CRC0085 - Evidence on Complaints and Raising Concerns

Written Evidence submitted by Which? (CRC0085)

I. Summary

User feedback and complaints provide a critical source of information and intelligence that public service providers should be using to improve the quality of the services they offer. But people are less likely to complain when they have cause to providers of public services than to companies in many private markets. Too many public service providers also fail to capture feedback and complaints effectively and use them to drive service improvements.

Which? welcomes the Government’s response to the Francis Inquiry in which it set out actions to improve how NHS organisations handle complaints, covering frontline professionals, management and boards, regulators and ombudsmen.

However, there are three further reforms that, if applied across the public services landscape, would help to: simplify the complex complaints landscape; signal to consumers that, if they have cause to complain about public services, their complaints will be taken seriously; and incentivise providers of public services to handle complaints more effectively. These reforms are:

Establishing a unified public services ombudsman for England to improve the fragmented complaints landscape, including a merger of the PHSO and LGO into a single ombudsman.
Establishing a principle for user-triggered inspections with regulators of public services setting out a proportion of unresolved serious complaints which would act as an automatic ‘trigger’ for regulatory inspections.
Establishing a super complaint power in public services for designated bodies, including consumer representatives, in the same way that exists in private markets.

While these calls should cover all public service markets, we focus in this response on health and social care given the remit of the Committee’s inquiry. It is particularly important that policy and practice relating to complaints in these two areas are viewed together, rather than in isolation, given the Government’s ambitions for integration.

II. Introduction

Which? exists to make individuals as powerful as the organisations they deal with in their daily lives, in private markets and in public services.

We began life in a garage 56 years ago as a volunteer organisation committed to providing expert and impartial advice. We are now the largest consumer body in the UK with almost 800,000 members: we understand consumers and what makes them tick.

We operate as an independent, apolitical, group social enterprise working for all consumers and funded solely by our commercial ventures. We receive no government money, public donations, or other fundraising income.

We work closely with political, corporate and regulatory stakeholders to drive change for consumers. We plough the money from our commercial ventures back into our campaigns and free advice for all. Over the last 10 years this has enabled our charitable arm to increase its spending six-fold to £10m a year.

Which? has a long history of working on behalf of consumers in relation to public services, including higher education, social care and healthcare. Our magazine investigations have revealed varying quality in services such as social care and GPs. In higher education, we have conducted research which shows strong variation in the student academic experience at different institutions.

We also work to empower consumers in public services through the provision of free information and advice: our website Which? University helps prospective students to make informed choices about higher education. Earlier this year we also launched Which? Birth Choice, a website that helps expectant parents decide in what type of setting and where to give birth, and Which? Elderly Care, a site that provides clear, accessible information about the process of arranging care for older people and their relatives.

III. Why are people reluctant to complain about public services?

Which?’s own investigations have highlighted stark variations in the quality of primary health services, for example GPs and dentistry, and social care services, making consumer power exercised through choice and voice particularly relevant.[1] However there are often limits on choice between services locally, people are not always well-equipped to make decisions about providers; and users may be unable or unwilling to switch. In this context it is all the more important that services are responsive to user voice. User feedback and complaints provide a critical source of information and intelligence that public service providers should be using to improve the quality of the services they offer.

Highly-competitive private markets provide strong incentives for businesses to respond to customer feedback and complaints. The best businesses in the private sector have a variety of methods for gaining insight into the customer experience, and make sure that these experiences are heard by those who have the power to act on them.

The same incentives to respond to people’s feedback are often lacking in public services. While there are some excellent examples of best practice in public services, too many public services do not have a culture of encouraging and responding to feedback and complaints and using it to drive quality services. This was highlighted in the findings of the Francis Inquiry in relation to NHS institutions.

