Unreasonably lengthy processing times at the Health and Social Care Inspectorate persist

The Swedish National Audit Office has examined how the Health and Social Care Inspectorate manages healthcare complaints lodged by individuals. The overall conclusion is that processing is not efficient.

“In 2018, the Government decided to scale down the agency’s obligation to investigate, so that complaints would be handled more efficiently in terms of resources. We cannot see such an effect. On the contrary, the situation is headed in the wrong direction pretty much across the board,” says Auditor General Christina Gellerbrant Hagberg.

Processing times have increased sharply since 2021. In 2024, the median processing time was just over 19 months, increasing to 23 months in the first three months of 2025. According to the Health and Social Care Inspectorate, an investigation should take a maximum of nine months and the aim is to achieve this by the end of 2025. In 2024, only roughly ten per cent of investigations were completed within that deadline.

The lengthy processing times mean that the complainant and those under investigation are forced to wait an unreasonable amount of time for a decision. These circumstances also lead to a risk of healthcare providers and healthcare staff not receiving legitimate criticism.

For individuals, this can prolong their suffering after a traumatic event. For healthcare staff under investigation, but who may not have done anything wrong, it can affect their situation in the workplace and make changing jobs more difficult.

The lengthy processing also impedes investigations. Healthcare staff and responsible managers may have been replaced, documentation may be missing or no longer relevant, and those involved find it harder to recall the incident.

"This also risks leading to important experience not coming to the benefit of the healthcare system in its work on patient safety. By the time the Health and Social Care Inspectorate issues its decision, the activities may have changed so much that matters addressed in the decision may no longer be relevant,” says Maria Karlsson, project leader for the audit.

According to the Health and Social Care Inspectorate, the lengthy processing times are due to aspects such as a lack of resources and greater specialisation in the healthcare system. At the same time, the agency’s remit has expanded and become increasingly complex, placing heightened demands on deliberate resource allocation. In 2024, the Health and Social Care Inspectorate increased its resources for the processing task. All the same, the number of completed investigations has dropped.

This audit also shows that the agency does not perform systematic risk analysis based on information that emerges in complaints. Complaints may be analysed as one of several source materials in other types of cases, but only once a case has already been opened. Complaints are therefore not used efficiently as a basis for planning of, for example, self-initiated supervisory measures.

The Health and Social Care Inspectorate has an extensive and important supervisory role, which has also been expanded with several government assignments in recent years. In 2024 and 2025, the Health and Social Care Inspectorate reorganised its processing procedure. The Swedish National Audit Office considers that, in the long term, this may lead to more efficient complaint processing. At the same time, numerous fundamental problems persist, making it unlikely that the Health and Social Care Inspectorate will address the shortcomings in the near future.