Complaints – Despair, Specs and Teeth

Coming in Threes

You know how it is – life is ok for a while and everything more or less works. Some minor niggles, something goes wrong perhaps but it is soon fixed or can be parked for the future and then bang! like the proverbial No 11 bus they all come at once.

Banging our Heads against Banks

The MAC Partnership has been involved in a prolonged and head-banging dialogue with Barclays our bankers for over a year trying to achieve a simple administrative task – adding a person to our internet account with the authority to make payments. The saga of lost pieces of paper and endless delay while the ‘customer service team’ conferred and promised to phone back will be familiar to all who have gone a few rounds with their banks but the unexpected one that amazed us all was the sending of our data, equipment and PIN to a local Park User Group. This rang a chord with me since in the summer I had asked for a replacement bank statement and some time later found I had been sent the statements for a football club in Wales and a Somali refugee centre in Birmingham. Where my statement went, no one knows. A nice man called Alec took my details, gave me a reference number and disappeared. We still have no solution after a year to letting one more Partner use the internet banking facility.

The key block to solutions here is that when the team – see ‘customer service’ above – is in charge, no one is in charge. When no one is in charge, no one ever phones you back or if they do or you phone again, they know nothing. Also since they have no history or experience of the account, they tell us that it is impossible to do things which we have been doing for 5 years. This is the world of the customer service team – unable to connect with or comprehend a world that is not on their screen, unable to call with confidence on other parts or people in the bank to help them sort out their – well not their actually – customer’s problem. The internal emphasis of Barclays as experienced is to end the call not resolve the case. The customer is always someone else’s.

We have been passed from relationship manager to complaint department to special services team to web development to branch business manager. For over a month we have been trying to get our Business Manager to ring us.   Every time we are told she or he will call back in 3 hours and a week later there is still silence.  We have spent an estimated 5 or more hours on 0845 numbers. In the meantime Barclays are as far as we can tell in serious breach of data protection regulations. In the meantime of course we still cannot get the third partner permission to use the site. View it – OK. Do anything useful with it – no. Ombudsman as well I think. Of course if we had wanted a loan or an overdraft they would have been all over us.

Complaints and Sod’s Law – how bad things keep happening to good people

Of course it is not just banks that get it wrong – even when complaint handlers are trying hard, taking responsibility and sorting stuff out, their lack of success in getting something sorted can still provide a decent anecdote or two for the Sod’s Law training session. Specs handed in for repair to Boots were not returned and no one could tell me where they were or when they migth be back. Central customer service was involved since I am a lazy man and thought that they would be able to pull the strings and sort stuff out while I was away. Also I have reason to know that they are a well-trained and professional bunch.

Emails were exchanged and promises made and then the final call that they were ready and in the shop. Except they could not be found when I turned up. The manager had them in her drawer – eager no doubt to make the handover herself but alas she was not around. Another phone call and a second visit since the postie’s strike made posting them problematic and I have my specs plus a cost waived and a Boots Gift card. There was a solution and I think I will go back to Boots for the next pair but even here in spite of efforts to resolve, Sod’s Law meant that once one thing had gone wrong, lots went wrong. Even the generous gesture of refund plus gift card funds came over as rather hesitant since the person who finally saw me had to pick the story up by reading post-its and bits of paper atttached to the spectacle case.  I got the glasses but felt glum and as for Boots Optician in Croydon, all that effort and expenditure with what result – a customer rescued and twice as loyal as they were before? Don’t know.

Opening Wider on Dentists’ Complaint Data

This was all prompted by seeing a survey done about complaints about private dental care. I know the man who was instrumental in getting their Dental Complaints Service – the escalated complaint handling system for private complaints set up – Derek Prentice ex of Consumers’ Association and a long time believer in the power of an effective way of resolving complaints.

They got some uncomfortable answers but were brave enough to publish them. All the data is actionable and useful – the 26% with a problem who did not complain plus the reasons why not – fear of the consequences, ‘not worth it’, did not have the confidence to see it through. The % satisfied amongst those who did complain to the practice?  Low at 53%.

