Healthcare Complaints Analysis

Healthcare Complaints Analysis Tool (HCAT, said as “H” then “cat”) is a method for systematically analysing complaints, and grouping key insights reported within thousands of experiences reported by patients every year to healthcare institutions. The tool, which is free to use, allows staff to reliably determine the problems reported in complaints at three-levels of specificity; to grade their severity, the harm caused to patients, and where in the hospital system problems occurred.

88,069complaints in the founding systematic review

60+peer-reviewed HCAT studies

20+countries

~2problems reported per complaint letter

8.5 minto code a complaint after training

23%of reported problems are high severity

Explore HCAT

Guide

Four steps to applying HCAT to your own complaints: read the manual, complete the free online training, analyse your data with the graphing tool, then produce a report that informs learning.

Open the guide →

Evidence & Research

Six featured studies, from the founding 2016 paper to the 2025 work on the dark figures of complaints — plus sortable tables of 13 validations, adaptations and translations, and 48 HCAT research papers.

See the evidence →

Team & Contact

HCAT was developed by Prof Tom Reader and Prof Alex Gillespie in the Department of Psychological and Behavioural Science at LSE. Adaptations and translations are welcome.

Meet the team →

“It is no pity to receive a well-founded complaint about healthcare. However, it is a pity to draw no learning from it!”

Birkeland, Bogh & Morsø (2024), BMJ Open Quality

“Many of the organisations we work with spend significant resources ‘managing’ complaints, but recognise that they need to get better at learning from them. HCAT provides an evidence-based methodology, approach and system to facilitate this.”

Clinical Leadership, Southern Trust, Northern Ireland

“Complaints are often reviewed on an individual basis but we needed a strategy to collectively analyse several hundred narrative complaints received over 12 months. HCAT provided us with a free, user-friendly yet comprehensive method to categorise a vast quantity of narrative data in a systematic manner.”

Centre for Quality and Patient Safety Research, Deakin University, Australia.

“HCAT has proved to be a useful tool that has assisted us to better utilise complaints information to monitor and improve patient safety. Adding the HCAT dimension to our complaints analysis process has helped us identify where our systems and processes can be improved.”

Medical Project Manager, Southern Trust, Northern Ireland

Who uses HCAT?

Odense University Hospital, Denmark

All complaints at the hospital have been HCAT-coded since 2022 — “likely… the world’s largest sample of HCAT-scored complaints” (Bogh et al., 2023). Coding is supported by a Danish training and certification programme (Morsø et al., 2023).

Victoria, Australia

HCAT domains and categories were built into VHIMS, the state-wide incident management system, in its July 2021 upgrade, and are used to classify complaints data (Street et al., 2022). The stage-of-care and harm modules are “currently not in use”.

NHS end-of-life care, England

A licensed HCAT derivative for analysing end-of-life care complaints is in routine use in the NHS (Walker & Dowling, 2024), who acknowledge Gillespie & Reader as “developers and licensors” of the tool.