by
PSHO
Enquiries accepted for
investigation by PSHO
Investigations fully or
partly upheld by PSHO
Enquiries per 100
complaints to trust by
PHSO
Investigations per 100
written complaints to trust
Enquiries per 10,000
clinical incidents
Investigations per 100,000
clinical incidents
Total number of clinical
incidents recorded by
trust
Harrogate and District NHS
Foundation Trust
215
36
8
2
16.7
3.7
3.67
8.15
98122
Heatherwood and Wexham
Park Hospitals NHS
Foundation Trust
548
73
17
2
13.3
3.1
5.1
0
11.87
143223
Hull and East Yorkshire
Hospitals NHS Trust
789
51
7
2
6.5
0.9
1.72
2.36
297217
Imperial College Healthcare
NHS Trust
884
106
16
2
12.0
1.8
2.79
4.20
380584
James Paget University
Hospitals NHS Foundation
Trust
266
30
9
2
11.3
3.4
2.42
7.27
123824
Mid Cheshire Hospitals NHS
Foundation Trust
228
27
3
2
11.8
1.3
1.87
2.08
144206
Milton Keynes Hospital NHS
Foundation Trust
395
38
6
2
9.6
1.5
3.05
4.82
124482
North Bristol NHS Trust
755
92
15
2
12.2
2.0
4.49
7.32
205052
North Cumbria University
Hospitals NHS Trust
365
43
9
2
11.8
2.5
2.81
5.89
152919
North Tees and Hartlepool
NHS Foundation Trust
319
34
15
2
10.7
5
2.65
11.68
128479
Northern Lincolnshire and
Goole NHS Foundation Trust
537
62
4
2
11.5
0.7
2.97
1.91
209025
Oxford University Hospitals
NHS Trust
890
67
13
2
7.5
1.5
1.76
3.41
381294
Peterborough and Stamford
Hospitals NHS Foundation
Trust
502
39
6
2
7.8
1.2
2.16
3.33
180165
Plymouth Hospitals NHS
Trust
860
64
20
2
7.4
2.3
2.84
8.86
225693
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TB2015.08
Complaints made to trust
Enquiries received by
PSHO
Enquiries accepted for
investigation by PSHO
Investigations fully or
partly upheld by PSHO
Enquiries per 100
complaints to trust by
PHSO
Investigations per 100
written complaints to trust
Enquiries per 10,000
clinical incidents
Investigations per 100,000
clinical incidents
Total number of clinical
incidents recorded by
trust
Royal Brompton and
Harefield NHS Foundation
Trust
65
14
4
2
21.5
6
2.66
7.59
52686
Sandwell and West
Birmingham Hospitals NHS
Trust
663
90
12
2
13.6
1.8
3.36
4.48
267644
Shrewsbury and Telford
Hospital NHS Trust
444
47
17
2
10.6
3.8
2.08
7.51
226374
St Helens and Knowsley
Hospitals NHS Trust
325
25
6
2
7.7
1.8
1.38
3.31
181283
Tameside Hospital NHS
Foundation Trust
412
34
5
2
8.3
1.2
2.91
4.27
116985
The Queen Elizabeth
Hospital, King's Lynn. NHS
Foundation Trust
569
35
6
2
6.2
1.1
2.57
4.41
136201
The Royal Wolverhampton
NHS Trust
402
69
14
2
17.2
3.5
2.85
5.79
241810
University College London
Hospitals NHS Foundation
Trust
788
108
19
2
13.7
2.4
3.12
5.48
346409
University Hospitals
Birmingham NHS Foundation
Trust
664
70
14
2
10.5
2.1
3.21
6.43
217769
University Hospitals Of
Leicester NHS Trust
203
4
101
19
2
5.0
0.9
2.51
4.73
401821
Warrington and Halton
Hospitals NHS Foundation
Trust
422
66
15
2
15.6
3.6
4.77
10.85
138243
West Hertfordshire Hospitals
NHS Trust
619
49
8
2
7.9
1.3
2.84
4.63
172640
Table 6: Trusts with two PHSO investigations upheld source: PHSO
TB2015.08 PHSO Complaints report
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Oxford University Hospitals
TB2015.08
Appendix 7: The Trusts with similar number of complaints (the range is between
860 and 895 complaints)
Enquiries per 10,000
clinical incidents
Investigations per 100,000
clinical incidents
2
7.4
2.3
2.84
8.86
225693
868
84
18
8
9.7
2.1
4.63
9.91
181593
883
43
17
5
4.9
1.9
2.32
9.16
185520
884
106
16
2
12.0
1.8
2.79
4.20
380584
890
67
13
2
7.5
1.5
1.76
3.41
