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Moreover, the experience of making a complaint, including its outcome, often falls short of patient expectations, particularly in relation to the interpersonal conduct of National Health Service (NHS) staff. Over half of unresolved (local) complaints are subsequently upheld by the ombudsman with others potentially resulting in costly litigation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>A nuanced discourse analytical approach to analysing the language choices within complaint-responses could potentially provide greater insight into why many local complaints continue to remain unresolved. Over a period of 1 month we collated a data corpus of written complaints and their responses (<jats:italic>n<\/jats:italic>\u2009=\u200960) from an NHS healthcare area in Scotland, United Kingdom (UK) following anonymisation by NHS complaint handling staff. We took a qualitative approach to analysing the data drawing upon Discourse Analysis with this paper reporting on the complaint-responses only (<jats:italic>n<\/jats:italic>\u2009=\u200959). We had undertaken a similar review of the initial written complaints and this is reported elsewhere. In this paper we examine <jats:italic>how, and to what extent<\/jats:italic>, the complaint-responses fully addressed the complainants\u2019 perceived grievances.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The complaint-responses rarely acknowledged the amount of detail or \u2018work\u2019 involved in making the complaint. Complaint-responses constructed complainants\u2019 accounts as subjective by using specific discourse strategies. Further, complaint responses used unintentionality or exceptionality to mitigate sub-standard experiences of care. We also observed the \u2018fauxpology\u2019 - a non-apology or false apology (e.g. I am sorry <jats:italic>you feel<\/jats:italic>) which imputes the cause of distress to the subjective (and possibly misguided) impressions of the complainant. The complaint-responses thereby evade blame or responsibility for the complainable action by implying that the complainants\u2019 feelings do not align with the facts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Complainants and complaint-responders work to different frames of reference. Complaint responders need to engage and align with complainants from the outset to ensure more appropriate complaint- responses. Complaint resolution as opposed to complaint handling could be enhanced by the approach of linguistic analysis and reference to the consumer literature\u2019s justice-based approach to post-complaint behaviour.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-021-06733-5","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T13:02:59Z","timestamp":1626354179000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A qualitative study of National Health Service (NHS) complaint-responses"],"prefix":"10.1186","volume":"21","author":[{"given":"May","family":"McCreaddie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethan","family":"Benwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Gritti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"6733_CR1","volume-title":"Annual Report and Accounts","author":"SPSO: Scottish Public Services Ombudsman","year":"2020","unstructured":"SPSO: Scottish Public Services Ombudsman. 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(2021) https:\/\/www.realtalktraining.co.uk\/ Accessed 24 Feb 2020."}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-021-06733-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-021-06733-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-021-06733-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T13:06:17Z","timestamp":1626354377000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-021-06733-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":64,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6733"],"URL":"https:\/\/doi.org\/10.1186\/s12913-021-06733-5","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,15]]},"assertion":[{"value":"11 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures and methods performed in this study involving human participants were in accordance all the relevant guidelines and regulations. Ethical approval was obtained from the Local Research Ethics Committee (Tayside Local Research Ethics Committee 11\/ES\/0048). All written complaints and their responses over the period of 1 month were collated and fully anonymized by the complaint handlers prior to being received by the researchers, negating the need for explicit a priori consent, as approved by the LREC which included consent for publication. Caldicott data protection consent forms [] were completed with data securely held in storage (soft and hard copies) as per ESRC guidelines []. No subjects were aged 18 or under. No experimental protocols were involved in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"696"}}