The Health and Social Care Inspectorate’s management of individuals’ complaints about health and medical care

Even though the agency’s obligation to investigate complaints was limited in 2018 to enable enhancing efficiency in its complaint management, processing times remain protracted. This risks adversely affecting legal certainty and the effect of the agency’s decisions on complaints. The complainant and the healthcare professional under investigation may have to wait an unreasonable amount of time for a decision. In addition, the lengthy processing times exacerbate complaint investigation. There is also a risk of healthcare providers and healthcare professionals not receiving legitimate criticism, while important experience does not come to the benefit of the healthcare system in its continuing work on patient safety.

The Health and Social Care Inspectorate does not have a sufficiently advanced system for following up on the agency’s decisions in complaint cases. The Swedish National Audit Office considers that the Health and Social Care Inspectorate therefore cannot make any certain statements on the equivalence of application of the complaint rules, or on developments over time.

There are weaknesses in the agency’s risk analysis based on how it processes information from complaint cases. Such information is not used systematically and proactively to identify at-risk individuals, activities or areas. Complaints may be analysed as one of several source materials in other types of cases, for example self-initiated supervision, but only once a case has already been opened. Complaints are therefore not used efficiently as a basis for planning self-initiated supervisory measures.

The Health and Social Care Inspectorate needs to develop information for and communication with individuals about complaints. The information on complaint rules, and what a complaint can be expected to lead to, are unclear to individuals. Furthermore, it is difficult for individuals to follow their complaint case with ease. This limits the individual’s insight into the process and impedes communication between the individual and the agency.

The Swedish National Audit Office notes that the Health and Social Care Inspectorate’s problems of processing individuals’ complaints have been an ongoing issue since the current rules were introduced in 2018. The shortcomings are essentially considered to be linked to the agency’s internal governance and execution of complaint management. In 2024 and 2025, the Health and Social Care Inspectorate has reorganised the processing procedure, which can lead to improvements in the long term. However, this audit shows that there is a risk of several fundamental obstacles to efficient processing persisting. The long-term efficiency problems in complaint management should be resolved through various measures. These include the need for a more appropriate IT support system for efficient processing and for developing ongoing monitoring of this type of case. Going forward, the Health and Social Care Inspectorate should also implement long-term measures to bolster complaint processing.

Another fundamental reason for the lengthy processing times revealed in this audit is that the number of case officers is insufficient, in terms of both processing the large volume of ongoing complaint cases, and at the same time receiving and processing new incoming complaints. The Swedish National Audit Office therefore considers that a targeted effort is needed to address the longstanding problems of large caseloads and lengthy processing times.