Looking at complaints differently

Complaints are not often associated with innovation and creativity. When we think of complaints, we think of frustration, failure and poor service. Receiving lots of complaints is seen as something to be wary of, not celebrated. But getting complaints show that people think it’s worth complaining and that they will be listened to, and that they believe that they have power to influence the system.

They are a good sign of democracy in action.

A complaint – defined as any expression of dissatisfaction, where a response or resolution is explicitly or implicitly expected – identifies a problem, or at the very least a gap between people’s expectations and what was delivered. Though the usefulness of complaints may vary just like any feedback, a complaint can provide important insight on where there is need for improvement or an opportunity for innovation. And with advances in information and communication technologies, making and receiving complaints is becoming more and more commonplace.

Fuelling innovation
But are complaints changing public services? As the services we turn to at times of need such as the death of a loved one, ill health, financial risk or our children’s education, complaints in public services are dealt with seriously and systematically. But do they lead to innovation? To what extent do complaints help public services adapt to today’s rising and complex demands? How can public services use complaints to listen, and engage with the public as co‑producers of better outcomes?  And how can public services make it easier for people to complain and encourage them to do so?

These are some of the questions we address in our report ‘Grumbles, gripes and grievances: the role of complaints in transforming public services’. We’re particularly interested in complaints because we think they can help to re-shape the relationship between individuals and the public services they use.

It is frequently recognised that public services need to change. People want better outcomes, care about public services and expect them to be delivered well. Our demands and expectations of what public services can and should deliver are rising, in part in response to service innovations in other areas of our lives. New technology is rapidly changing how we access media and the news, how we communicate, how we shop and share goods. The growth of apps and social media tools makes giving feedback a part of everyday life. We expect responsive public services to adapt and change.

A look at the past
But the way that public services are currently organised remains largely a legacy of the way the post-war welfare state was designed, along with market-oriented changes of the 1980s and beyond, and an understanding of how best to manage delivery based on targets and centralised control. Despite lots of examples of innovation and moves towards more personalised services, the majority of public services place the public in a passive role, the recipient of relatively standardised and uniform services.

Given the changing nature of demand, we argue that public services need to be centred around citizens and responsive to their needs, and work in different ways to engage and involve the public, communities and frontline staff. And responding differently to complaints is one way of doing that.

Complaints can help to identify and prioritise need; highlight opportunities to  change; challenge established wisdom; co-create and co-produce solutions; and uncover system failures.

Once complaints have been made, how do we ensure that they are acted on and are valued, so that those complaining are satisfied and so that services develop in response? People only complain rather than ‘exit’ from a service if they think that complaining will be effective and that they will be listened to and that their complaint will be taken on board.

Complaints provide an opportunity to open a dialogue with the public. This means being open to criticism and making it easy for people to complain by seeking and encouraging feedback. It means being responsive in dealing with complaints, responding appropriately, having a culture of listening to what citizens have to say, learning from it and working with them to co-produce better outcomes.

Examples of innovation
Our report highlights some great examples of how complaints can get the public and service deliverers working together to transform public services.

While technology is breaking new barriers in parts of the public sector many important innovations in the online environment are being led by citizens themselves. Patient Opinion is an example of a citizen-led innovation enabling users of health services to join forces and voice their feedback and complaints.

A social enterprise, founded by former GP, Paul Hodgkin, Patient Opinion has grown from a forum for reporting complaints, to a respected platform for patient feedback. Many registered health organisations are now listening and responding. Some NHS trusts pay for a live feed facility which allows for prompt responses to complaints or suggestions from members of the public.

When it comes to eliciting complaints, there are many examples of innovations in online, mobile and citizen-led channels for complaining. Creating innovative online platforms and mobile apps such as FixMyStreet for citizens to report problems, or make complaints about services, is a way of anticipating problems and initiating prompts for change and innovation.

FixMyStreet is a digital intermediary where individuals can upload photos to report problems to their local authority through their phone. It is used by a large number of local authorities in the UK and is a tool for individuals to report a problem rather than having to make a complaint that a problem has not been fixed.

Moffatt Community Flood Group provides a different way to achieve savings. Their willingness to co-produce by ‘adopting’ drains helps avoid the failure of the drainage system and prevent the huge financial costs of severe flooding.

The community had repeatedly complained about flooding, and were angry with the agencies not accepting responsibility. They formed a Flood Resilience Group to be pro-active to the threat of flooding. To help reduce the risk, residents have agreed to “adopt” a drain, notifying the Council if it needs to be unblocked.

Complaints help identify blind spots in operational contexts, and thereby hold the key to unlocking innovation and improvement. The Homeless Discharge Project at Arrowe Park Hospital in the Wirral, shows one such blind spot. The problem had been completely missed by hospitals and councils until it was raised by homeless people.

Homeless patients were being discharged with little support, resulting in poor health outcomes. They complained about the support both on admission and in relation to early discharge. The local acute hospital worked with the council to fund a link worker to improve the level of support.

People power
Key to all of this is the great people we have delivering public services. We make some recommendations in our report for a few key things we can do to make a difference.

We suggest keeping a range of channels open for complaints, providing choice in the way complaints can be made, and using new technology to record and respond to complaints, therefore making it easier to complain and to collaborate to resolve complaints).

We urge public authorities to communicate effectively and give people more immediate feedback so that they understand how their complaints are being dealt with, and to learn from complaints data alongside other sources of intelligence to redesign services.

We also recommend local authorities inform complainants of the analysis and outcome of complaints, thereby improving accountability and giving opportunities for people to collaborate in co-producing service redesign.

Other suggestions include leading a culture of openness (strategic leadership is needed to create a listening culture), and giving frontline staff the power and flexibility to quickly resolve complaints and feed into change and innovation (avoiding processes that formalise complaints too quickly).

Advice for all levels
We also make specific recommendations for those involved in dealing with complaints about public services at different levels:

Senior leaders should prioritise innovation; use complaints as source of ideas and innovation; create an open atmosphere; and ensure accountability.

Managers should create an open culture that values complaints; train and empower frontline staff to make changes to improve customer experience in response to complaints.

Complaint specialists should embrace new technology to make it easier to elicit complaints; use complaints data to stimulate innovation; co-produce solutions with service users.

And commissioners should include complaint handling as a criterion in awarding contracts; ensure providers embed learning from complaints.

Let’s grasp the opportunity to use complaints to deliver better outcomes for all of us.

Further information
Grumbles, Gripes and Grievances: The role of complaints in transforming public services is available to read on Nesta’s website at www.nesta.org.uk/complaints_report