Partly because of this issue, people are less likely to complain when they have cause in public services than in private markets. Which? research found that only six in ten of those who had cause to complain about an NHS service in the last year did so, compared to nine in ten of those with cause to complain about a high street retailer.[2]

The reasons for not complaining included:

Scepticism that their complaint will lead to any impact. Forty per cent of those who experienced a problem with the NHS over the last twelve months but did not complain said they did not think it was worth the effort; 34 per cent did not feel that anything would be done about the problem [3]. Conversely, across all public services, 79 per cent of people said that they would be more likely to complain if they knew it would make a difference to other peoples’ experiences of public services. Seventy five per cent said that they would be more likely to complain if they knew it would result in a direct action, for example triggering an inspection.

Fear of repercussions on the quality of their ongoing care. One fifth of those who experienced a problem in relation to the NHS said that they did not complain because they feared worse treatment as a result.

Lack of understanding on how to make a complaint. One third of people who experienced poor treatment in the NHS did not make a complaint because they did know who to complain to. Forty three per cent of people thought that they should take an unresolved complaint about a GP to the Department of Health, against 23 per cent who though that they should take it to the ombudsman (PHSO). This is not surprising when you consider that four in ten (41 per cent) said that they had never heard of the PHSO.

IV. Reforms to public services complaints

Which? welcomes the Government’s response to the Francis Inquiry, in which it set out actions to improve how NHS organisations handle complaints, covering frontline professionals, management and boards, regulators and ombudsmen. However, there are three further reforms that should now be made across public services complaints.

A. The public services ombudsmen landscape

The complaints architecture in public services is highly-complex and fragmented. This creates confusion at the level of first and second-tier complaints, but also means that there are varied, and at times poor, first-tier complaint handling practices among providers. Sixty three per cent of people who had made an initial complaint to the provider in relation to the NHS did not take it further despite only 18 per cent saying that they felt that the problem had been resolved. 43 per cent of people who made a complaint were dissatisfied with the outcome. Which? is calling for the rationalisation of the public services ombudsman landscape, including health and social care.

In relation to health, at the first (local) tier, the right of people to have their complaint heard fairly is enshrined in the NHS constitution, and in the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. Yet research by the Patients Association, which looked at practice across 20 trusts, identified variation in the quality of complaints management arrangements, difficulty finding complaint-related information for some of the trusts and examples of a lack of complaint-related training for staff [4].

At the second tier, there are several ombudsmen and other bodies operating in the same space, with overlapping coverage that varies depending on how the service is funded and which part of government has oversight. As well as making the system more complex for the user to navigate, this also increases the risk that systemic problems are overlooked or fall through the gaps.

For example, an individual with a complaint about a nursing home could potentially take their complaint to two or three different ombudsmen depending on who the responsible department is and how their place at the home is funded. If it were a social care issue they would need to go to the Local Government Ombudsman (LGO), but if it related to a health matter they would need to approach the Parliamentary and Health Services Ombudsman (PHSO). If the complaint straddled both of these issues, it would fall under the remit of both ombudsmen, and the user would need to decide which to go to. If it was regarding a health matter that was privately-funded, they would not have any access to PHSO (See annex A which details coverage of the various public services ombudsman schemes).

This overlapping and confused landscape bears little resemblance to the regulatory landscape in public services, which has been rationalised over the past decade. For health and social care, quality regulation has been brought together within the remit of the Care Quality Commission. In our nursing home example, there is a single relevant quality regulator: the CQC [5].

Processes vary from ombudsman to ombudsman: complaints to the PHSO have to be made in writing, while the LGO will receive complaints in any format including over the phone; complaints regarding Whitehall departments which go to the parliamentary office of the PHSO must be made via an MP rather than directly. (See annex B for further details).