381294
East Kent Hospitals
University NHS
Foundation Trust
895
102
25
6
11.4
2.8
2.69
6.60
378869
Total number of clinical
incidents recorded by
trust
Investigations per 100
written complaints to
trust
20
Enquiries per 100
complaints to trust
Enquiries accepted for
investigation by PHSO
64
Investigations
fully or partly upheld by
PHSO
Enquiries received by
PHSO
860
Complaints made to trust
Plymouth Hospitals NHS
Trust
East and North
Hertfordshire NHS Trust
Southend University
Hospital NHS Foundation
Trust
Imperial College
Healthcare NHS Trust
Oxford University
Hospitals NHS Trust
Table 7: Trusts with a similar number of complaints source: PHSO
TB2015.08 PHSO Complaints report
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Oxford University Hospitals
TB2015.08
Enquiries received for Trusts with
similar numbers of complaints
120
102 106
100
84
80
60
Trusts with similar numbers of
complaints
64
900
890
883 884
880
67
870
43
40
860
20
850
0
840
890
895
868
860
Chart 19: Enquiries received for Trusts with
Chart 20: Trusts with similar numbers of
similar numbers of complaints
complaints
Enquiries accepted for investigation
for Trusts with similar numbers of
complaints
30
25
25
20
15
13
16
17
18
20
10
5
0
Investigations fully or partly upheld
for Trusts with similar numbers of
complaints
9
8
7
6
5
4
3
2
1
0
8
5
2
2
6
2
Chart 21: Enquiries for investigation for
Chart 22: Investigations fully or partly upheld
Trusts with similar numbers of complaints
for Trusts with similar numbers of complaints
TB2015.08 PHSO Complaints report
Page 22 of 29
Oxford University Hospitals
TB2015.08
Enquiries per 100 complaints for
Trusts with similar numbers of
complaints
14
11.4 12
12
9.7
10
2.5
1.5
4.9
2.8
3
2
7.4 7.5
8
6
Investigations per 100 written
complaints to Trusts with similar
numbers of complaints
1.8
1.5
1.9
2.1
2.3
1
4
2
0.5
0
0
Chart 23: Enquiries per 100 complaints for
Chart 24: Investigations per 100 written
Trusts with similar numbers of complaints
complaints to Trusts with similar numbers of
complaints
Enquiries per 10,000 clinical
incidents for Trusts with similar
numbers of complaints
5
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
Investigations per 100,000 clinical
incidents for Trusts with similar
numbers of complaints
4.63
12
8.86 9.16
10
1.76
2.32
2.69 2.79 2.84
8
6
4
9.91
6.6
3.41
4.2
2
0
Chart 25: Enquiries per 10,000 clinical
Chart 26: Investigations per 100,000 clinical
incidents for Trusts with similar
incidents for Trusts with similar numbers of
numbers of complaints
complaints
TB2015.08 PHSO Complaints report
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Oxford University Hospitals
TB2015.08
Appendix 8: Trusts with the same level of clinical activity as OUH (The range is
between 370820 and 382999)
Enquiries accepted for
investigation by PHSO
Investigations fully or
partly upheld by PHSO
Enquiries per 100
complaints to trust
Investigations per 100
written complaints to
trust
178
24
5
18.2
2.4
4.80
6.47
370820
Pennine Acute Hospitals
NHS Trust
813
112
31
11
13.8
3.8
2.96
8.20
378255
East Kent Hospitals
University NHS
Foundation Trust
895
102
25
6
11.4
2.8
2.69
6.60
378869
Leeds Teaching Hospitals
NHS Trust
1066
118
15
3
11.1
1.4
3.10
3.94
380315
Imperial College
Healthcare NHS Trust
884
106
16
2
12.0
1.8
2.79
4.20
380584
Oxford University
Hospitals NHS Trust
890
67
13
2
7.5
1.5
1.76
3.41
381294
Central Manchester
University Hospitals NHS
Foundation Trust
1192
120
17
2
10.1
1.4
3.13
4.44
382999
