Positive option satisfies patients: Nicholas Timmins looks at how complaints are dealt with in two different parts of the country

WHEN Margaret Goodwin went into Warrington NHS Trust for a hip replacement last November, she judged the quality of care 'atrocious'. There was, she said, 'nothing wrong with the operation, or the medical care, that was all first class'.

But the standard of nursing and catering during her 10- day stay had the former NHS administrator fulminating. 'My first day post-operatively when I was still full of tubes and drips and so on, I had to use the bed-pan. I rang for the nurse to take me off and half- an-hour later I had to get a male visitor to the ward to help me up. There was no sign of a nurse.'

She was discharged without anyone checking the wound, so that the dressing had to be changed at the last minute in a hospital bathroom, and the catering arrangements were such that 'anyone at the end of the ward, as I was, was lucky to get anything reasonable to eat'. The attitude of the nurses, she said, had been one of 'couldn't care less'. Older patients on the ward were talked to 'as if they were idiots.'

Mrs Goodwin, 57, wrote a long letter of complaint.

The outcome rather than a formal reply, a formal investigation and an exchange of letters was an invitation to meet the senior nursing officer and the hospital's director of quality for a meeting which lasted two-and-a-half hours.

All the points she had raised were gone into. On some Mrs Goodwin was satisfied by the answers she heard. On others, she says, the hospital promised action. 'It think they were quite mortified by what I told them. I think they may not have known. If no one complains, you assume it's all hunky- dory. They said they planned to rotate the staff round the wards and do things about the catering. I have been assured that action is being taken on the points I raised.'

The handling of her complaint was excellent.

Mrs Goodwin's experience is the result of a less confrontational approach the trust says it has taken, attempting to use complaints to improve services, and thus to defuse them.

Those complaining get an invitation to come in and discuss the issue. That applies just as much to complaints about medical treatment as nursing care or catering. 'If the patient requests a meeting, the consultant or other doctors have to be there,' Sylvia Yates-Dutton, the hospital's complaints and litigation officer, who mediates at such meetings, says.

Since last November, 40 patients had taken advantage of such meetings and gone away happy. One measure of the new approach's success may be that Mrs Yates- Dutton has not been required to act as litigation officer in a year.