Next Review Date: May 2016

Version 2.0

Date published: May 2015

Next Review date: May 2016

THE BELL SURGERY

PATIENT COMPLAINT FORM

Overview

At the Bell Surgery we welcome compliments, concerns or any other comments you may have about us. We make every effort to give the best service possible to everyone who attends our Practice.

However, we are aware that things can go wrong sometimes resulting in a genuine cause for complaint. If this is so,we hope that we can sort most problems out easily and quickly, often at the time they arise and with the person concerned.
If you have a complaint or concern about the service you have received from the Doctors or any of the personnel working in this Practice, please let us know. We operate a Practice Complaints Procedure as part of an NHS Complaints System, which meets or exceeds national criteria.

We are continually striving to improve our service and we welcome any helpful suggestions you may have.

How & When to Complain

Our Complaints Procedure is structured around three main principles – listening, responding and improving.Most problems can be sorted out quickly and easily so please talk to us.

Where we are unable to resolve your complaint andyou wish to make a formal complaint, please do so in writing as soon as possible after the event, ideally within a few days.

Please use the attached form and be as specific and concise as possible andthis will enable us to establish what happened more easily.

If you are unable to complain as soon as possible after the event then your complaint should be submitted within 12 months of the incident that caused the problem; or within 12 months of discovering that you have a problem.

This 12 month limit may not apply if the practice is satisfied thatthere were good reasons for not being able to make the complaint within the time limit. Despite the delay, it may still be possible to investigate matters effectively and fairly.

The Practice Complaints Manager is Louise West and DrChris Langleyis the GP partner ‘responsible person’ for complaints.

Please address your complaint in writing to the Practice Manager.

Complaining on Behalf of Someone Else

We keep strictly to the rules of medical confidentiality. If you are not the patient, but are complaining on their behalf, you must have their permission to do so. An authority signed by the person concerned will be needed, unless they are incapable (because of illness or infirmity) of providing this. A Third Party Consent Form is provided below.

What we will do

Our Practice Manager will make sure that your concerns are dealt with promptly and will acknowledge receipt within 3 working days. She will aim to have looked into the matter within 10 working days.

If the matter is likely to take longer we will let you know and keep you informed as the investigation progresses.

We will investigate the circumstances of your complaint; make it possible for you to discuss the problem with those concerned; make sure you receive an apology if this is appropriate, and take steps to make sure any problem does not arise again.

You will receive a written response setting out the result of the investigation.

If you are dissatisfied with the outcome

If you are not happy with the resolution provided locallyby the Practice you can make your Complaint known to:

The Health Service Ombudsman.

Their contact details are:

The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London
SW1P 4QP

Tel:0345 0154033

The Patient Advice and Liaison Service (PALS)

PALS provides confidential advice and support, to help you sort out any concerns you may have about the care we provide and to guide you through the different services available from the NHS. They arbitrate between both sides to seek a mutual agreement. This often takes time but can be very helpful having a third person review.

You can contact PALS:
by email at
byphone on0800 328 7971
by mail toOxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane,Headington, Oxford OX3 7JX

NHS England

NHS England is the body that commissions GP services and theycan help manage your complaint for you.
by phone on 0300 311 22 33(Monday to Friday 8am to 6pm, excluding English Bank Holidays)
by e mail to:(Please state: ‘For the attention of the complaints team’ in the subject line)

By post: NHS England, PO Box 16738, Redditch, B97 9PT

The Complaint Form is on the next page >
COMPLAINT FORM

Patient Full Name:

Date of Birth:

Address:

Complaint details: (Include dates, times, and names of practice personnel, if known)

...... ……......

……………………………………………………………………………………………………………………

(Continue overleaf if necessary)

SIGNED……………………………………………Print name……………………………………

PATIENT THIRD-PARTY CONSENT

PATIENT'S NAME:______

TELEPHONE NUMBER:______

ADDRESS:______

______

ENQUIRER / COMPLAINANT NAME: ______

TELEPHONE NUMBER:______

ADDRESS:______

______

IF YOU ARE COMPLAINING ON BEHALF OF A PATIENT OR YOUR COMPLAINT OR ENQUIRY INVOLVES THE MEDICAL CARE OF A PATIENT THEN THE CONSENT OF THE PATIENT WILL BE REQUIRED. PLEASE OBTAIN THE PATIENT’S SIGNED CONSENT BELOW.

I fully consent to my Doctor releasing information to, and discussing my care and medical records with the person named above in relation to this complaint only, and I wish this person to complain on my behalf.

This authority is for an indefinite period / for a limited period only (delete as appropriate)

Where a limited period applies, this authority is valid until…………………….. (insert date)

Signed: ………………………………………. (Patient only)

Date: …………………………………………..

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