The remit of public services ombudsmen varies and is more limited than in some regulated private markets

The scope of the complaint they are able to consider varies. For example, unlike in private markets, public services ombudsmen are often limited to looking at issues of maladministration (the notable exceptions being health, where the ombudsman can consider matters of quality, and the LGO which can consider service failures).
Their role also varies in relation to setting consistent standards and promoting best practice at the level of first-tier complaint handling. In contrast, within financial services, there is an explicit duty on providers to make users aware of the Financial Ombudsman Services; the Welsh Public Services Ombudsman has an explicit signposting duty; and the Scottish Public Services Ombudsman also plays a role in setting local complaint practices.
The nature of their relationship with the regulator varies. There are often memoranda of understanding between ombudsmen and regulators in public services, but the relationship between them is not always clear and transparent. In legal services, the Legal Services Act 2007 places a requirement on the ombudsman to refer regulatory issues either to the individual professional regulators (such as the Solicitors’ Regulation Authority) or to the oversight regulator, the Legal Services Board. The failure of the PHSO to flag and respond to the complaints relating to Mid-Staffordshire were identified in the Clwyd Review [6].
The nature of their powers: unlike in regulated private markets like financial services, decisions by the ombudsmen are not binding on the public body.

While unified public services ombudsmen were created in both Scotland and Wales via legislation enacted in 2002 and 2005 respectively, reform in England has not happened despite numerous calls. This is in contrast to the public services regulatory landscape in England, which has seen significant reform and rationalisation in recent decades.

Most recently this included a call by Robert Gordon for a unified public services ombudsman in his review of the LGO, commissioned by the Department for Communities and Local Government [7].

Any reform of the ombudsman landscape in England needs to reflect the nature of the public services landscape. In many areas there is a market in terms of both provision and funding, with more services contracted out to the private and voluntary sectors.

The issue of privately-funded healthcare was raised by the Keogh review of cosmetic surgery [8] in 2013, which called for all privately-funded health care to be covered by the PHSO in recognition that consumers had limited access to redress outside of the courts, and that existing arrangements were out of date with today’s consumer policy. This would bring it more in line with the move in 2010 by the LGO to cover both privately- and publicly-funded social care and would help address the existing lack of coverage who are privately provided health services. The Independent Sector Complaints Adjudication Service, a voluntary scheme for private providers of healthcare, reported that, in 2012-13, 38 per cent of complaints were regarding non-members.

We recommend the following reforms to address the fragmented landscape:

The Government should establish a ‘one-stop’ telephone and web complaints portal for public services along the lines of the Complaints Wales service, run up by the Welsh Public Services Ombudsman. Its functions would include signposting people to the right body for first-tier complaints, directly sending their complaint to providers and commissioners if they wish, and acting as a gateway for second-tier complaints, directly sending people’s complaints to the relevant ombudsman service [9].

Behind this one-stop portal there should sit a rationalised set of public services ombudsmen with consistent powers and processes, that would mirror the regulatory landscape, for example:

Publicly- and privately-funded health and social care
Publicly- and privately-funded schools and childcare
Social housing
Higher education
The police and fire services, prisons and probation
Central government and local authority administrative functions not covered in the above (for example, complaints relating to tax and benefit payments and the Work Programme).

The PHSO and LGO should be merged into a single ombudsman, bringing together health and social care; schools; and central and local authority administrative functions in the same institution. This would help bring their respective processes in line in relation to health and social care. We think privately-funded healthcare should also be brought within the remit of the merged PHSO and LGO.
One possible structure for governance and accountability would be for parliament to appoint a Public Services Complaints Commissioner and Committee that would commission the sector ombudsmen schemes and the complaints portal. This would help ensure that consistent processes and standards were applied across the board and learning could be shared.
There should be a full review of ombudsman powers across all public services which would include looking at whether scope to investigate issues of quality should be expanded beyond health and social care; whether ombudsmen decisions should be binding on the public body; and whether the ombudsmen should have the power to set first-tier complaints standards across all public services. In health, there are already regulations in relation to first-tier complaints but there are not specific enforceable standards. Which? supports formalising the relationship between the relevant public services ombudsman and regulator, giving the ombudsman power to mandate a regulator to undertake an investigation and report back where it has evidence of systematic provider-level failings.

B. User-triggered inspections

High levels of unresolved complaints about a particular service are a critical flag that something is wrong with service delivery and the way complaints are being handled.

