Complaints Report for Planned Care, Urgent Care, and

Diagnostics and Pharmacy forSeptember 2015

  1. OVERVIEW

During September 2015the Trust investigated 13 new complaints (7 less than in August 2015). This is the lowest number of complaints received in month since 2012. 8were related to the Urgent Care Division, and 5related to the Planned Care Division. No complaints related to the Diagnostics and Pharmacy Division.

Table 1 below highlights the number of complaints investigated by the Trust each month since April 2014.

Table 1

  1. COMPLAINTS BY PROFESSION

Table 2 below highlights the number of complaints investigated in September 2015 by profession.

Table 2 –Complaints Breakdown by Profession,September2015

Division / Profession / Number
Planned Care (5) / Clinical / 2
Nursing / 1
Clinical and Nursing / 1
Management and Admin / 1
Scientific, technical and professional / 0
Urgent Care (8) / Clinical / 3
Nursing / 3
Clinical and Nursing / 2
Management and Admin / 0
Scientific, technical and professional / 0
Total / 13
  1. COMPLAINTS BY SPECIALITY

Table 3 below highlights the number of complaints investigatedin September 2015by speciality.

Table 3 –Complaints Breakdown by Speciality,September 2015

Division / Speciality / Number
Planned Care (5) / Gynaecology / 1
Obstetrics / 1
Orthopaedic Surgery / 1
Urology / 1
Vascular Surgery / 1
Urgent Care (8) / Care of the Elderly / 2
Emergency Medicine / 4
Ophthalmology / 2
Total / 13

In 2013/14 Planned Care, Urgent Care,and Diagnostics and Pharmacy investigated 220 new complaints (out of a total number of 228 new complaints investigated).

In 2014/15 Planned Care, Urgent Care,and Diagnostics and Pharmacy investigated a total of 264 new complaints (out of a total number of 266 new complaints investigated). The 266 complaints investigated in 2014/15 represents an increase of 38 new complaints (14%) in comparison to 2013/14.

In 2015/16 to date, Planned Care, Urgent Care, and Diagnostics and Pharmacy investigated a total of 107new complaints (out of a total number of 111 new complaints investigated to date).

A breakdown of the numbers of complaints investigated can be found in Table 4 below.

Table 4 –Complaints Breakdown by Speciality, 2013/14 and 2014/15 (YTD)

Division / Speciality / 2013/14 / 2014/15 / 2015/16 (YTD)
Planned Care / Breast / 2 / 5 / 1
ENT / 7 / 8 / 4
Fertility / 1 / 1 / 0
General Surgery / 34 / 34 / 11
Gynaecology / 9 / 16 / 5
Obstetrics / 24 / 20 / 4
Orthodontics / 3 / 2 / 1
Pain Management / 2 / 1 / 1
Plastic Surgery / 4 / 2 / 4
Trauma & Orthopaedics / 19 / 22 / 9
Urology / 10 / 13 / 7
Vascular Surgery / 7 / 19 / 6
Urgent Care / Emergency Medicine / 36 / 26 / 18
Care of the Elderly / 16 / 22 / 7
Acute Medicine / 2 / 13 / 2
Paediatrics / 10 / 11 / 4
Gastroenterology / 4 / 10 / 3
Cardiology / 1 / 10 / 2
Dermatology / 0 / 0 / 1
General Medicine / 8 / 5 / 1
Ophthalmology / 10 / 6 / 4
Respiratory Medicine / 7 / 8 / 1
Renal Medicine / 0 / 0 / 1
Rheumatology / 0 / 2 / 2
Therapies / 1 / 2 / 0
Stroke / 0 / 0 / 5
Diabetes/Endocrinology / 0 / 0 / 2
Diagnostics
and Pharmacy / Pharmacy / 0 / 1 / 0
Radiology / 3 / 5 / 1
Total / 220 / 264 / 107
  1. COMPLAINTS CATEGORIES & TRENDS

Table 5 below highlights the key themes identified:

Table 5 – Overview of the Patient Theme by Location in September 2015

Division / Trend / Location / Number
Planned Care (5) / Clinical Treatment (2) / Central Labour Suite / 1
Ward 53 / 1
Record Keeping (1) / Ward 34 / 1
Communication (1) / Appointments Office / 1
Staff Attitude (1) / Theatre Admissions Lounge / 1
Urgent Care (8) / Clinical Treatment (4) / ED / 3
Westminster Eye Unit / 1
Delay in treatment (1) / ED / 1
Discharge/Transfer Arrangements (2) / Ward 51 / 1
Ward 43 / 1
Staff Attitude (1) / Westminster Eye Unit / 1
Total / 13

For further information about these cases, please see Appendix 1.