The central service was seen as doing better with 85% rating them as good or excellent when it came to responding with the time promised; 98% rating the overall attitude and courtesy as excellent or good (84% excellent). Encouragingly enough, the dental professionals liked them too. Too often those on the ground, the front line see themselves as shafted by the people at ‘head office’ flinging money around and agreeing solutions which appear ludicrously biased towards complainants, all too often labelled as ‘vexatious’. On the attributes of attitude and courtesy 98% rated them as excellent or good (79% excellent.) So once people get to the escalated service they are OK.

However the main point I wanted to make was that it is good to see the data – I am sure Boots collects data about satisfaction and probably Barclays too. Let us see that data and then we can tell what is going on and more importantly so can the people within the company who either do not see the data at all or bin it when they do. The thought that it might emerge into the public domain would concentrate minds.

Bye Bye WM

Which reminds of the great achievement – one of many – of Walter Merricks at the Financial Ombudsman Service where his service now names the worst offenders. I missed his leaving party on 8th October and so must say our farewells in this blog. Great work and we hope to be in touch again soon.

Early Apples – an early harvest after a glorious summer of posts

Boundless Blogs

We may not have published a newsletter since June but the blogs abound. Over the summer, the creativity and productivity of Partners ( and one in particular – the indefatigable Andrew Craig)  has produced a bumper crop of posts addressing the topical, the public and the personal at home and abroad – all active issues in the world of public engagement, healthcare costs and reform and good old complaint handling.

Who are you going to call?

Back in June we were reminded of the power of the personal anecdote – link – and picked up on what remains the most used way of contacting health services – 999 is now embedded in the national consciousness as the number to call. Can we be weaned off 999 in favour of numbers such as 111?

Find out about ‘Thought Bubbles’

Telephone access and response was not on the list of comparators in the recent row about comparing NHS and US health care – cost was the main bone of contention. Rachel Piper (Caroline Millar’s daughter) pointed us in the direction of a great website where the US debate about healthcare is summarised wittily and pithily. Take a look – short and fun which is more than you can say about most of the interventions in the health debate especially when national pride is involved.

Forget Global Warming – Prepare to get cold

Undaunted and perhaps indeed inspired by this technological tour de force, Andrew’s blog about future NHS financing floated off in a cloud of meteorological and geophysical images – what happens to the NHS climate when the warm Gulf Stream of funding is switched off? Answer: the NHS becomes Labrador. Not a dog but that chilly island unvisited by the Gulf Stream. This makes making the health service more efficient even more important – there is money that can be saved not by firing and closing but getting all in the NHS to perform as well as those in the top quartile. Beyond that, it is time to address the fundamentals:

• what is a health system for?
• who should own it? and then and only then
• how should it be paid for?

Best Practice Customer Recovery

If you are feeling that you may drown in this sea of debate – be it warm or or be it freezing – Caroline Millar’s piece about the modern art of customer recovery as practised by Eurostar will be straightforward and encouraging. Read all about how Eurostar complaint handling turned her into one of the company’s greatest fans.

They do things differently in Wales

The NHS is notorious for not paying much attention to what other people are doing and for its slowness in absorbing best practice from elsewhere. For all those engaged in user representation in health and social care, there are lessons to be learned in Wales where Community Health Councils have survived to become a key ingredient in the future development of NHS Wales. Andrew identifies the key ingredients for success for “CHCs Mark 2″ in England. .

Leadership is one theme that recurs frequently in any discussion of successful change and improvement. So we finish by raising a question asked by Colin Adamson prompted by the regime changes at both the Office of the Information Commissioner and the Financial Services Ombudsmen where both Richard Thomas and Walter Merricks have already or are moving on.

