Handling Complaints in Irish Health Services: Training Staff to Respond

How a health service responds to a complaint often shapes what happens next: whether it is settled at the point of contact, goes to a formal investigation, reaches the Ombudsman, or feeds into a regulator's view of the service. For managers in hospitals, nursing homes, disability services and primary care, including those in Dublin, training staff to handle complaints well is one way to support a safe service. This guide summarises what the HSE, HIQA and the Ombudsman's materials we read say, and suggests how to structure staff training around them. It is a workforce and compliance guide, not legal or clinical advice. It sits alongside our guide to HIQA inspections and staff training.

Which rules apply depends on the service

The documents we read describe a public-service process (the HSE) and a regulator's role (HIQA), and they treat private services differently. HIQA's 2024 booklet on feedback and complaints says private hospitals usually have a complaints officer and a complaints policy, while the HSE's "Your Service Your Say" policy sets the stages for public services. The manual's definition of a complaint covers services provided by the HSE or by a service provider, so confirm which policy applies to your service. The first step for any employer is to identify which policy governs its service, and to make sure every member of staff can find it.

The HSE Your Service Your Say approach

The HSE's policy and guidance manual, titled as the 2017 edition and showing no issue date in the text we read, sets out how feedback is managed. Under it, a complaint can be made under Part 9 of the Health Act 2004 by anyone who is or was receiving, or is seeking, a HSE or service-provider health or personal social service. If the person cannot complain because of age, illness or disability, a close relative, carer, legal representative or other authorised person may do so for them. Comments and compliments can come from anyone.

The stages

• Stage 1, point of contact: staff try to resolve the matter at first contact. If they cannot, it goes to the line manager and then to a Complaints Officer if still unresolved.
• Stage 2, formal investigation: an assessment phase, with informal and formal routes. The Complaints Officer decides whether the complaint falls within the statutory process.
• Stage 3, internal review: a Review Officer reviews the Complaints Officer's recommendations.
• Stage 4, external: the complainant may go to the Office of the Ombudsman or the Ombudsman for Children's Office.

The manual states timeframes for these steps, such as a response from the line manager within two working days at Stage 1, notice to the complainant within five working days where a complaint is not taken forward after assessment, and investigation within 30 working days or an update to the complainant, with further updates every 20 working days. HIQA's 2024 booklet gives a similar picture for HSE complaints. Because the manual is older, confirm the current timeframes with your HSE area before using them in a training programme.

What the manual expects of staff

The manual describes several staff responsibilities. Staff are asked to accept all feedback under a "no wrong door" approach, to resolve complaints at the point of contact where possible, and to make sure the person's immediate healthcare needs are met first. They should offer an apology or explanation where possible and avoid blame or defensiveness, complete a point-of-contact resolution form when a complaint is resolved at first contact, and record feedback so that it can feed into improvement. Complaints Officers must update the complaints management system and tell the Complaints Manager about high-risk complaints.

What the manual says about training

The manual says training will be provided for all staff to help them handle feedback, that each service should provide an induction module on the complaints process for new staff, that Complaints Officers receive extensive training, and that training is available from induction level up to full Complaints Officer level. It also refers to anonymised learning notifications that a Complaints Officer may circulate after an informal resolution. We did not read a current training curriculum, so treat these as the manual's own statements of intent.

What HIQA says

HIQA's "Report a concern or give feedback" page says HIQA does not have the legal power to investigate individual complaints, and generally directs people to the provider first. The page suggests speaking to the person in charge or a complaints officer and putting the concern in writing. HIQA's 2024 booklet on feedback and complaints about health services adds that HIQA reviews feedback to judge whether services are safe, effective, caring and well managed. An inspector may request a plan from the provider, carry out a risk-based or focused inspection, use the information at a planned inspection, or track patterns across services, and in serious cases where people are at immediate risk HIQA may use its legal powers.

For employers, the practical point is that complaints are information a regulator may use. Complaints that are well recorded and learned from are easier to explain at inspection. Our guide to the HIQA Safer Better Healthcare standards explains the standards that frame this.

The Ombudsman route

HIQA's booklet says that people who are unhappy with an outcome or with how a complaint was handled can contact the Office of the Ombudsman, but should try to resolve the matter with the provider first. It states that complaints generally must be made within 12 months of the action or of becoming aware of it, unless there are very special circumstances, that the Ombudsman cannot examine complaints about private practitioners or private hospitals, and that children's complaints about public bodies, schools and hospitals can go to the Ombudsman for Children's Office. We could not open the Ombudsman's own website, so check ombudsman.ie for the current scope.

Building a staff training plan

None of the sources we read set out a mandatory national complaints training syllabus. The following is therefore our suggestion, built on the responsibilities listed above.

• Induction: A practical approach is to cover where the complaints policy lives, who the Complaints Officer is, and the "no wrong door" principle in the first week for every new starter, including agency and locum staff.
• First contact: Practise listening, acknowledging, apologising or explaining where appropriate, and checking that immediate needs are met, using realistic scenarios from your own service.
• Recording: Show staff exactly what to write, where, and how soon. Poor records make it hard to demonstrate that a complaint was handled properly.
• Escalation: Make clear when a matter goes to a manager, when it is a safeguarding or incident matter, and who decides.
• Respectful behaviour: Complaints can involve conflict. Pair complaints training with your dignity and respect policies; see dignity at work training for healthcare staff.
• Learning: Review themes regularly with the team and record what changed.

Learnsignal's offices are off Baggot Street in Dublin, and we offer in-person training from there. For current details, see our CPD pages.

Frequently asked questions

Does HIQA investigate individual complaints about a health service?

HIQA's page says it does not have the legal power to investigate individual complaints in general. It reviews the information it receives and assesses it against regulations and standards, and it directs people to the provider first.

Who can make a complaint under the HSE process?

The HSE manual says anyone who is or was receiving, or is seeking, a HSE or service-provider health or personal social service can complain, and that an authorised person such as a relative, carer or legal representative can complain for someone who cannot.

Is there a time limit for going to the Ombudsman?

HIQA's 2024 booklet says the Ombudsman generally requires complaints to be made within 12 months of the action or of becoming aware of it, unless there are very special circumstances. Check the Ombudsman's website for the current rule.

Should every member of staff be trained to handle complaints?

The HSE manual says training will be provided for all staff to help them handle feedback. Whatever your service type, a short common module for all staff, with deeper training for managers and Complaints Officers, is a sensible approach.

In summary, good complaints handling combines a clear policy, trained staff and honest records, and the sources above show how closely it connects to regulation.