About the Project

Real Complaints is a novel qualitative study combining conversation analytic research with ethnographic research to identify key moments across an entire complaints journey that influence what the outcome looks like for the patient and complaints handler.

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The experience of making a complaint, including its outcome, often falls short of patient expectations and in a worst-case scenario can lead to patients taking legal action against the NHS. Legal action is mostly likely to occur due to dissatisfaction with communication including in the complaints handling process. To improve patients’ experience of complaining and to better support complaint handlers we need to better understand what patients are looking for when they make a complaint and as a result of this, how call handlers can best address this with their communication skills.


Real Complaints’ training resources are a collection of structured workbooks and workshop resources designed with and for complaint handlers and based on the specific communication practices that have emerged as important from our research. The training incorporates real (anonymised) clips from recordings of complaint conversations which show how the language choices of complaint handlers influence how the patient feels about the encounter.


The evidence base for the Real Complaints training resource comes from our analysis of the communications that a patient has during the period of their complaint. The data set includes a survey of patient expectations and impressions of the NHS; recordings of phone calls, meetings, letters and emails; and ongoing reflections gathered from diaries and semi-structured interviews. We used conversation analysis to analyse the recordings, and ethnographic tools to capture how, over the course of a complaint, a patient reports their experience. By documenting and comparing all of these interactions, we have identified both examples of best practice and challenges for best practice in complaints communication.