New Leaders Needed

Under the heading ‘Ubi Sunt?’ we wrote in July:
Just a few weeks ago, we blogged about Richard Thomas throwing off his crusader cape as the Information Commissioner and now Walter is handing in his SuperOmbuds costume. Last week I attended a leaving party for Allan Asher ex-head of Energywatch and chair of the BSI’s Consumer and Public Interest network just before he headed back to Australia. Ou sont les consumer heroes d’antan? More to the point. Ou sont les consumer heroes d’avenir?

If you know of any, we would be interested to hear who they are. Self-nomination is fine.

Ombuds Off – Merricks CBE Moves On

Walter Merricks told me at the end of June saying that he was moving on after 13 years an Ombudsman – 10 at the Financial Services Ombudsman Service and 3 before that as the Insurance Ombudsman. He is going to do adjudication in the Health Professions which is no doubt important but is not enough I would have thought to keep Walter engaged and interested.

Ombuds Idol?

We look forward to the book and indeed the spin-off TV series – why not some reality TV with Walter as the judge in a consumer small claims court televised live. Walter was always a bit of a thesp – a star of TV and before that he trod the boards in student drama with perhaps his finest hour as a member of the cast of the original 1966 Edinburgh Festival Fringe Oxford Theatre group production of Rosencrantz and Guildenstern.

Surprised by another record breaking year

In his final Annual Review Walter points out how wrong he and his team had been in their expectation that complaints would fall in 2008/9 (after the big boom associated with endowment mortgages died away). 2007/8 had been a record year but 2008/9 saw even higher figures. That may not be a surprise with all the crashes and crunches of recent times in financial services but what is disappointing is that almost 6 out of 10 were justified. This is an increase in the proportion upheld in the past which ran fairly steadily at 30-40%. It would seem that business is not ready to use its complaints data to learn lessons and avoid repeating the same mistakes – and the chances of these mistakes becoming public are increasing.

The impact of claims management companies

The chances of companies getting away with it are lessening as the activities of claims management companies grow in parallel with changes in consumer complaint behaviour. Walter has been grappling with the question of why consumers should use these companies and pay them a hefty chunk of any winnings when the Ombudsman service is free? Lazy? Frightened? Too busy? Whatever the reason consumers have for using these companies, the prospect of profits gives these companies the energy to dig up and expose lots of cases involving ‘legacy-issues’ that can severely dent profitability if companies have made no provision for such cases. Remember that if in retrospect it becomes clear that a business has broken FSA rules, then all the customers who have been disadvantaged by that breach have to be given redress whether or not they have bothered to complain.

Over half the complaints received about payment-protection insurance (PPI) were sent in to the Ombudsman from claims management companies and a very high proportion of the cases were upheld by the FOS. So the claims companies are doing good for their customers. The consumer who would otherwise have got nothing still gets something even after paying the claims companies’ costs.

Collective Action – one idea for reform

Reform is needed with Walter listing the objectives of any reform as well as citing proposals of great current interest to governments and regulators that would allow a collective claim to be made on behalf of all consumers adversely affected without them having to make an individual claim. This should achieve two aims – redress for individuals who have suffered and speedier market improvement action because the size and nature of the problem have been identified earlier than would have been the case with complaints brought by individuals being tracked and aggregated over time.

Ubi Sunt..?

Just a few weeks ago, we blogged about Richard Thomas throwing off his crusader cape as the Information Commissioner  and now Walter is handing in his SuperOmbuds costume. Last week I attended a leaving party for Allan Asher ex-head of Energywatch and chair of the BSI’s Consumer and Public Interest network just before he headed back to Australia. Ou sont les consumer heroes d’antan? More to the point. ou sont les consumer heroes d’avenir?

If you know of any, we would be interested to hear who they are.

MAC Buds in May – why health is different from a PlayStation®

There has been only a couple of articles on our blog since the last newsletter – one was a review of Christine Hogg’s up to the minute history of public involvement in the NHS. I have bought my copy and would urge you to do the same if you are trying to make sense of the structures and techniques you need to do public involvement better and to understand why you are finding achievement so elusive. I read it to get some thoughts going for a training course for GP practices and their staff on understanding and engaging with customers.

