Version 2 – Status: finalComplaints Handling Policy and Procedure

COMPLAINTS HANDLING POLICY AND PROCEDURE (NHSNottinghamCity)

June 2010

VERSION CONTROL
Version / Date / Author / Status / Comment
v1.1 / June 2010 / GG / Draft / Consultation
v1.2 / June 2010 / GG / Approved / Quality & Patient Safety Committee
V1.3 / July 2010 / GG / For ratification / Performance & Governance Committee
V2 / July 2010 / GG / Ratified / Performance & Governance Committee
CONTROL RECORD
Title / Complaints Handling Policy and Procedure (NHSNottinghamCity)
Reference
Purpose / Describes the policy and procedure for handling complaints about services provided, commissioned and contracted by NHSNottinghamCity
Audience / All staff involved in receiving, investigating and responding to complaints about NHSNottinghamCity and patients or members of the public making complaints about NHSNottinghamCity
Issue / 1 / Issue date / July 2010
Version / 2 / Date / July 2010
Status / Final / Review / July 2012
Owner / Director of Nursing and Quality
Author / Complaints Lead
Superseded Documents / Policy & Process for Managing Complaints (Commissioning - Corporate) 2007
Other Related Documents / Incident Reporting Policy (approved December 2009)
Safeguarding Children: Common Assessment Framework (approved July 2009)
Safeguarding Adults: Policy, Procedure and Guidance for Alerters and Referrers (approved October 2007)
Policy and Procedure for the identification, management and support of performers on NHSNottinghamCity performers lists whose performance gives cause for concern (approved March 2010)
Equality Impact Assessment / Date – July 2010
Approved by / Quality & Patient Safety Committee / Date / June 2010
Ratified by / Performance & Governance Committee / Date / July 2010
Target audience / All staff involved in receiving, investigating and responding to complaints about NHSNottinghamCity
Distribution list /
  • Document Management System

Method / Paper copies  Intranet  Other  Document Management System
Archived / Date / Location
Access

Contents

Page

1

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Introduction

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4

2

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Purpose

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4

3

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Scope

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4

4

/

Legal Framework

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4

5

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Principles

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5

6

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Roles and Responsibilities

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6

7

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What is not covered by this policy

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8

8

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Who can make a complaint

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8

9

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Time Limits on Making a Complaint

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9

10

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Support for Complainants

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9

11

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Training and Support for Staff

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10

12

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Reporting and Learning

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10

13

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Unreasonably Persistent Complainants

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10

14

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Complaints Procedure

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11

Appendix 1

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Process Flowchart

/ 16

Appendix 2

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Risk Matrix

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17

Appendix 3

/ Unreasonably Persistent Complaints Procedure / 18

Appendix 4

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Redress Procedure

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21

Appendix 5

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A Protocol for Joint Handling of Health and Social Care Complaints

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26

1.Introduction

1.1NHSNottinghamCity(Primary Care Trust) commissions health services for its local resident population. NHSNottinghamCity is committed to ensuring stakeholders, patients and the public are involved in shaping the services we commission.

1.2NHSNottinghamCity aims to commission the highest quality care, treatment, level of services and facilities to the local community. We want to know what people think about the services and welcome both positive and negative feedback from the local community.

1.3Compliments, comments, concerns and complaints help us to confirm what we are doing right and to identify problem areas. They give us an insight into the standards of care that we commission. Above all, they help us to take action to prevent similar problems occurring in the future and to continually improve services.

1.4Complaints are taken seriously and resolved, whenever possible, at local level by front-line staff and their managers.

1.5NHSNottinghamCity aims to ensure that patients, relatives, carers and all other users of local health services have their complaints dealt with sympathetically, promptly, confidentially, impartially and with courtesy.

2. Purpose

2.1.The purpose of thispolicy is to ensure that patients, relatives, carers and all other users of local health services have their complaints and concerns dealt with in confidence and impartiality, with courtesy in a timely and appropriate manner.

2.2.The purpose of this policy is also to inform staff of NHSNottinghamCity of the policy and procedure in relation to complaints and their role within the procedure.

3. Scope

3.1This procedure applies to all patient complaints relating to NHSNottinghamCity corporate services as well as services commissioned and contracted by or on behalf of NHSNottinghamCity.

3.2Complaints made to and handled by CitiHealth will be considered under CitiHealth’s complaints procedure.