Total number of
clinical incidents
recorded by trust
Enquiries received by
PHSO
980
Investigations per
100,00 clinical
incidents
Enquiries per 10,000
clinical incidents
Complaints made to
trust
King's College Hospital
NHS Foundation Trust
Table 8: Trusts with the same level of clinical activity as OUH source: PHSO
TB2015.08 PHSO Complaints report
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Oxford University Hospitals
TB2015.08
Total number of clinical episodes
recorded by Trust (in thousands, to
nearest)
384
382
380
378
376
374
372
370
368
366
364
378
379
380
Number of complaints to Trusts with
similar activity levels
383
381 381
1400
1200
1000
800
813
884 890 895
980
1192
1066
600
371
400
200
0
Chart 27: Total Number of clinical episodes
Chart 28: Number of complaints to Trusts with
recorded by Trust (in thousands, to nearest)
similar activity levels
Enquiries received for Trusts with
similar activity levels
Enquiries accepted for investigation
for Trusts with similar activity levels
200
180
160
140
120
100
80
60
40
20
0
178
35
31
30
112 118 120
102 106
67
24 25
25
20
15
13
17
15 16
10
5
0
Chart 29: Enquiries received for Trusts with
Chart 30: Enquiries accepted for investigation
similar activity levels
for Trusts with similar activity levels
TB2015.08 PHSO Complaints report
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Oxford University Hospitals
TB2015.08
Investigations fully or partly upheld
for Trusts with similar activity levels
Enquiries per 100 complaints for
Trusts with similar activity levels
11
12
10
8
5
6
4
2
2
2
2
6
3
0
20
18
16
14
12
10
8
6
4
2
0
18.2
10.1
12
11.1 11.4
13.8
7.5
Chart 31: Investigations fully or partly upheld
Chart 32: Enquiries per 100 complaints for
for Trusts with similar activity levels
Trusts with similar activity levels
Investigations per 100 written
complaints to Trusts with similar
activity levels
Enquiries per 10,000 clinical
incidents for Trusts with similar
activity levels
4
3.5
3
2.5
2
1.5
1
0.5
0
3.8
2.4
1.4 1.4 1.5
2.8
1.8
6
4.8
5
4
3
2
2.69 2.79 2.96
3.1 3.13
1.76
1
0
Chart 33: Investigations per 100 written
Chart 34: Enquiries per 10,000 clinical
complaints to Trusts with similar activity
incidents for Trusts with similar activity levels
levels
TB2015.08 PHSO Complaints report
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Oxford University Hospitals
TB2015.08
Investigations per 100,000 clinical incidents for Trusts with similar
activity levels
9
8
7
6
5
4
3
2
1
0
Oxford University Hospitals
NHS Trust
Leeds Teaching Hospitals NHS
Trust
Imperial College Healthcare
NHS Trust
Central Manchester University
Hospitals NHS Foundation
Trust
King's College Hospital NHS
Foundation Trust
Chart 35: Investigations per 100,000 clinical
incidents for Trusts with similar activity levels
TB2015.08 PHSO Complaints report
Page 27 of 29
Oxford University Hospitals
TB2015.08
Appendix 9: Activity undertaken by the Trust in response to the PHSO’s questions
PHSO question
Activity undertaken by the Trust.
Why are some trusts more 1.
successful than others at
resolving
complaints
locally?
OUH Trust’s complaints algorithm has been completed and
presented at the Trust Management Executive (TME) and will be
launched at the Chief Nurses Grand Round in February 2015. This
will be embedded throughout the Trust using the ‘Model for
Improvement’ approach.
2.
Complaints investigation and resolution training by Bond Solon LLP
for 40 members of staff during January and February 2015.
3.