Citizen vs Consumer

The point that struck home for me with my background working for Which? and other consumer bodies is the one where Christine argues that health is a more complex business than the consumerist model can accommodate. The example she chooses to make her point is that of mental health services users whose rights as citizens are more important to them than their role as a consumer of health services. Their choices are few and in some cases, they have to rely on their rights as citizens to exit the system or refuse treatment. She goes on to see a situation where expert patients and others who care for themselves ‘break out’ (in Christine’s words) out of the role of patient and become providers. She sees that service that is truly user-centred is the one where the users work with equal status with professionals.

Health is Different

This is a radical and ambitious view that goes well beyond the conventional consumer model of market influence where user and producer interract but remain separate. Christine’s view takes into account the fact that health is different from other things that people want. Jonathan Miller has written “Of all the objects in the world, the human body has a peculiar status: it is not only possessed by the person who has it, it also possesses and constitutes him. Our body is quite different from all the other things we claim as our own. We can lose money, books and even houses and still remain recognisably ourselves, but it is hard to give any intelligible sense to the idea of a disembodied person. Although we speak of our bodies as premises that we live in, it is a special form of tenancy; our body is where we can always be contacted ( Miller J The body in question Random House 1978 quoted in The World Health Report 2000 Health Systems: Improving Performance so ably edited by our Associate Angela Haden ) So being a consumer of health is different from being a user of a PlayStation®. We do not live inside something made by Sony – not yet anyway.

Better Customer Care

The reason for this revisiting of this debate is to explore my idea that the tensions embodied in the arguments about differences between being a user of a consumer good or service and being a consumer of health impact on complaint handling. A couple of the many things we have failed to blog about recently are the latest initiatives on complaint handling from the Department of Health and the Health and Public Services Ombudsman. The Better Guide to Customer Care represents a great leap forward in its simplicity, clarity and freedom from an obsession with process. There is an explicit overlap with the work of Ombudsmen and the six principles of good complaint handling. One of the unacknowledged things that make complaint handling – never easy – more difficult in the NHS is the difference between the complaint about health-related service received and the one about your electronic gizmo. As we have written before, emotion is the driver and the emotion involved in complaining about the place ‘where we can always be contacted’ is of a different order and magnitude than a complaint about an object external to us. The only example in the world of consumer goods and services when the emotional temperature came close to rising into the health temperature range in my complaint consultancy experience, was men complaining about repeated quality failures in their Range Rovers. The letters and calls made Jeremy Clarkson look like the soul of reasonableness.

While the Treasury’s advice about financial redress is worth reading, the question of money while it can no doubt help resolution, is not the clincher – recognition of how close to home any complaint about our health and the body we live in remains the best route to resolution.

Owning and Using Data

And if our body is our own, we argue in Andrew’s blog on Real Patient and Public Power, so is the data that we give the NHS by filling in questionnaires and being available to be measured and counted is data which patients and their families should be able to understand and use in any initiative to improve health and social care services. We would like to see the definition of expert patient extended to include an expertise in how user data can be put to work and create action for improvement and change.

Data Delusions

We are reminded how open to interpretation, questions on a checklist can be in one of the final publications of the Healthcare Commission as it morphs into the CQC – Listening, Learning, Working Together? The question mark indicates uncertainty about some of the findings – what the Healthcare Commission calls ‘mixed evidence’ about the standards of patient and public engagement. 98% of healthcare organisations claimed in their annual health check returns that they met core standard 17 which is the one about taking the views of patients and others into account when designing services. The snag is that there were a lot of negative comments from patient forums, voluntary organisations as well as the relevant local government committees (OSCs)  that trusts were failing to seek the views of patients and public. Mixed not to say contradictory evidence indeed. Which is the correct view?

