What's so hard about saying sorry?

What’s so hard about saying sorry and meaning it? The Health Service Ombudsman, Dame Julie Mellor, has reported that the NHS adds to the distress of patients by the way it responds to complaints.

Far too often, unclear explanations and insincere apologies result in dissatisfied patients and relatives taking complaints to the Ombudsman.

‘People would have more confidence in the public sector complaints system if they thought they were treated seriously’

Most people who complain simply want an apology or an explanation. They are not looking for compensation or for staff to be disciplined.

Complaints tend to fall into two categories: those about indifferent, unhelpful, uncaring staff; and those about the system that often seems to make no sense and designed to frustrate.

Blaming the system

Front line staff, be they doctors, nurses or social workers, are often equally frustrated by the system.They are sympathetic to patients and families but convey the message that changing the system is beyond their control, it’s not their fault and complain if you want but I doubt it’ll make a difference.

Managers have a tendency to focus on staff. If only people were better trained, if only we were better at recruiting the right people, if only it was easier to get rid of unsuitable staff − then things would be as they should be. 

When I lost my bags at Gatwick airport it was clear this was not an isolated incident but a regular feature for those changing planes there. There is often simply not enough time to get bags off one flight and on to a connecting one. A delayed flight incurs a large financial penalty for the airline, so flights frequently take off without passengers’ baggage. 

Clearly this is the fault of the system. You can always fly with a difference airline and use a different airport. The government would like it to work like this in the public sector. 

Quick fixes

Sometimes complaining to the right person gets a quick fix. Before my father-in-law could leave hospital he had to wait for his drugs to come from the pharmacy. He waited and waited but the ward couldn’t say when the drugs would come. After a couple of hours sitting on a hard seat in a drafty corridor, my wife who had gone to collect him put him in a taxi and waited alone for the drugs. 

‘Complaints are an early warning to management that things are going wrong’

She waited most of the afternoon, checking at regular intervals with the ward staff if there was any indication when the drugs would arrive. There wasn’t. She offered to go down to the pharmacy herself but she was told there was no point. 

Eventually even her patience was worn out. Being a senior manager herself she understood there was no point blasting off at the ward staff, so she rang the hospital switchboard and insisted on speaking to the chief nursing officer. She explained the situation in a calm and reasonable way, resulting in a commitment to send the drugs by taxi later that evening.

In both cases there were clearly problems with the system rather than the staff.

Complaints present opportunities

People would have more confidence in the public sector complaints system if they thought complaints were treated seriously and resulted in changes to the system. 

All too often, the impression given is if you make a fuss you’ll be viewed as a nuisance and if you make a formal complaint you’ll just get a standard response − an empty apology and a vague commitment to raise the issue with the staff concerned.

It doesn’t have to be like this. Complaints can be used as an opportunity to improve services. They can be analysed with a view to learning from them and making changes to the system.

Complaints are also an early warning to management that things are going wrong and that cost savings are having an unintended and unacceptable impact on patient care.