4. Legal Framework

4.1This policy is written to conform with current regulations and guidance and in particular:

4.1.1The Health and Social Care (Community Health and Standards) Act 2003

4.1.2The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 (SI/2009/309 & SI/2009/1768)

4.1.3Listening, Responding, Improving, a guide to better customer care (DH 2009)

4.2This policy is underpinned by the Principles of Good Complaint Handling as set out by the Health Service Ombudsman in 2009, which are:

  • Getting it right
  • Being customer focused
  • Being open and accountable
  • Acting fairly and proportionately
  • Putting things right
  • Seeking continuous improvement

4.3This policy also takes into account:

4.3.1The NHS Constitution

4.3.2The NHS Litigation Authority Standards

4.3.3The NHSNottinghamCity Media Handling Policy

5.Principles

5.1.NHSNottinghamCity recognises that most patients receiving NHS health care do not wish to complain about their care, therefore when a complaint is received it is significant. All complaints will be listened to and treated seriously.

5.2.Most complaints and concerns will be resolved informally by front-line staff or their managers.

5.3.Providers of commissioned or contracted services will be supported by NHSNottinghamCity to resolve complaints with the consent of the complainant.

5.4.When patients and members of the public make a complaint to NHSNottinghamCity we will:

5.4.1.Invite the complainant to have a say in how the complaint is handled and how to put things right

5.4.2.Consider all aspects of the complaint in a timely manner using the most appropriate method

5.4.3.Provide an honest and open response including a detailed explanation of events covered by the complaint

5.4.4.Where possible, put things right and apologise if something has gone wrong

5.4.5.Consider financial redress if the complainant has suffered financial loss as a direct consequence of a justified complaint (see the financial redress procedure at appendix 4)

5.4.6.Identify learning from the complaint

5.5.Where a person complains on someone else’s behalf, NHS Nottingham City will obtain the consent of the patient, or where that is not possible, will satisfy itself that the complainant is acting in the best interests of the patient before accepting the complaint.

5.6.No-one will be discriminated against or treated badly as a result of making a complaint or raising a concern. Complainants who are patients will not have their care or treatment compromised as a result of making a complaint.

5.7.NHSNottinghamCity supports the use of advocacy to support patients and members of the public making complaints. All complainants will be provided with details of the Independent Complaints Advocacy Service when their complaint is acknowledged.

5.8.All complaints information will be confidential to the complainant, NHSNottinghamCity and providers of services commissioned or contracted by NHSNottinghamCity where appropriate.

  1. Roles and Responsibilities

6.1Chief Executive has overall responsibility for complaints handling within NHSNottinghamCity.

6.2Director of Nursing and Quality is authorised by the Chief Executive to ensure compliance with the regulations and that any necessary action is taken in light of the outcome of complaints.

6.3Assistant Director of Quality and Patient Safety is authorised by the Chief Executive to quality assure and sign off individual complaints and will ensure:

6.3.1Appropriate complaints handling

6.3.2Compliance with policy objectives

6.3.3Making employees in the organisation fully aware of the policy and procedures, and ensuring they receive the necessary training

6.3.4Completion of accurate and adequate records in the recording and investigation of complaints

6.3.5Prompt corrective action to rectify, modify and ensure high standards as a result of findings from any complaint

6.4Complaints Lead is responsible for managing the complaints procedure, and will

6.4.1Provide the organisation with the strategic lead on complaints issues

6.4.2Highlight any concerns in regard to organisational compliance with the complaints policy and procedure and complaints regulations

6.4.3Update the organisation as to changes in complaints processes

6.4.4Maintain a database of all formal complaints

6.4.5Develop clear information for service users and staff in regard to the complaints process

6.4.6Risk rate all received complaints (and seek advice in doing so as appropriate)

6.4.7Ensure consent; confidentiality and Caldicott principles are adhered to

6.4.8Ensure that the complaints procedure is compliant with Mental Capacity Act 2005 guidance

6.4.9Report and provide relevant information to the Care Quality Commission and Parliamentary and Health Service Ombudsman

6.4.10Advise and support Investigating Officers in regard to the carrying out of complaints investigations

6.4.11Review and evaluate compliance with the procedure

6.4.12Be responsible for ensuring that the Quality and Patient Safety Committee and the Board of NHS Nottingham City receive quarterly reports on complaints

6.4.13Liaise with the Communications Team to highlight any risk of media attention.