The Francis Inquiry called for there to be much more transparency about the number of complaints made about each service and whether or not they are resolved to the user’s satisfaction. In its response, the government set out new regulations about reporting complaints for hospital trusts:

Every hospital trust will have to publish quarterly information on its complaints, which will include the number of complaints received, as a percentage of patient interventions, in that period; the number of complaints the hospital has been informed have subsequently been referred to the ombudsman, and lessons learned and improvements made as a result of complaints.

The government has also committed to explore with NHS England and other key partners the introduction of a regular and standard way to survey people who have made a complaint, to find out whether they were satisfied with the way it was handled.

Both the Francis Report and the government’s response indicated that there needs to be a stronger link between complaints made by members of the public and inspections by the Care Quality Commission. This is particularly important given moves towards more risk-based regulation. User complaints are an important form of intelligence that regulators should be using to inform their decisions about inspection patterns.

Which? wants to see more power in the hands of the public. We think there should be an automatic trigger for inspections if enough people using that service have complained. Regulators of public services should be required to set out transparently what proportion of serious complaints, that were unresolved or not dealt with to the users satisfaction, should act as an automatic ‘trigger’ for a quality inspection. This would provide further incentives for providers to handle complaints correctly, and ensure peoples voice and concerns are heard where providers are failing to respond to serious complaints, for example in the case of Mid Staffs.
In the case where there is a defined group of users that use a service on an ongoing basis (for example, GP surgeries, schools, or nursery settings) the government could further extend this by giving patients and parents the right to trigger a quality inspection by the relevant regulator. Here’s one way this might work: if a certain proportion of parents or patients were formally to register a concern about a provider’s quality with the commissioner of that service (a local authority in relation to a maintained school, for example), this could oblige the commissioner to open a ballot or petition that would give a supermajority of registered users the power to trigger a quality inspection.

C. Super complaints

In private markets, super complaints have been an effective fast-track way for consumer bodies to get systemic market issues that are causing considerable consumer detriment addressed by regulators. Significant benefits have arisen from super complaints, for example, a super complaint by Which? on excessive credit and debit card surcharges resulted in the Treasury banning excessive surcharges from the end of 2012.

Super complaints can already be made to the OFT in relation to public services where the service is provided by a private entity and is paid for directly by the end-user/consumer (and assuming the other requirements for a super complaint are met). Which? has previously submitted a super complaint to OFT on the dentistry market (in 2001) and called for an investigation into the care home market (in 2003). Both of these resulted in a market study.

There is no equivalent super complaint power in relation to regulators of quality and financial sustainability in public services. However, under the Health and Social Care Act 2012, there is a similar, but weaker, power given to Healthwatch England. The Healthwatch England Committee has a statutory duty under the Act to provide the CQC itself, the Secretary of State, the NHS Commissioning Board, Monitor and local authorities with information and advice on:

The views and experiences of users of health and social care services.
The views of local Healthwatch organisations on the standard of provision of health and social care services and on whether and how that standard should be improved.

When Healthwatch England provides this information and advice to the CQC, the Secretary of State, the NHS Commissioning Board, Monitor, or to local authorities, these bodies are obliged under the Act to inform Healthwatch in writing of their response or proposed response to the advice. However, there is no limit on the amount of time these bodies have to respond and no guidance on how they must consider whether or not to take action. It is too early to know how Healthwatch will use these powers, but it is conceivable that they could be used as a form of super complaint to these bodies.

In our view this power should be strengthened into a public service super complaint power that would be equivalent to the super complaint power in private markets:

There should be a 90 day maximum time limit for a response.
Regulators should be required to set out how they will consider a super complaint, in the same way that the OFT and other economic regulators must in relation to private markets.
The test could be ‘any feature, or combination of features, of the provision of public services in the United Kingdom that is, or appears to be, significantly harming the interests of end-users’. The types of issues that might be considered include the use of 15 minute care slots by local authorities and providers of care.
The power should apply to designated consumer representative bodies that meet a set of tests (an equivalent definition for private markets exists in the 2002 Enterprise Act), so that other consumer bodies working in health, education, social care and childcare can formally raise issues with the relevant public services regulators.