Management – Delusions, Comfort and Safety

Christine Hogg tells us that it is a mistake to ‘believe that user involvement can be managed and voices captured’. She is worried that participation ’seems to be a management tool to be disposed of when it does not produce the goods’. Actually it is not being ‘disposed of’ that is the problem and of course the activity has to be managed – it costs money and involves resources so how else would organisations behave? No – what we have to be wary of is delusion. And the delusion amongst public and patient involvement managers is that the performance of the function – attended 10 meetings, produced 4 newsletters and ran a stand at the local fair or whatever and printed 5000 leaflets on topic X – is enough to tick the box. Delusion of this sort is after all a much more comfortable and safer place for managers to be than copping the comeback from relaying rude and disruptive comments from outside, uncensored and un-deodorised – a terrible assault on the sensitivities of one’s superiors whose lives are difficult enough without this vulgar din.

Thank you and farewell Health Commission – we knew you when you were still CHAI. How short institutional life is in the NHS, we Partners muse.

November’s Newsletter: No downturn here – M-A-C blogging team’s creative outputs breaks all records

10 posts since 30th September represents an all-time record as M-A-C engages with the issues and causes dear to our collective and individual hearts.

Our first ever post back in 2003 was about our central interest – user involvement. A theme echoed in this month’s output with Andrew’s post Engagement isn’t enough. Two posts later, we were taking a look at Ann Abraham’s approach to her then quite new job as Health Ombudsman. Complaints and the way they are managed and treated and what they mean for the organisations trying to deal with them are another abiding interest – see the piece on 24th looking at how common themes can emerge from different surveys of the complainant/ customer experience.

It is not all about the familiar themes – since 2003 we have broadened our interests to embrace two new areas – Policy Governance and parental involvement in schools. In the case of the model developed by John and Miriam Carver, Policy Governance® has taken a while to get off the ground in the UK. Most of the work and case histories reflected US practice and we have not had a good UK example of how this approach to corporate governance can help organisations here. Now the Southend University Hospital NHS Foundation Trust have led the way for others to follow. Val Moore reported on this on 27th October.

Finally, Caroline Millar reports on how the new models of participation – involvement, engagement – are impacting schools, parents and teachers. Her piece focuses on the consultation on complaint handling in schools and how parental problems are handled (or not).

We call ourselves a consultancy that specialises in the user interest. What keeps us interested and involved and in business, is how that interest can manifest itself in so many different contexts while the principles underlying best practice can be so similar. Different diagnoses, different solutions but underpinning them all are the common questions – what do users think of this? Has anyone asked them? Has anyone listened? Has anyone done anything with what they have heard? What happens when people have a problem? Easy really.

The final question that comes up when looking back over 5 years – has anything changed?  Well Andrew inspired us all with a 2006 look at what the NHS will be like by 2015. We are almost halfway there and what has come true? Well the Department of Health seems to see things the Andrew Craig way. Allowing people to pay for their drugs was something Andrew took a look at in March this year when he pointed out that ‘topping up’ was something that Beveridge seemed to have explicitly anticipated when he wrote about the State leaving “room and encouragement for voluntary action by each individual”.  As far as the management ethos of the NHS as a whole is concerned, we will wait and see how PG will change all that.

In the meantime, it is still worth repeating a little Olympic-flavoured M-A-C joke from 28th November 2006 -

A parable of NHS reforms

(Elements are borrowed from several sources and sexed up a bit by us)

An NHS rowing team raced against a Japanese team. There were eight people in each team, of similar fitness, but the Japanese team won by a mile. How could this have happened asked John Reid? Top NHS management established a committee of analysts, which reported that the Japanese had seven rowers and one captain, whereas the NHS has seven captains and one rower. The experts called for restructuring of the NHS team. The new team comprised four captains, two service managers, and a director who also did the rowing. After a second lost race to the Japanese, the single rower was dismissed on the grounds of incompetence, and the management team received a bonus for strong leadership. A new NHS boat is currently being designed , but is reported to be running behind delivery schedule due to IT problems.

Let us see what has changed by the Olympic year of 2012 assuming we have not had to make a choice before then between funding bread and circuses or the NHS.