OUH Trust reports on the number of reopened complaints each
month. The Board Quality Report includes the trend of reopened
complaints from May 2014 to November 2014.
4.
The Patient Experience Team have produced a Trust wide level
dashboard. This details all the patient experience information
including Friends and Family Test (FFT), complaints, PALS and
compliments. This is supported by a narrative. The team has also
developed a divisional based patient experience report. It is
envisaged that this report will be produced on a quarterly basis and
facilitate a more productive analysis of patient experience at the
divisional governance groups and the quarterly divisional
performance reviews. This style of report will be presented to the
Executive Directors, TME and to Quality Committee in February
2015.
5.
OUH Trust is developing an electronic FFT methodology and this will
be piloted across Outpatients, Day Case and either the Emergency
Department or Maternity Services. This methodology yields a higher
response rate with real time electronic reporting; thus enabling ward
and department teams to review their patient experience feedback
within a very short timescale. This enables team leaders to rectify
and resolve concerns early on. This approach will not eradicate
complaints but does give teams a more timely gauge of patient and
carer experience.
6.
The complaints team are reviewing the complaints subject codes in
conjunction with the Organisational Development Team. This work
will also include a complaints coding using the Trust values. It is
envisaged the new coding will be distributed for consultation on the
8 December 2014.
What can account for the 1.
15-fold variation in how
trusts handle complaints?
OUH Trust has benchmarked the complaints algorithm and
complaints codes against the Shelford group and other national
acute Trusts. This has enabled the Trust to learn from best practice.
2.
OUH Trust is a member of the National Complaints Network which
shares good practice.
3.
OUH Trust has joined the National Complaints Benchmark
Satisfaction Survey. This is administered by the Patients Association
and the national benchmarking team. Feedback from patients
indicates that they are reluctant to give their views to the Trust
regarding the coordination and resolution of their complaint and
prefer to give their views to an independent organisation.
TB2015.08 PHSO Complaints report
Page 28 of 29
Oxford University Hospitals
PHSO question
TB2015.08
Activity undertaken by the Trust.
Why are some trusts 11 1.
times more likely to have
their
complaints
investigated
by
[the
PHSO] than others, even
after accounting for their
activity levels?
The complaints algorithm, complaints training and PALS escalation
and resolution model is designed to resolve concerns complaints
early and on the first time of complaint submission. The Trust
monitors the number of reopened complaints in an active drive to
reduce the number, as this is an indicator of the satisfaction with the
complaints investigation and resolution process.
And
why
are 1.
communication, diagnosis,
and clinical care and
treatment
consistently
ranked as the top three
issues people come to the
PHSO to complain about?
The reasons for complaints to the Trust echo those of the PHSO’s
findings. There are two important factors in reducing the number of
complaints highlighted by the PHSO.
a.
Accurate recording which facilitates the Trust and divisions to
analyse the reasons for their complaints. As discussed above,
the Trust is reviewing and updating the complaints codes. This
includes the inclusion of the Trust’s six values.
b.
The development of programmes to reduce the complaints of
this nature. One element of this is the Compassionate Care
Programme. This has seven elements, some of which have
already been described;
•
The bespoke Compassionate Care course developed by
the Trust’s Values into Action Project Manager with VBA
consulting. The methodology used is ‘train the trainer’, to
ensure sustainability. This will augment and complement
the Values Based Interviewing and Values Based
Conversations projects.
•
The externally delivered customer care training for
Outpatients staff utilising the Trust’s outpatients’
standards.
•
Complaints Investigator Training to deliver a patient
centred complaints service.
•
Complaints
satisfaction
surveys
and
national
benchmarking with NHS Trusts in conjunction with NHS
Benchmarking and the Patients Association
•
Chief Nurse’s Complaints Review: This has incorporated
the development of a comprehensive algorithm to guide
the organisation in the coordination, administration,
investigation and learning from complaints. It incorporates
key learning from the Francis Enquiry and Berwick
Report:
•
Development of a Trust DVD/video on customer care and
the Trust’s values.
Table 9: The work undertaken by the Trust to answer the questions posed by the PHSOs
TB2015.08 PHSO Complaints report
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