Unified NHS complaints system urged: Bottomley welcome for call to scrap 'cumbersome' procedures. Nicholas Timmins reports

THE complex mix of at least four different NHS complaints procedures should be scrapped and replaced by one system, a government-appointed committee will recommend this week.

The new system would cover everything from complaints about hospital food to GP services and complaints about treatment. It should provide much greater emphasis on conciliation and rapid response, the committee says, with written complaints acknowledged within two days and normally replied to within three weeks.

If a second stage of more formal investigation were needed, the panel undertaking the inquiry would have a lay majority and would normally be expected to report within five weeks.

The recommendations from the committee, chaired by Professor Alan Wilson, Vice-Chancellor of Leeds University, have been welcomed by Virginia Bottomley, the Secretary of State for Health. She will publish them for consultation with a view to legislation in the autumn. She believes the new system will provide much more 'openness and dialogue' between the NHS and its patients at a time when complaints have been rising sharply and the complaints systems have come under increasing fire for being cumbersome, difficult to understand and unresponsive.

The report, Being Heard, whose recommendations have been seen by the Independent, recommends one common system to replace the four currently used - the formal and informal procedures used to deal with complaints involving GPs, dentists or pharmacists, the hospital complaints procedure and the clinical complaints procedure. The hope is to reduce both formal procedures and litigation through a greater willingness to acknowledge errors earlier and apologise.

All types of staff should be encouraged to deal with oral complaints on the spot, the report says. If a written complaint still results, there should be investigation and/or conciliation followed by a written response, with professional advice sought where complaints involve clinical judgement or professional matters. The same approach would be followed within GP practices, hospitals and health authorities, with smaller practices banding together and having someone whose job is to deal with complaints.

If the complainant remains dissatisfied, the internal approach would be followed by a more formal 'external' stage two. An independent panel with a lay chairman and a lay majority would investigate. Panels would normally have three members, but two professionals could be added as independent assessors if the complaint involved issues of professional judgement or specialist knowledge. The panels should normally provide a full written report to the complainant and those complained against within five weeks. How the panels would be appointed is yet to be resolved.

The new procedures should only be concerned with resolving complaints, the report says - not with disciplining doctors, nurses or other staff. All the information gained from handling the complaint, however, should be made available to managers or professional bodies if disciplinary action were to arise.

The report says the NHS should take a more positive view of complaints, seeing them as a way to improve services. GP practices, NHS trusts and others should review their handling of complaints quarterly and publish an annual report, as should the Department of Health.

Among the committee's 67 recommendations are that the health service ombudsman should have his jurisdiction extended to cover family doctors.