The Miserabilist Contribution to Happiness

The New Miserabilism?
Complaints and the people who make them are often seen as confirmation of the new miserabilism – a condition that led an outburst from Tom Harris MP asking why everyone is so bloody miserable in a world where in the UK at least, we have a lot to be grateful for. A new book on complaining behaviour by Julian Baggini “The Complaint Book” (www.thecomplaintbook.com) mentions a sub-set of chronic complainants labelled by a psychologist as “help rejecting” people who prefer moaning to being given a solution. The Victor Meldrew persona certainly hit that vein.

The Ombuds View
What does the Financial Ombudsman say about all this in his latest latest Annual Report? There were two areas where numbers of complaints rose very sharply – complaints about current accounts which saw a five-fold increase and those about payment protection insurance up from 1832 in the year ending March 2007 to 10,652 by March 2008. These are both interesting example of how complaint volumes can now be driven by media and internet campaigners – chief amongst them Martin Lewis whose site moneysavingexpert.com leads on these two areas of consumer problems suggesting templates for letters and other encouragements to complain against these practices.

Hire your own complaint handler?
Another phenomenon identified by the FOS is the rise in the commercial complaint handler. In almost one in five cases referred to the Ombudsman service, consumers used the services of such a company. This is strange – after all the service is free to use. However it may be because the consumer believes that the product is too complex to understand let alone complain about – the Ombudsman specifically mentions pension and SERP-related cases where the complaint handler makes unrealistic promises about the money that they can get for the consumer with a problem.

The New Community Agenda
The FOS has set up an Access working party. The Board had asked Lord Hunt of Wirral to look at access and transparency issues in particular and now the service is looking at implementation. Walter Merricks is now looking at what he calls a more active community agenda – awareness-raising with outreach programmes. He is already claiming some success with more under 35s and more women complaining diluting the historic profile of the Ombuds-user as the retired male with a duff pension, time on his hands and a new skill in word processing.

The Heavy Mob
As Walter gets interested in the ’soft’ skills of awareness raising etc, the OFT and BERR are looking at the role of the enforcers and how that sits with the new emphasis on principle-based law. 23 laws have been repealed and now as of end May this year we have The Consumer Protection from Unfair Trading Regulations which implement the Unfair Commercial Practices Directive. 31 specific trading practices – my favourite is the one that bans the ‘wolf in sheep’s clothing. See all 31 practices here (links to PDF file at OFT).

As part of this new approach, principled but pragmatic, the Office of Fair Trading and the Department for Business, Entreprise and Regulatory Reform (BERR) are looking to use the improved complaint data that they are getting from sources such as Consumer Direct to direct the searchlight towards those areas of the greatest consumer detriment. The OFT has recently published some more work in this area in April 2008. The amount of consumer detriment was estimated at £6.6 billion.

Remember “Jewels to be Treasured”?
So the miserable complainer is getting taken very seriously indeed. Long ago in another political area/ universe, the then Secretary of State for Health Virginia Bottomley characterised complaints – and by extension we suppose those who make them – as “jewels to be treasured”. A leap across time to the present brings us back to the health service and our current pre-occupation with health and social care services user involvement and engagement.

Complaining and Engaging
After all the complainant is someone who has made the choice to become engaged to pursue an individual goal – apology, correction, compensation. That initial individual impetus to action can cross-over into the more sustained and collective experience of engagement. We have noticed that many of those who come forward for patient forums and liaison groups have had an experience of health provision which has made a deep impression on them. The experience of complaining can act as the recruiting sergeant for patient engagement – the challenge of that is a double one. We have to understand how to convert what is often a negative into a positive directed towards improvement for all rather than vengeance on the few associated with the initial failure and we must make the experience of joining a patient body such as the LINks one that sustains commitment over the longer term.

