The Swedish Agency for Public Management

Patient complaints and patient safety. Interim report containing proposals for changes to the handling of complaints from private individuals regarding the health services (2013:24)

Statskontoret (the Swedish Agency for Public Management) has a multi-year government assignment to monitor and evaluate the handling of complaints from private individuals under the Swedish Patient Safety Act. On 1 June 2013, the Health and Social Care Inspectorate (IVO) assumed responsibility for receiving and investigating complaints regarding the health services. The final report on Statskontoret's assignment will be presented in October 2014.

Within the assignment framework, this interim report by Statskontoret proposes changes to the handling of complaints in order to address the problems that we have observed during IVO's investigative work. Among the problems identified are large balances of open cases, long processing times and higher costs for IVO activities than originally calculated.

The report submits proposals for a number of measures that IVO may take within the framework of current legislation in order to speed up its processing of complaints. Among other things, we recommend IVO to implement shorter reply deadlines when requesting information during its investigative work and, to a greater extent where appropriate, to make use of verbal contacts in that work.

However, we assess these measures to only be capable of influencing the overall set of problems to a limited extent. For this reason, Statskontoret proposes changes so that complaints which are relevant from a supervisory perspective will continue to be investigated by IVO, while the primary responsibility for handling complaints within the health services will instead reside with the Patient Advisory Committees of the county councils.

Statskontoret proposes the following amendments to the Patient Safety Act:

  • IVO should be enabled to prioritise from a supervisory perspective which complaints the Inspectorate will investigate.
  • IVO, as a main rule, should be obligated to forward complaints not being investigated by the Inspectorate to the relevant Patient Advisory Committee.
  • To simplify the processing of complaints, the IVO should apply the communication and party insight provisions of the Administrative Procedure Act. IVO should also be able to make the same kinds of decision in complaint cases as in other cases of supervision.

Statskontoret's proposals seek to streamline IVO's role as a supervisory agency and to strengthen the role of Patient Advisory Committees in the work towards patient safety. Our assessment is that the changes we are proposing will result in an enhancement of efforts to achieve safer healthcare.