11 March 2014

Annex A: the redress landscape across publicly and privately funded services

Higher Education

Health

Social Care

Childcare

Schools

Housing

Prisons and probation

Police

Publicly- funded

Publicly-funded Universities in England and Wales have to be a member of the Office of the Independent Adjudicator (OIA).

The Parliamentary and Health Service Ombudsman (PHSO) covers all NHS funded services including GPs, dentists, pharmacists or hospitals.

The Local Government Ombudsman covers publicly funded social care.

Ofsted will look at complaints about childcare providers in some cases, but there is no ombudsman scheme.

The LGO will respond to complaints about children’s centres.

Local authority schools are covered by the LGO; complaints about academies and free schools are handled by the Education Funding Agency.

The Housing Ombudsman oversees complaints about social landlords.

The Prisons and Probation Ombudsman

investigates complaints from, and deaths among prisoners, those on probation and those held in immigration removal centres.

The Independent Police Complaints Commission oversees complaints relating to the police.

Privately- funded

Membership of the OIA is optional for privately-funded bodies.

Complaints about members of the Independent Sector Complaints Adjudication Service (ISCAS) can be made to ISCAS

For private dental or optical complaints people can complain to Dental Complaints Service or the Optical Consumer Complaints Service.

Since 2010 the Local Government Ombudsman also covers privately- funded social care.

Private schools and colleges are covered by the Independent Schools Inspectorate.

Complaints about letting agents or estate agents are covered by the Property Ombudsman or Ombudsman Services: Property (OS:P).

Annex B: coverage and functions of public ombudsmen (with the Financial Services Ombudsman included as a comparator)

Parliamentary and Health Service Ombudsman (PHSO)

Local Government Ombudsman

(LGO)

Office of the Independent Adjudicator (OIA)

Financial Ombudsman Service (FOS)

Scope

Health Service Ombudsman: all publicly-funded healthcare, from the NHS or other providers.

Parliamentary Ombudsman: government and its departments.

Health Service Ombudsman: complaints regarding publicly-funded healthcare. Will look at issues of quality as well as maladministration.

Parliamentary Ombudsman: person aggrieved must have suffered injustice due to maladministration.

PHSO will undertake joint investigations with LGO when cross over with social care.

Health Service Ombudsman: cases must be presented in writing.

Parliamentary Ombudsman: cases must be presented in writing and via an MP.

Advocate can present complainant’s case on their behalf.

Complaints must usually be raised within 12 months of the event.

KPIs: 100 per cent of email enquiries acknowledged within one working day; 100 per cent of written enquiries acknowledge within two working days; 90 per cent of enquiries closed within 40 working days; 95 per cent of complaints about PHSO acknowledged within five working days; 90 per cent of complaints about PHSO resolved within 16 weeks; no more than 30 investigations over 12 months old at 31 March 2013. In 2012-13 missed KPI of 90 per cent of investigations being completed within 12 months.

Social care: both privately- and publicly-funded.

Most council matters including: housing (but only certain topics); planning; education; housing; benefit; transport and highways; environment and waste; council tax.

Complaints relating to maladministration or service failings.

Will do joint investigations with PHSO when cross over with health (enabled by 2007 Regulatory Reform Order).

Memorandum of Understanding with Housing Ombudsman for joint work where complaints overlap.

Cases do not have to be presented in writing.

Advocate can present complainant’s case on their behalf.

Complaints must usually be raised within 12 months of the event.

KPIs: 55% of customers advised of the outcome of their complaint within 13 weeks; 85% within 26 weeks; and 97% within 52 weeks.

All publicly funded universities belong to the scheme. Private providers can choose to join but don’t have to. Level of coverage also differs where students are studying Higher Education (HE) in Further Education (FE), where they are studying at overseas campuses and where they are studying at colleges with Foundation Degree awarding powers.

Most issues except academic judgement and teaching quality, the admissions process, and employment issues.

Cases must be presented in writing.

Can track complaints online.

Complaint to OIA must be made within 3 months of Completion of Procedures letter.

