David Kerr: Complaints via social media

David KerrSocial media seems to be the modern equivalent of the stocks. The main objective of the stocks was public humiliation. Nowadays, any member of the public can use social media to highlight grievances they might have against companies, organisations, and institutions and post them for all to see and comment on.

Our current political masters are very keen to persuade clinicians to consider patients as customers rather than passive recipients of care. If this is the case then customers need “great” customer service. Until fairly recently, the process of registering a complaint against a utility or other large private sector company had become a health hazard in terms of potential for a rise in systolic blood pressure. Despite companies employing people in their customer service departments it proved almost impossible to speak to one directly. The technology used for customer service was especially frustrating with the perpetual need to choose “option 2 followed by the pound sign,” and the ubiquitous but bland and unhelpful email response that “we value your custom,” and “thank you for bringing this to our attention,” without any hint of apology or a possibility of change. In later years this has been followed by the outsourcing of customer care to call centers in other countries, which are manned by incredibly polite and patient individuals adept at reading pre-prepared answers to FAQ’s. On a positive side these types of approach to customer care remained more-or-less hidden from public view.

This has all changed with the exponential growth in social media. In a recent article in the Harvard Business Review, Michael Schrage highlighted the new form of public humiliation available through social media sites such as twitter. A tweeted complaint moves much faster to the top of the customer service totem poll leaving any carefully penned (and polite) letter gathering dust. Schrage argues that this encourages bad behaviour; he (or she) who speaks loudest, especially in public on a social media site, gains the most – so called “power complainers.” The problem for those in receipt of a tweeted complaint is the potential for the response to develop a viral life of its own with the actual cause of the complaint being of secondary consequence.

The UK healthcare system actually seems rather good at handling complaints. The NHS complaints procedure is a statutorily based system and all NHS organisations are required to operate the procedure. In 2010-2011 almost 150,000 complaints were received. The NHS constitution states that everyone should have any complaint dealt with efficiently with a “proper” investigation and that the outcomes from the complaint should be provided. If this is not to the complainants liking then further investigation can take place at the level of the Health Service Ombudsman or even the Judiciary. Each NHS hospital is also obliged to make details of the number of complaints available and this is an indirect measure of a hospital’s performance. Somehow it is difficult to imagine BT or British Gas adopting a similar approach!

The great unknown will be what happens when patients-customers start to use social media to complain? How many NHS hospital “patient advice and liaison services” are able to pick up an adverse tweet or a grumbling Facebook comment? The Guardian newspaper reckons there are around 134 NHS organisations on Twitter–which means that there are very many who still do not have a social media presence.  These are vulnerable to complaints going viral before they realise this! Perhaps another reason for the NHS to “get social?”

David Kerr wears many hats, sometimes at the same time – Diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. He has received consultancy fees and honoraria for participating in advisory boards for Medtronic, Roche, Lifescan, and Abbott Diabetes Care. He also holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.

  • John Dale

    David is right. It is important for all NHS establishments to have an ear out on the new and emerging social media channels for complaints. A complaint not properly dealt with can very soon mushroom taking the reputation of the Trust with it. Unfortunately the latest NHS Procedure for complaints failed to recognise this emerging force and while some organisation have picked it up it has often been on the throughtfulness of the IT or Web staff rather than a concerted effort of the Trust Board.

    One wonders under the forthcoming arrangements how individual surgeries are going to have the time and effort to monitor these systems and if there will be somebody somewhere in the ether doing it for them. Perhaps a private company????

  • @joinedU1

    Having been exploring NHS Complaints for over 6 years since Healthcare Commission offered to “take your complaint outside of system” WHY? We refused and challenged all to respolve complaint within process it had in place for everyone!
    In June 2011 The Health Select Committee found “NHS Complaints system is not working” and “role of PHSO needs a complete overhaul inf to provide an effective appeals process for complaints” http://www.parliament.uk/busin
    Then NOTHING!
    We need to have our voices heard and we will find a way!

  • @JoinedU1

    I have presented this #1-6
    to the Health Select Committee when I gave evidence and have heard no more . I
    agree complaints need to be independent of NHS.


    I now believe SMART(er) #7
    must be employed across all services for a less fragmented approach. …see


    Possible solution to ineffective NHS
    Complaints service


    1.   All complaints on avoidable deaths, across all
    services , must be ‘truly’ independently investigated.


    on Advocacy experience, Independent Complaints Advocacy Service (ICAS) could oversee
    the complaints process.


    would come from a ‘complaints pool’ funded by all Trusts.


    4  Trusts who failed to resolve the complaint at
    local level aka “local resolution” must pay substantially more into the pool.
    This would have the added benefit of saving money (as we would no longer  need the ineffective PHSO process.  Local resolution would mean not escalating
    complaints to the PHSO.


    In fact the £34m that the PHSO service currently costs the tax payer annually,
    may not be needed as the PHSO service only investigates less than 1.5% of
    complaints, has never  investigated a
    reconsidered complaint, despite keeping it in

     ‘reconsideration’ for up to a year.   


    All investigation reports must be aligned to show where service failures have not
    adhered to National Service Framework, local and national policy and NICE guidance.


    7. Ideally across all services, SMART(er) targets replace random
    fundamentally flawed ones:

    Specific (what is it?)

    (what is needed?)

    (Can this be done?)

    Realistic (What is the learning from this?)

    Timebound (By when, what timeframe?)

    Only then (Evaluate and Review) for continuous improvement.