Dare to Discuss Being Happy
My thought is that we have to turn to the work highlighted at the recent summer party held by the Ipsos MORI Social Research Institute. Yes of course it rained but the topic was a daring one – Happiness. The research shows that happiness once a reasonable level of material comfort has been reached comes from elements in our lives associated like getting married, being a member of a faith group and attending services regularly, using some extra leisure to spend time with family and friends and staying healthy. This last attribute will help you get beyond the trough of the middle years – the slough of despond linked in particular with having teenagers sharing the family home. Once they have gone, the happiness line slants upward only interrupted by the death of a spouse.

Can we add to the list – membership of a LINk?
Or perhaps participating in a quick survey?

The Hunt Review of the Financial Ombudsman Service – Opening Up, Reaching Out and Aiming High

The title has a bit of the ring of a rock anthem about it, don’t you think? Up, Up and Away by the 5th Dimension? Or perhaps one of these inspirational business books that promise to get you out of that career rut. A big hallo then for the review of the Financial Ombudsman Service (FOS) by the Rt Hon Lord Hunt of Wirral MBE available at http://www.thehuntreview.org.uk/

I took a look at what Lord Hunt (LH) identified as “the most contentious and difficult issue for this Review“. It got a chapter of its own called “Transparency – Performance Data”. The consumer bodies wanted lots of information with poorly performing companies ‘named and shamed’. The companies resisted it for various fairly predictable reasons – one of which was that “consumers would not understand the information and might be misled by it.” So easily confused they are – poor things. So consumer orgs for and companies against. LH said he was disappointed by this polarised response but he could hardly have been surprised.

In the event he went on to conclude that information on complaint performance is relevant and that there was “no legitimate justification for withholding it as a matter of principle.” The FOS already publishes an anonymised benchmarking table showing the top 11 financial groups. What is surprising is not that the worse performing companies want to keep their performance under wraps but that, according to Walter Merricks, the chief Ombudsman, “the best firm (does not) seem to want to promote its performance positively“.

Hunt suggests a mix of carrot – an Award for exceptional improvement in complaint handling – and stick – the Worst Performer identified in each of the markets the FOS covers by reference to the rate of upheld complaints. Much remains to be decided and the negotiations will go on for a while I would guess. Hunt concludes by saying he finds “openness both desirable and inevitable“. Amen to that.

All this manoeuvring brings to mind how the public sector has addressed the challenge of openness. Public sector performance in this area is a model of openness. If you look at the reports of the Healthcare Commission and the Parliamentary and Health Service Ombudsman, you will find the parties listed and named.

Case No. E.1947/02- 03 Discharge Procedures
Poor transfer arrangements and nursing care
Complaint against BUPA Care Homes and Bexley Bromley and South East London Strategic Health authority, formerly Greenwich Health Authority
Summary of Case
etc. – this is from an old Ombudsman Case – we will await the revised format of cases promised for any day now.

The Healthcare Commission also names the organisations involved in the complaints it deals with – a job it is giving up in April 2009. Escalated complaints go straight to the Ombudsman after that.

So perhaps in preparation, Anne Abraham’s office is doing a consultation on principles of complaint handling – get your comments in by 12th August even if they are covered with sand stuck on with Factor 50. Great reading for the beach.

Read more about how M-A-C approaches complaint handling and our account of complaint handling at a London hospital.

When Citizens Complain – what should happen?

The Public Administration Select Committee are in the news for advocating a single entry point for public services complaints.

Para 42. “We agree with Sir David Varney and the National Audit Office that the Government should explore the scope for a common access point nationwide for all non-emergency public services. This would provide a single point of contact for impartial information on where to make a complaint or seek redress. We restate our predecessor Committee’s recommendation in favour of just such a service-’Public Services Direct’-which would offer an easy access, one-stop-shop approach to a complex web of public services. Public Services Direct should be both a gateway to government organisations and services, and a source of basic advice to public service users. It would act as the starting point for people unsure of how or where to lodge their initial complaint, and would provide them with the appropriate information and guidance.” When Citizens Complain, Fifth Report

In the terms we use about complaint handling, the above is a referral site. What the public want is a problem-resolution site. Most people build complaint handling processes offering an initial point of contact and then a second one if the problem does not get sorted there. Where the complainant wants to see Houses of Correction, the public service build great Palaces of Escalation. For resolution, read referral.