KPIs: in 2012, 87% of enquiries processed within five working days (KPI 80%); total number of complaints awaiting allocation 58% (KPI 30%); 21% of complaints over nine months from receipt of complaint (20%KPI).

Banking; insurance;

mortgages;

credit cards and store cards;

loans and credit;

pensions;

savings and investments;

hire purchase and pawnbroking;

money transfer;

financial advice

stocks, shares, unit trusts and bonds.

Cover businesses regulated by the Financial Conduct Authority (FCA) for retail financial-services activities;

businesses with a standard consumer-credit licence issued by the Office for Fair Trading (OFT) for consumer-credit activities; and some other financial services that are not necessarily regulated by the FCA e.g. where they were regulated by the FCA in the past.

Most financial problems involving products and services provided in (or from) the UK.

Time limits generally six months from final response (which has to mention the six-month time limit); and six years from the complaint-generating event (or - if later - three years from when the consumer knew, or could reasonably have known, they had cause to complain). Some exceptions.

Resolved 58% of all disputes within six months - and 43% of non-PPI cases within three months.

Raising standards

Complaint handling: publishes Principles of Good Complaint Handling.

Service improvement: can ask organisations to ensure staff learn lessons and set out how they will avoid future failings. Can send findings to regulators.

Parliamentary Ombudsman provides each government department with an annual analysis of complaints about them and the organisations for which they are responsible.

Complaint handling: provides guidance and training on effective complaint handling.

Service improvement: anonymised case digest with lessons. Good practice guidance. Training for providers in complaints handling.

Send annual letters to councils setting out how well they are doing at handling complaints.

Complaint handling: provides good practice guidance along with seminars and workshops.

Service improvement: issues guidance notes, runs policy seminars and workshops for institutions and student unions, can provide bespoke training.

Formal Complaints by institution published from Jan 2013. Can name the University when publishing cases with a wider public interest application.

23,381 calls to technical advice desk, dedicated service for professionals handling complaints in the financial services sector and consumer-advice world.

Service improvement: seminars, roadshows, exhibitions and events.

Relationship with regulator

Memorandum of Understanding with Care Quality Commission and Monitor, broadly to acknowledge statutory responsibilities; to share information; to align data collection where appropriate; to have regular contact and to be open and transparent.

No specific statutory power to automatically trigger a CQC investigation.

Memorandum of Understanding with CQC to acknowledge independent and separate statutory responsibilities; facilitate information sharing and quality monitoring; inform each other of issues; co-ordinate actions to ensure proportionate and timely approach; be open and transparent; ensure that people who deal with one organisation are suitably signposted to the other when necessary.

No specific statutory power to automatically trigger a CQC investigation.

Memorandum of Understanding with QAA: identify and agree areas where information-sharing is appropriate and contribute to the other organisation’s work, including: inform one another on relevant developments ; exchange information; look to maximise opportunities for joint communication on matters of

mutual and public interest.

No specific statutory power to automatically trigger a QAA investigation.

Memoranda of Understanding with FCA, OFT, Information Commissioner’s Office (ICO), Claims Management Regulator, Lending Standards Board, Pensions Ombudsman, and some other Ombudsman schemes.

Co-ordination committee made up of senior staff from FOS, FCA, and OFT. The purpose of this committee is to help to identify emerging issues that could lead to widespread consumer detriment – and to co-ordinate each organisation's separate response to these.

Providers have statutory duty to signpost to Ombudsman?

No.

Institutions must tell student about OIA once the internal process is complete.

Explicit signposting duty on providers to make users aware of FOS.

Role, powers and accountability

Action to put things right, apology, compensation for financial loss, compensation for inconvenience/distress, staff training, changes to policies and procedures.

Can report non-compliance to parliament, NHS provider and/or professional body as appropriate.

Decisions not binding.

Public Administration Select Committee is both the parliamentary champion of the PHSO’s work and the body that scrutinises it and holds it to account. The committee holds a pre-appointment hearing with the recommended candidate for PHSO, and scrutinises the office through an annual appearance in front of the committee.

