The Parliamentary and Health Service Ombudsman partners with Totara to improve public service complaints handling

The Parliamentary and Health Service Ombudsman (PHSO) is an independent organisation in the UK that investigates complaints about public services provided by the National Health Service (NHS) and UK government departments and agencies.

The PHSO is responsible for making impartial and final decisions on complaints that remain unresolved by the NHS, UK government departments, and other public organisations. PHSO looks into complaints fairly and this service is free for everyone.Their goal was to assist organisations in achieving best practice in handling complaints. In pursuit of this, they conducted interviews with complaint handlers employed in the NHS and UK Government departments and examined more than 300 complaints regarding complaint handling. Their research revealed several critical findings such as:

• the lack of consistent guidance or training for staff responsible for managing complaints
• the negative perception of complaints by public bodies
• the inability of the current complaints system to meet the public’s needs and serve as a valuable learning opportunity for improving services.

The Challenge

In partnership with the NHS, healthcare regulators, members of the public, and advocacy groups, the PHSO developed a single set of NHS Complaint Standards to address the issues identified.

These standards offer a consistent and comprehensive guide to handling complaints, providing support to frontline NHS staff, and promoting a positive culture that values and learns from feedback.

The NHS Complaint Standards are based on My Expectations, which set out what patients, their families and carers expect to see when making a complaint about health or social care services.

The PHSO published the Complaint Standards, along with a model complaint handling procedure and accompanying guidance for both standards, and launched training for the NHS in March 2023 to help NHS organisations meet these expectations. The next phase of the project will involve complaint handling training for UK government departments.

The PHSO’s aim with Totara is to provide a platform that can offer free complaint standards training to all NHS staff as well as other government departments.

The Solution

The PHSO partnered with Totara Partner Chambury Learning to scope a suitable platform to best meet their complex needs.

The PHSO also needed a platform which could provide spaced learning, in a variety of formats to help cater for different learner preferences, including e-learning, live online, workshops and other self-directed learning functionality. Totara’s ability to link to Microsoft Teams, build in notifications, reminders and feedback notifications meant they could automate much of admin processes to help them provide more learning opportunities to internal and external learners.

The extensive reporting functionality, with the capability to build scheduled reports meant the PHSO could clearly understand activity, engagement and opinions on the training being delivered. It meant they could build reporting to manage learners, encourage feedback and provide a timely service to learners through approving accounts, scheduling training based on interest through the declared interest process, and build statistics to demonstrate value and engagement.

Results

Before offering this training, PSHO’s platform had 600 internal learners. With the introduction of the new training program, they have added 1400 external learners to their platform, expanding their reach beyond the internal team. Their licences are valid for a period of 3 to 6 months, providing them with the potential to engage with approximately 3000 external learners annually.

This project is in its early stages, however, research conducted during the Complaint Standards design phase identified the following challenges which introducing the Standards will overcome:

• The evidence they have heard underlines the real benefit to be gained from sharing insight and best practice to promote a culture of learning and accountability that values complaints as vital insight to help stimulate improvement in services
• Greater consistency was not the only benefit of a central standard among those they spoke to. The head of an NHS Trust complaints team said that unified guidance could empower complaints Teams across the country, giving them greater credibility when they tell their colleagues in clinical departments what good complaint handling looks like.
• The research suggested numerous improvements to the complaints process, including increased transparency and engagement with staff subject to a complaint, and better management of investigations.
• Healthwatch England’s analysis also highlighted that NHS trusts often focus on simply counting the number of complaints, rather than demonstrating learning and improvements made following complaints.
• Staff must also improve at making sure vulnerable patients know their rights and how they can raise a complaint, signposting them to the support available to do this where needed.
• Other research has highlighted similar concerns connected with reporting on complaints. A recent academic study found little evidence that NHS organisations use complaints data to identify priority areas for quality improvement in their services.

Additional statistics can also be found in Appendix B: Online survey results in the ‘Making Complaints Count’ report, which will act as the PHSO’s measurement for success at the end of the project and should result in them receiving less complaints and systemic failings, combined with effective complaint handling will mean patients receive a better level of care and service, reducing the need to escalate concerns to the PHSO.

“We needed to separate internal and external learners, providing a different learner experience for each. Totara’s multi-tenancy functionality was the perfect match for us to be able to achieve this initial requirement. As well as our gated training content, we also required some information to be publicly available. We were able to implement this thanks to Totara’s guest access feature.”

– Shaun France, Learning and Organisation Development Manager