Involving nurses in the complaints process leads to more effective care

“sorry” when things go wrong – and to do so in a way that makes such apologies meaningful for aggrieved patients and their relatives.
But an apology alone, however sincere, does not make an effective complaints system. It is essential that staff understand that an apology is only one (very important) event in the process of dealing with a complaint. Otherwise there is a danger that lessons will not be learn, trends will be missed, and more patients will require apologies after further mistakes.

Complaints are an essential part of an organisation’s feedback mechanism and linked to incident reporting and other quality indicators such as pressure sores and infection. Nurses need to see the complaints system as an important educational tool for everyone, from the individuals involved in an incident to the board – rather than simply a paper exercise run by administrators, or a blunt instrument for NHS regulators to beat the chief executive with.

That is why trusts need to ensure their education and support for practitioners is broadly based, explaining the process, supporting proactive management and training in conflict resolution.
The acknowledgement by those investigating a complaint that it is not just one individual’s “fault”, but more often the fault of a system that failed to prevent the incident leading to the complaint, helps to support the professional at a difficult time. This makes it much easier for them to make a sincere and meaningful apology to the patient or family, as part of the wider response to the incident.

We need to do more than just teach nurses how and when to apologise, and give them permission to do so. We need to involve them in the whole of the organisation’s complaints system, so that every clinical team feels familiar and comfortable with the investigation and learning processes.

Professionals are always extremely anxious about complaints: understandably, because they are answerable not only to their employer but also to their regulatory body. The ultimate sanction of being struck off their professional register looms large in every nurse, doctor and therapist’s mind. But a greater focus on the learning process of complaints handling should help remove the personal, individual emotion from the issue, and replace it with a professionally-justifiable – indeed, professionally mandated – focus on turning a bad incident into a better service for future patients.