The Parliamentary and Health Service Ombudsman is an independent crown servant appointed by the Queen.

26,358 initial enquiries in 2012-13 of which 4,889 needed a closer look. 3,914 decisions of no more action to take.

508 issues put right without need for formal investigation,

467 formal investigations.

Action to put things right, apology, compensation for financial loss, compensation for inconvenience or distress, provision of a service, staff training, changes to policy and procedures.

Decisions are not binding.

Powers enabled by the Commission for Local Administration in England.

Communities and Local Government Committee monitors spending, administration and policy of DCLG and its arm’s length bodies, including the LGO. The Ombudsmen are Crown appointments.

In 2012-13, helped 20,186 people register a complaint/enquiry about local public services/adult social care. 10,307 needed further consideration. 4,771 of these needed further investigation. 1,937 resulted in identification of failings and agreement to put things right or report with recommendations for remedy. 2,834 investigations where body had acted correctly or issues caused no adverse consequences.

Compensation or other remedies possible. Can name institutions for non-compliance. Has set indicative bands of compensation for distress and inconvenience awards. Usually aim to put student back in the position they would have been in, e.g. exam retake.

Decisions are not binding.

The OIA is a Company Limited by Guarantee and is governed by its Memorandum and Articles of Association as amended.

Members of the Company are: Association of Heads of University Administration;

Committee of University Chairs;

GuildHE; Higher Education Wales;

National Union of Students; and

Universities UK.

Independent Adjudicator and Chief Executive is appointed by the OIA Board: majority of members are independent of the sector.

The Independent Adjudicator and Chief Executive and the independent Board members are appointed under Nolan rules.

The OIA is a registered charity.

2012 – 2,012 complaints received, 1,795 closed.

Two types of redress: money awards and directions awards (telling the business what it needs to do to put things right). Can also make an award for non-financial loss.

Decisions are binding on the business but not the consumer.

The Financial Ombudsman Service is a public body set up by Parliament. Statutory functions are carried out on non-commercial, not-for-profit basis.

Board of six directors appointed by the FCA. The chairman appointed by the FCA with the approval of the HM Treasury.

Directors take a strategic ‘public interest’ overview and ensure that the ombudsman service is properly resourced/able to carry out its work effectively and independently.

Directors appoint the ombudsmen and publish a report annually – as well as minutes of board meetings. Directors also form a number of sub-committees of the full board.

2,161,439 initial enquiries and complaints in 2012-13.

508,881 new cases, up 92% on the previous year (mainly PPI).

Resolved 223,229 cases - compensation for consumers in 49% of complaints.

[1] Investigation: GPs, Which? Magazine, April 2013; Investigation: Home Care, Which? Magazine, October 2012; Care Homes Investigated, Which? Magazine, May 2011

[2] Populus, on behalf of Which?, interviewed a random sample of 2,101 UK adults aged 18+ online between 3rd and 6th May 2013

[3] Populus, on behalf of Which? conducted an online poll of UK adults asking about their experiences of the following services over the last twelve months: GP, hospital, care home, home care services, childcare, schools and higher education. The data was collected in two waves, totaling 4132 consumers, and took place between 19th - 23rd February 2014. Data were weighted to be representative of all UK adults. Populus are a member of UK the British Polling Council and abide by their rules.

[4] The Patients Association, Complaint handling in Trusts signed up to the CARE campaign, January 2013

[5] The CQC’s remit as regulator of health and social care services in England covers much of the wider private healthcare industry, save some exceptions (for example, talking therapies).

[6] Ann Clwyd MP and Patricia Hart, A review of the NHS Hospitals Complaints System: putting patients back in the picture, October 2013

[7] Robert Gordon, Governance Review of the Local Government Ombudsman Service, November 2013

[8] Report for the DoH, An independent review of cosmetic surgery recommends better regulation, better training and proper redress if things go wrong, April 2013

[9] This will be something Which? will be looking at in the coming months as part of its work on alternative dispute resolution in private markets.