  1. PARLIAMENTARY & HEALTH SERVICE OMBUDSMAN INVESTIGATIONS

1 new investigation was accepted for investigation by the Ombudsman in September 2015. This case related to a Care of the Elderly patient, whose daughter was opposed to her being transferred to Ellesmere Port Hospital. The complainant also raised a variety of concerns about social service. A joint Local Government/Health Service Ombudsman investigation was proposed. However, this was subsequently stopped when the Trust advised that the complaint was still at the Local Resolution stage of the complaints process and therefore it would not have been appropriate for the Ombudsman to have investigated at this time.

The 8existing PHSO investigationsremain ongoing. The Ombudsman has advised that they have completed their investigation of C97/14. They have decided to provisionally uphold the complaint on the grounds that staff did not follow NICE guidelines. Further information about this case will be forthcoming shortly.

Table 6 below has further details of these cases.

Table 6 – PHSO Ongoing Investigations

Division / Ref. No. / Speciality
Planned Care (3) / C147/13 / General Surgery
C132/13 / Plastic Surgery
C126/14 / Vascular Surgery
Urgent Care (5) / C123/14 / ED
C97/14 / ED
C64/13 / Elderly Care
C16/14 / Diabetes/Endocrinology
C108/14 / Gastroenterology
  1. HOT TOPICS
  • How can we make things better for patients?

We continue to receive a number of complaints which relate to perceived failures to follow the appropriate procedures as highlighted above by the Ombudsman. These include delays in treatment and care, lack of documentation, and poor communication. Previous concerns have included patients who have been lost to follow up, and incorrectly listed for day case surgery. Consideration needs to be given by the Divisions as to what action needs to be taken to prevent these types of complaints from occurring.

  • Delayed Responses

In September 82% of responses were sent out on time (down from 90% in August). A number of responses were delayed due to annual leave during August.

However, we still continue to experience a delay in receiving responses from all staff groups, and in approving responses for sign off.

  • Requests for Meetings

A number of meetings have been held in September. The number of new requests for meetings remains highand continues to impact on the workload for the Complaints and PALS Department and also for individual members of clinical, nursing and management staff. In order to speed up responses, the Trust is recording meetings (subject to the approval of the relevant staff and the complainant). Following the meeting, the complainants will be provided with a record of the meeting on CD. This will cut down on the typing up of lengthy notes and reduce the length of time complainants have to wait to receive this information.

  • Ombudsman Investigations

There has been a significant increase in the number of Ombudsman investigations in 2014/15. In 2014/15 the number of enquiries (32) received by the Ombudsman relating to this Trust almost doubled. The Ombudsman investigated 4 of these cases and upheld/partially upheld 3 of these cases.

In the same period, the Ombudsman carried out 10 times the number of investigations as in previous years (nationally). 1652 investigations relating to acute trusts (nearly half of the total number of Ombudsman investigations) were completed in 2014/15.

Key themes include:

  • Non-medical aspects of patient care, such as communication and staff attitude, account for just under half of the complaints investigated by the Ombudsman in 2014/15.
  • Poor communication accounts for 35% of complaints investigated.
  • Staff attitude accounts for 21% of complaints investigated.
  • Failure to diagnose accounts for 31% of complaints investigated.
  • Clinical treatment and care accounts for 38% of complaints investigated.

The Ombudsman published her annual report in September. Please see the following link for further information about the investigations undertaken nationally in 2014/15:

  • Accuracy of Responses

It is vital that complaints responses are factually correct. Otherwise this damages the integrity of our investigation as well as the reputation of the Trust if the complainant subsequently puts their complaint to the PHSO. An increasing number of complaints are being successfully challenged by complainants and further investigation of these cases has shown that the information previously provided by staff is often incorrect or incomplete. It is the responsibility of individual members of staff to ensure that the information they provide is factually correct.

  • Action Plans

When the Trust has identified shortcomings in the service provided, an action plan must be completed and returned promptly confirming the action being taken to address the concerns, and a deadline for completion. Action plans must be returned and completed by the agreed deadline and Divisions are reminded of the need to complete any actions identified by audits.

Geraint Jones

Head of Complaints and PALS

9 October 2015

1

1