All frontline health staff should be equipped with the skills to respond to complaints constructively, a National Audit Office report has recommended.

Feeding Back? Learning from complaints handling in health and social care, published this month, says: 'Focussing on the early and prompt response to concerns can avoid escalation into a formal complaint.'

It cites the example of a patient 'Mr J' who had been with a dentist 15 years having twice-yearly check ups until the dentist retired. On consulting a new dentist he was diagnosed with chronic gum disease and urged that prompt action was needed to rectify the situation. 'Mr J complained that his former dentist had failed to diagnose a chronic gum infection during numerous consultations,' says the report.

'As the dentist had retired Mr J's complaint was made directly to the PCT. The complaint progressed to the Ombudsman as the dentist did not respond to the PCT's. or the Healthcare Commission's requests for information.

In 2006-07 the NHS received 133,400 written complaints of which 32 per cent related to primary care services. It spent an estimated £68 million on local resolution.

The culture and attitudes of an organisation are often a barrier to responsive complaints handling and staff can be defensive, the report notes.

Managers should communicate to staff the importance of complaints in patients' experience of a service and patients should be given clear explanations about how to make a complaint including the use of 'email, telephone, letter and informal approaches.'

The report says that more could learned from complaints.