{"id":44438,"date":"2019-04-11T17:40:06","date_gmt":"2019-04-11T16:40:06","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=44438"},"modified":"2019-05-02T12:58:54","modified_gmt":"2019-05-02T11:58:54","slug":"richard-smith-making-your-complaint-count","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/04\/11\/richard-smith-making-your-complaint-count\/","title":{"rendered":"Richard Smith: Making your complaint count"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/richard_smith_2014.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-33037\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/richard_smith_2014-150x150.jpg\" alt=\"richard_smith_2014\" width=\"148\" height=\"136\" \/><\/a><span style=\"font-weight: 400\">I\u2019m a great complainer. As <a href=\"https:\/\/blogs.bmj.com\/bmj\/2012\/02\/15\/richard-smith-you-have-a-duty-to-complain\/\">I have written before<\/a>, I believe that we have a duty to complain in order to improve services and products.<\/span><span style=\"font-weight: 400\">\u00a0We usually complain after a poor experience, so the benefit is mostly to others; in other words, there is something selfless and even glorious about complaining. Experts on complaints have told me that there are usually 500 dissatisfied people for every one person who takes the trouble to complain. \u201cEvery defect is a treasure,\u201d because it offers a route of improvement. Both the NHS organisations that I have complained to recently say that they welcome complaints, and I have taken them at their word. But how can you increase the chances that your complaint makes a difference?<\/span><\/p>\n<p><span style=\"font-weight: 400\">One way is to persist, making sure that you get a response, and challenge responses that are unsatisfactory. Your complaint should also be specific, detailed, and offer ideas for improvement.<\/span><\/p>\n<p><span style=\"font-weight: 400\">One of my complaints was about multiple miserable experiences in an eye clinic. The next paragraph summarises my complaint, but it\u2019s dull and complex and you might want to skip it unless you are a connoisseur of failures and the ridiculous. The complaint is not about my clinical care but about multiple administrative failures, reflecting the common observation that the NHS has 21<\/span><span style=\"font-weight: 400\">st<\/span><span style=\"font-weight: 400\"> century care embedded in a 19<\/span><span style=\"font-weight: 400\">th<\/span><span style=\"font-weight: 400\"> century unresponsive bureaucracy.<\/span><\/p>\n<p><span style=\"font-weight: 400\">To summarise my complaint: every appointment has been postponed; the clinic has two receptions, and you are not told which to attend; I was called back after an operation for a postoperative clinic that wasn\u2019t happening, and they took two hours to recognise this failure (indeed, I worked it out myself in the end and left); every time I\u2019ve waited about 45 minutes to be seen and spent two hours in the clinic and am seen by staff for about 10 minutes (I don\u2019t think I\u2019m alone in this, which explains why the clinic is so full it\u2019s hard find a seat); boiling hot tea is served by a volunteer in a paper cup (and remember this is a clinic where many people don\u2019t see well); the clinic still has paper notes, and, although I\u2019m not a complicated case, clinicians struggle to find the right page in the notes, and despite being written in my notes nobody seems to know what I have had done until I tell them; and my follow-up operation was marked by the doctor as urgent but that marking was lost until I rang up a month later to see what was happening and was made to feel by the person on the phone as if the failure was my fault.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I sent my complaint with full detail, making clear that there was nothing wrong with my clinical care and that I was complaining in the spirit of offering ideas for improvement. I made suggestions for improvement and pointed out that a family member\u2019s surgical appointments had gone very smoothly, showing that the hospital can do things well.<\/span><\/p>\n<p><span style=\"font-weight: 400\">An acknowledgement told me I would hear in 45 days, which struck me as slow. After 90 days I\u2019d heard nothing, so I emailed the officer who had sent the acknowledgement. She\u2019d left. After I\u2019d emailed another address I received a response that had been sent to me two weeks ago (after about 75 days). For some reason I had never received the response. The officer suggested that it might have gone into my junk file, which prompted me to suggest that they might consider posting the response as well. The cost of the postage would be tiny compared with the cost of generating the response.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The response I have now received is signed by the chief executive of the hospital and covers all my complaints in about 1500 words. The hospital is clearly aware of the problems and is working to improve the flow of patients through the clinic, solve the problem of there being two receptions, improve the software, and introduce electronic records. A specific change in response to my complaint is that they have stopped the offering of tea and coffee. The chief executive thanks me for complaint, and the letter contains multiple apologies.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The second way to increase the chances that your complaint makes a difference is to place it on the website <\/span><a href=\"https:\/\/www.careopinion.org.uk\/\"><span style=\"font-weight: 400\">Care Opinion<\/span><\/a><span style=\"font-weight: 400\"> where it can be read by anybody. <\/span><span style=\"font-weight: 400\">A patient advocate told me that a complaint posted there would be much more likely to get a response and be acted on. The spirit of the website is that it offers a way for patients, carers, and others to work with the NHS and social services to improve services. (Writing this sentence reminds me that I have never received a response from a long complaint I sent to social services about five months ago.)<\/span><\/p>\n<p><span style=\"font-weight: 400\">One odd thing about the site is that you are told not to use your own name. Why? Could the implication be that somehow you might receive poorer services as a \u201cpunishment\u201d for complaining?<\/span><\/p>\n<p><span style=\"font-weight: 400\">A good thing about the site is that once you\u2019ve submitted your complaint or feedback you are directed to other comments on the same service. To my surprise all the other comments on the eye clinic (about five) are positive: grateful patients praise the services. I\u2019m immediately suspicious that negative responses may be filtered out and positive ones kept, but I assume that can\u2019t be the case. It shows importantly that there is more need for complaining.<\/span><\/p>\n<p><em style=\"font-size: 1rem\"><strong>Richard Smith<\/strong>\u00a0was the editor of <\/em>The BMJ<em style=\"font-size: 1rem\"> until 2004.<\/em><\/p>\n<p><span style=\"font-weight: 400\"><strong>Competing interest:<\/strong> RS is the chair of the board of Patients Know Best, which has multiple contracts with the NHS to give patients access to and control over their health and social care records. He is unpaid but has shares in the company.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I\u2019m a great complainer. As I have written before, I believe that we have a duty to complain in order to improve services and products.\u00a0We usually complain after a poor [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/04\/11\/richard-smith-making-your-complaint-count\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38364,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236,955],"tags":[],"class_list":["post-44438","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs","category-richard-smith"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Richard Smith: Making your complaint count - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/04\/11\/richard-smith-making-your-complaint-count\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Richard Smith: Making your complaint count - The BMJ\" \/>\n<meta property=\"og:description\" content=\"I\u2019m a great complainer. As I have written before, I believe that we have a duty to complain in order to improve services and products.\u00a0We usually complain after a poor [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2019\/04\/11\/richard-smith-making-your-complaint-count\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2019-04-11T16:40:06+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-05-02T11:58:54+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"540\" \/>\n\t<meta property=\"og:image:height\" content=\"350\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Richard Smith: Making your complaint count\",\"datePublished\":\"2019-04-11T16:40:06+00:00\",\"dateModified\":\"2019-05-02T11:58:54+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/\"},\"wordCount\":975,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2017\\\/02\\\/Richard-Smith.jpg\",\"articleSection\":[\"NHS\",\"Richard Smith\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2019\\\/04\\\/11\\\/richard-smith-making-your-complaint-count\\\/\",\"name\":\"Richard Smith: Making your complaint count - 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