Health and Social Care Bill

Baroness Wheeler Excerpts

Monday 14th November 2011 Lords Chamber

Handling complaints is a delicate—and should also be a transparent—process. The NHS Commissioning Board is committed to transparency. Its role is overseeing service provision and so it should see a breakdown of the complaints that are arising within the service it oversees—not personal details of Mrs Gidden’s hip replacement or Mr Patel’s hernia, but an appropriate format that will reflect the health of the NHS. As the board also oversees commissioning, it should also see complaints that relate to an organisation’s competence in commissioning. So, with that as the framework of my complaint, I wonder whether the Minister could clarify the nature of reporting such information to the NHS Commissioning Board. I am sure he will be happy to agree to its importance. I beg to move.

[Baroness Wheeler]

My Lords, I am pleased to speak on this group of amendments, in particular on Amendments 143A and 143B, on behalf of my noble friends Lady Thornton and Lord Hunt. I am also speaking to the clause stand part debate on Clause 275, which relates to the abolition of the National Patient Safety Agency.

A critical function of the NHS Commissioning Board is to improve the quality of services and drive improvements in health and social care. A key way of achieving these objectives is learning from complaints information. There is a clear need for the NHS Commissioning Board to have meaningful comparable complaints data from service providers which can be used to help drive improvements in healthcare and strengthen the quality of services for patients and the public. This information can contribute significantly to an enhanced patient experience and enduring service improvement. It can enable the board to identify possible trends and patterns of risk and to take appropriate action through putting pressure on healthcare providers to raise standards and demonstrate how they have learnt from patients’ complaints.

Through this means, the board can hold providers to account for the safety and effectiveness of healthcare. Having this information is important because it identifies which providers are failing to learn from complaints. In collaboration with other organisations, such as the Care Quality Commission, Monitor, the NHS Information Centre and HealthWatch England, there will be the capacity to identify trends, themes and patterns of significant risk and respond through the commissioning process.

While NHS complaints systems have been much improved and enhanced in recent years—my own Government introduced the current system in 2009—we recognise that the current systems for capturing complaints information require significant improvement. We know that a sadly recurrent theme at the Mid Staffs public inquiry has been that the complaints of patients and families were not heard. A system which ensures that complaints information gets transmitted to the people running the NHS would help to remedy this.

Another crucial point is that, with the loss of primary care trusts, there is nowhere independent where complaints about GPs who are members of the local CCG can be investigated. It is clearly not appropriate for the CCG to investigate a complaint about a GP who is a member of the group.

The Health Select Committee has supported the view that commissioning bodies should be the engines that drive improvement in complaints handling, in the analysis of data and leading change within the NHS. Amendment 143A, in particular, would enable the NHS Commissioning Board to play its part as a major service commissioner in developing more meaningful NHS complaints procedures and information, establishing a duty on Monitor to publish information.

Amendment 143B is a probing amendment, which would delete the board’s proposed functions in relation to information. This is in the context of our support for the continuation of the National Patient Safety Agency’s much valued independent role. The National Patient Safety Agency provides a vital function under its current remit, managing the National Reporting and Learning Service, the National Clinical Assessment Service and the National Research Ethics Service. The NPSA acts as an umbrella organisation, providing a valuable overview of patient safety incidents by collection and analysis of data, and monitoring to ensure that lessons are learnt that can be fed back and used to improve patient safety.

Under the National Reporting and Learning Service, the NPSA receives confidential reports on patient safety from incidents from healthcare staff across England and Wales, and oversees the independent processes of clinicians and safety experts who analyse these reports to identify common risks to patients and opportunities to develop improvements in care and practice. However, under the proposed new arrangements, the NPSA is to be dismantled and split up. On these Benches we are totally opposed to this. I ask the Minister how the information monitoring and service that it provides can be provided by the separate bodies that will now span across these issues. The NPSA’s value is as an arm’s-length body that is respected and valued by the NHS for its independence, expertise and the service it provides. Therefore, I also ask the Minister how he will ensure that there continues to be an overview, information and reporting system for the important functions currently undertaken by the NPSA.