Hospital investigations into complaints of harm 'not good enough'
NHS hospitals have been told to improve the way they undertake serious incident investigations after an official review found a number of failings.
A review by the Parliamentary and Health Service Ombudsman uncovered wide variation in the quality of investigations into complaints about avoidable harm or death. Some hospitals failed to gather adequate evidence, used inconsistent methods or failed adequately to determine the problem and then take action.
In almost three quarters of hospital investigations, organisations found no failings, despite the ombudsman's investigations of the same incidents, in which serious failings came to light.
The review found that in more than half (52%) of cases the investigating clinicians were not independent of the events in question.
Vital opportunities to learn from mistakes and improve care were missed because the lessons from investigations were often not disseminated to frontline staff, the report highlighted.
The health service ombudsman Julie Mellor said: 'Our review found NHS investigations into complaints about avoidable death and harm are simply not good enough. They are not consistent, reliable or transparent, which means too many people are being forced to bring their complaint to us to get it resolved.’
Ms Mellor said she wants the NHS to introduce an accredited training programme for staff carrying out investigations, and guidance on how these investigations should be conducted.
NHS England director for improving patient experience Neil Churchill said: ‘When people make a complaint that they have been seriously harmed, they should expect it to be taken seriously and thoroughly investigated.
‘The best way to improve care is to listen to what patients and their families tell us and learn from past experiences. Good quality, timely and consistent investigations are vital.’
Read the full report here