The committee quotes this example:

“…for agencies of the Department for Work and Pensions complaints are dealt with initially by staff at local level. Complainants can then escalate a complaint to line management as necessary. If they are still unsatisfied they can raise the case directly with the Business Chief Executive, and then appeal to the Independent Case Examiner.57 Finally, the Ombudsman can consider the case if it is referred to her by a Member of Parliament.”

The big growth in the public services is in the intermediate complaint handling organisations:

“There are also an increasing number of independent, or quasi-independent, complaint review bodies to which complainants can turn before raising matters with the Ombudsman. These intermediate or second-tier complaint handlers exist particularly where the Ombudsman receives a large number of complaints about an organisation. They include:

• The Adjudicator’s Office, which investigates complaints about HMRC, the Valuation Office Agency, the Public Guardianship Office and the Insolvency Service.
• The Healthcare Commission, which at present is responsible for reviewing complaints about the National Health Service (NHS) or independent healthcare services that have not been resolved at local level. From April 2009, however, the Healthcare Commission will no longer have a role in complaints handling, as complaints processes for health and social care will be brought together and the system streamlined to emphasise local resolution of complaints.
• The Independent Case Examiner, who reviews complaints about DWP bodies including the Child Support Agency, the Pension Service and Jobcentre Plus.
• The Independent Complaints Reviewer, who investigates complaints about a range of organisations including the Audit Commission, the Charity Commission, the Housing Corporation, the National Archives and the Land Registry.”

These organisations are sort of junior organisationally specific Ombudsoffices but without the clout or the power of being the last stop.

The committee’s suggestion for a one stop shop will merely add another layer to an already complex and expensive system that institutionalises delay, decreases satisfaction and increases escalation. Hooray for the Health Service that has abolished the middle layer.

Also people at entry points for complex multi-organisational or multi-cause complaints systems while often recruited from the ranks of the beginners, the juniors and the newly-joined have to be the best qualified people in the whole system. They must have extraordinary gifts of diagnosis, have access to completely up-to-date knowledge about who does what together with telephone numbers for named individuals and be possessed of extra-ordinary personal attributes of empathy, listening skills and clarity of expression.

Do you think ‘Public Service Direct’ could deliver that? How many years would pass as everyone from departments sat round tables evolving protocols, manuals, interrogative algorithms, contact detail updating processes? There would of course be a need for an independent complaint handler for complaints about Public Service Direct. Decades would drift by. NHS Direct anyone?

What surprised me finally was not to see NACAB’s name listed amongst those supplying evidence. They are at last trying to grapple with the complexities of how best to concentrate and manage resources to advise people on the whole range of public services and products. Give them £10 or £20 Million for 7 years and tell them to set up the front door – they seem to be well down that path already. See http://www.nacab.org.uk/ and their change programme:

Year one (2005/06)
In the first year, we had a good look at what we were already doing, produced an award-winning film showing what we might look like in the future and completed a number of key initiatives:

• designing a new approach to service delivery
• piloting an out of hours, telephone, email and chat service
• setting up three centres to pilot the new approach to service delivery
• developing a set of national referral protocols
• commissioning the production of a new advice kiosk

Year two (2006/07)
Having successfully completed year one we are now moving forward by:

• establishing a single national telephone advice number
• setting up a national email advice service
• improving access to web based information and services
• introducing the new approach to service delivery
• considering how interactive (chat room style) advice can best be used
• forging productive partnerships with other agencies and advice providers

And it goes on.

It is not a question of avoiding re-inventing the wheel – more a question of not adding yet another redundant wheel when we already have all the wheels we need to propel this particular vehicle thank you.

Read more about M-A-C’s complaint handling consulting, and download templates for reviewing and implementing better complaint handling at www.mooreadamsoncraig.co.uk