6.5Complaints Officers are responsible for the day to day operation of the complaints procedure and will

6.5.1Assist and support patients and members of the public who wish to make a complaint

6.5.2Agree the complaint details with the complainant

6.5.3Seek consent where required

6.5.4Agree complaints handling with the complainant

6.5.5Liaise with complainants, advocates, staff and providers of contracted and commissioned services to achieve resolution of complaints

6.5.6Arrange meetings, mediation or other complaints handling methods agreed with the complainant

6.5.7Ensure that each complaint is considered fully

6.5.8Draft complaint responses

6.5.9Ensure agreed timescales are met

6.5.10Undertake post-resolution complainant satisfaction surveys

6.5.11Support the Complaints Lead to provide reports and complaints data

6.5.12Support the Complaints Lead to provide training on complaints to staff and providers of contracted and commissioned services

6.6Investigating Officers are responsible for investigating individual complaints (see 14.12.3 for further details)

6.7All employees of NHS Nottingham Cityshould ensure that they are aware of the complaints policy and be able to signpost complainants to the complaints team.

7What is not covered by this policy

7.1The following are not covered by the NHS complaints procedure:

7.1.1Complaints that have already been investigated under the 2009 complaints regulations, unless there are significant reasons to do so.

7.1.2Complaints which are under investigation by the Health Service Commissioner.

7.1.3Complaints from professionals about other professionals.

7.1.4Staff complaints about employment issues.

7.1.5Complaints about privately funded health care.

7.1.6Allegations of a criminal nature, including allegations of fraud.

7.1.7Complaints which are subject to an ongoing police investigation or legal action, where a complaints investigation could compromise the police investigation or legal action.

7.1.8Complaints about an alleged failure to comply with a request for information under the Freedom of Information Act 2000.

7.1.9Complaints about an alleged failure to comply with a data subject request under the Data Protection Act 1998.

7.2Where NHSNottinghamCity has decided not to investigate a complaint because it falls within one of the categories specified above, then NHSNottinghamCity will write to the complainant to explain the decision and give reasons.

7.3Complaints regardingdecisions about continuing care fundingwill be considered under the NHS East Midlands NHS Continuing Healthcare Local Dispute Resolution Procedure. Complaints about any other aspects of the continuing care assessment and decision-making process will be considered in accordance with this complaints handling policy.

  1. Who can make a complaint
  2. A patient or any person affected by or likely to be affected by the action, omission or decision of NHSNottinghamCity and providers of services commissioned or contracted by NHSNottinghamCity.
  3. Someone acting on behalf of a person specified in paragraph 8.1 with that person’s consent.
  4. A child (under 16) who is considered competent to make her/his own decisions under the Fraser guidelines.

8.4A parent, carer or guardian on behalf of a child, either with that child’s consent if the child is considered competent to make his/her own decisions under the Fraser guidelines, or without consent where the child is not considered competent.

8.5A person complaining on behalf of someone who lacks capacity to make their own decisions (within the meaning of the Mental Capacity Act 2005) or on behalf of someone who has died, where the Complaints Lead considers that the complainant is acting in the best interests of the patient.

8.6A person who holds lasting power of attorney for a person specified under paragraph 8.1, where the power includes health and welfare matters and is registered with the Court of Protection.

8.7If the Complaints Lead (following consultation with the Assistant Director of Quality and Patient Safety) decides not to accept a complaint because the complainant does not fall within any of categories specified above, then NHSNottinghamCity will write to the complainant to explain the decision and give reasons.

  1. Time Limits on Making a Complaint

9.1The time limit on making a complaint is 12 months from the date of the incident giving rise to the complaint or the date that the complainant became aware of the incident giving rise to the complaint.

9.2Where a complaint is made after the 12 months time limit then the Complaints Lead (following consultation with the Assistant Director of Quality and Patient Safety) may use his/her discretion to accept the complaint if the complainant had good reason for not complaining earlier and it is possible to investigate the complaint fairly and effectively despite the delay.

  1. Support for Complainants
  2. Complainants will be offered independent support when making a complaint, through the Independent Complaints Advocacy Service (ICAS) and, where appropriate, specialist advocacy services.

