Being Open

How customers are treated when something goes wrong is often critical. We can all think of times a good response to a complaint has made us feel better about a company, whilst being ignored has left us seething.

This is just as true of the NHS.

Most people have excellent experiences of care in the NHS, with satisfaction now at an all-time high. But things do go wrong and too often the experience then is of the 'shutters coming down'. Often people pursue complaints because they simply want to know what happened and why. It is part of the way many of us deal with a serious incident. Of course, there is also the desire to make sure that lessons have been learned. Managed well, these conversations rarely lead to formal complaints and an apology is not in fact an admission of failure that puts the NHS at risk of litigation.

In a bid to be more responsive to patients or relatives who have bad experiences, the NHS has a policy of 'Being Open' after incidents. And yet a Strategic Health Authority audit that I have seen suggests that the policy is not widely used. Only 23 per cent of NHS trusts had trained staff in the policy, over a third had no-one identified to lead it and less than a quarter had said there was such a policy on their website. This rings true with my experience, as I am regularly told by asthma patients that openess is a problem.

Fortunately the NHS has recently relaunched 'Being Open' as a policy, to get transparency more embedded in practice. This is welcome. But to meet the needs of asthma patients, the policy must be extended. First, it must cover primary care as well as hospitals. Second, it must include failures due to omission of care, as well as incidents of wrong care. That would go further to ensuring patients get the transparency they need and the NHS learns from incidents.

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