10.2Complainants will be given support to overcome any communication or other difficulties to enable them to make a complaint e.g. provision of interpreters.

10.3NHSNottinghamCity will communicate with complainants in their preferred medium, e.g. email, letter, telephone or face to face wherever possible.

  1. Training and Support for Staff
  2. NHSNottinghamCity will arrange for all new staff to attend complaints training as part of their induction programme.
  3. Members of the complaints team will be available to offer help and advice on dealing with complaints for any member of staff.
  4. Staff who are subject to a complaint will be supported by their manager who will ensure that he/she is informed of the details of any complaint made against them, given the opportunity to answer the complaint, and kept informed of the progress of the complaint and its outcome.
  1. Reporting and Learning

12.1NHSNottinghamCity is committed to learning from complaints and patient feedback and where appropriate making service changes. NHSNottinghamCity welcomes complaints as opportunities to maximise learning and service development.

12.2Following the investigation of individual complaints an action plan will be drawn up by the relevant manager and the Complaints Lead advised of progress in completing the action plan. Where appropriate the complainant should also be advised of progress in completing the action plan.

12.3Satisfaction surveys will be sent to complainants at the close of each complaint and information obtained will be included in the quarterly complaints reports.

12.4Quarterly provider service complaints reports will be submitted to the appropriate quality leads and commissioning managers for information and analysis.

12.5Quarterly provider service complaints reports will be submitted to the relevant committees for information and analysis. These reports will contain both qualitative and quantitative information.

12.6Quarterly complaints reports will be provided to the Board, these reports will also be provided to the NHS East Midlands, ICAS, the Care Quality Commission and other bodies if requested.

12.7An annual report compiling information on complaints received will be submitted to the Board, Care Quality Commission, ICAS, NHS East Midlands and other interested parties and organisations.

  1. Unreasonably Persistent Complainants
  2. NHSNottinghamCity is committed to treating all complaints equitably and recognises that it is the right of every individual to pursue a complaint.
  3. However in a minority of cases people pursue their complaints in a way which can either impede the investigation of their complaint or can have significant resource issues for NHSNottinghamCity.
  4. Unreasonably persistent complainants are those complainants who, because of the frequency or nature of their contacts with NHSNottinghamCity, hinder the consideration of their, or other people’s, complaints.
  5. Where the Complaints Lead (following consultation with the Assistant Director of Quality and patient Safety) decides that a complainant is considered to be unreasonably persistent then the complainant will be informed and asked to behave reasonably.
  6. Where the complainant does not behave reasonably then the Complaints Lead will plan how to deal with the complainant and send copies of the plan to the complainant and any professional also in contact with the complainant.
  7. The full procedure for unreasonably persistent complainants is set out in appendix3.
  1. Complaints Procedure(Please see Appendix 1 for Process Flowchart)
  2. Complaints and concerns will be resolved as quickly and efficiently as possible. It is anticipated that most complaints and concerns will be resolved quickly without the need for them to go through the formal complaints process.
  3. When a oralcomplaint is resolved to the complainant’s satisfaction by the next working day after the day on which the complaint was made, then it will be recorded as a Patient Advice and Liaison Service (PALS) issue.
  4. The complaints procedure has two stages:
  • local resolution
  • independent review

14.4At the local resolution stage, complaints about Corporate Services will be considered by the Complaints Team with appropriate clinical advice as necessary.

14.5At the local resolution stage complaints about services commissioned and contracted by NHSNottinghamCity will be considered either by NHSNottinghamCity or the provider (independent contractor or commissioned service provider), whichever the complainant chooses.

14.6Where a complaint is received by NHS Nottingham City about a commissioned or contracted service, the Complaints Team will ask the complainant which NHS organisation they wish to handle the complaint and either pass the complaint to the provider (with the complainant’s consent) or consider the complaint at the local resolution stage.

14.7When a complaint is passed to the provider for local resolution, the Complaints Team will ask the provider to inform NHSNottinghamCity of the outcome of the complaints handling and provide NHSNottinghamCity with a copy of the response to the complainant.

14.8Independent review is carried out by the Parliamentary and Health Service Ombudsman. Once all reasonable steps have been taken to resolve the complaint at the local resolution stage the Complaints Team will inform the complainant that local resolution has been completed and advise them of their right to complain to the Parliamentary and Health Service Ombudsman.