The purpose of this Policy is to ensure that patients, relatives, carers and all other users of services have their complaints and concerns dealt with in confidence and impartiality, with courtesy and empathy in a timely and appropriate way.
A responsible person, who will ensure the organisation complies with the complaints procedure and actions, identifies as necessary during the investigation of a complaint, are taken. This person should hold a senior position within the organisation.
- All written complaints will be acknowledged within 3 working days of receipt and agreement reached with the complainant about the expected time scale and outcome of the investigation. Oral complaints would ideally be resolved within 24 hrs and front line staff actively encouraged to do this.
- Confidentiality will be respected at all times and the patient’s consent will be sought where complaints are made by anybody other than the patient themselves.
- The Director of Operations will undertake a thorough investigation of events and seek to address all aspects of a patient’s complaint; taking advice and where beneficial, arranging meetings with the complainant.
- Where appropriate the Federation will invite and co-operate with agencies such as PALS, Healthcare Resolutions or ICAS in order to achieve a local resolution.
- The Federation will also ensure that links are established with Social Services and other agencies to ensure a seamless response to complaints.
- Every effort will be made to keep the complainant informed of progress and for a final response to be sent to the complainant by the senior partner within the agreed timescale.
- The Director of Operations will keep a record of all complaints received together with details of timescales and outcomes. This information will contribute to the identification of service improvements, staff training needs as well as forming part of the practice’s Annual Report on Complaints for NHS England.
PROCEDURE FOR DEALING WITH COMPLAINTS
Complaints lead: Dr J Spinks - Facilitator: Helen Hutchings
Procedure: - Informal complaints
- Made verbally, may be resolved satisfactorily by telephone or a face to face meeting usually by the Director of Operations. These should be logged, records filed and a note that they were resolved satisfactorily. These complaints would not normally be a part of the annual review.
Procedure: - Formal complaints
- To the Federation, will be acknowledged in writing or by telephone, within three working days. The facilitator will contact the complainant to determine their desired outcome and to explain the process, the possibility of mediation and what to do if they are unhappy with the outcome.
- A leaflet will be given outlining this process. The timescale for resolution of the complaint will be agreed. If the matter is to be dealt with within the Federation then the complaint is reviewed by the complaint leads, statements and any other investigations obtained from concerned parties as appropriate.
- The complaints leads will then draft a response on behalf of the practice and this will be passed to the responsible person, only once the response has been agreed and signed off by this person, will the complainant receive a copy of the response. If there is no further issue the complaint will be considered closed.
- The complaint will be discussed at the next Federation Board meeting unless it is so serious that an emergency meeting needs to be called.
- Outcomes will be decided to correct any issues which arise from the complaint.
- The complaints log will be completed in full and in line with legislation; this will be done by the facilitator.
- If the complaint is made dually to NHS England then the practice needs to take no further action other than to co-operate with NHS England in the provision of statements and arranging face to face meetings.
- If the complainant wishes to meet the recipient of the complaint this will be organised by the facilitator lead who will take minutes and act as chair of the meeting.
- Any complaints not resolved and attempts at local resolution have been exhausted, they will be passed to the Health Service Ombudsman, which will include an independent clinical review, should the need arise, and all other options have been considered.
- Care will be taken not to breach a patient’s confidence unless their informed consent is received to do so.
- The complaint must be received within 6 months of the incident.
- A quarterly audit of complaints will be undertaken and reviewed at a Federation meeting to determine whether there are any clinical / organisational issues that are emerging as a trend or improving as a trend.
- An annual audit of complaints will be undertaken and a copy sent to NHS England.
- This will include the number of complaints received, which of these were found to be well founded and the number of complaints referred to the Ombudsman. It should also contain the subject matter but exclude confidential information and be confined to the details of the complaint. Also included should be any matters of general importance arising from the complaints, such as lessons learnt and improvements to service as a result of the complaint
The Federation is committed to resolving concerns and complaints raised by patients, and or members of the public, however, it is recognised that on rare occasions staff have contact with patients/members of the public whose complaints are considered to be vexatious or persistent. Complaints/concerns raised by patients/members of the public are considered to be a vexatious where previous or current contact with the member of the public or complainant shows that at least two of the following criteria have been fulfilled , or are in repeated breach of at least one, of the following criteria:
- Persistent in pursuing a complaint where the NHS complaints procedure has been fully and properly implemented and exhausted.
- Seek to unduly prolong contact by restating what is essentially the same complaint in different terms. (Care must be taken not to discard new issues which are significantly different from the original complaint. These should be addressed as separate complaints).
- Refuse to accept, without good cause, documented evidence of treatment given as being factual e.g. drug records, GP records, nursing notes.
- Deny receipt of an adequate response despite evidence of correspondence specifically answering their questions.
- Do not accept that facts can sometimes be difficult to verify when a long period of time has elapsed.
- Do not clearly identify the precise issues which they wish to be investigated, despite reasonable efforts of Trust staff and, where appropriate, independent advocacy, to help them specify their concerns, and/or where the concerns identified are not within the remit of the Trust to investigate.
- Focus on a trivial matter to an extent which is out of proportion to its significance and continue to focus on this point. (It is recognised that determining what a ‘trivial’ matter is can be subjective and careful judgement must be used in applying this criteria).
- Have, in the course of addressing a registered complaint, had an excessive number of contacts with the Trust placing unreasonable demands on staff. (A contact may be in person or by telephone, letter, E-mail or fax. Discretion must be used in determining the precise number of "excessive contacts" applicable under this section using judgement based on the specific circumstances of each individual case).
In determining arrangements for handling habitual or vexatious complaints the practice must consider: -
- Whether the complaints procedure has been correctly implemented and that no aspect of a complaint has been overlooked or inadequately addressed. In doing so it should be appreciated that complainants or members of the public who raised habitual or vexatious complaints may raise substantive concerns and issues which, even if unable to be resolved, should be approached rationally and sympathetically.
- Whether it can identify the point at which a complaint has become habitual or vexatious.
- Whether the complainant or member of the public whose complaint is considered vexatious is known to have recorded meetings or face to face/telephone conversations without the prior knowledge and consent of the other parties involved.
- Whether the complainant or member of the public whose complaint is considered vexatious displays unreasonable demands or expectations and fail to accept that these may be unreasonable (e.g. insist on responses to complaints or enquiries being provided more urgently than is reasonable or normal recognised practice).
- Whether the complainant or member of the public whose complaint is considered vexatious have threatened or used actual physical violence towards staff or their families or associates at any time - this will in itself cause personal contact with the complainant and/or their representatives to be discontinued and the complaint will, thereafter, only be pursued through written communication. (All such incidents should be documented).
- Whether the complainant or member of the public whose complaint is considered vexatious have harassed or been personally abusive or verbally aggressive towards staff dealing with their complaint or their families or associates. (Staff must recognise that complainants may sometimes act out of character at times of stress, anxiety or distress and should make reasonable allowances for this.) Staff should document all incidents.
Procedure for dealing with Vexatious Complainants
Careful judgement and discretion must be used in applying criteria to identify habitual and vexatious complaints and to decide what action to take in specific cases. This should only be implemented following agreement by all concerned, including the Director of Operations, the Complaints Manager and the Board.
The course of action must be agreed by the above and put in writing to the complainant, including reasons why the complaint has been classified as vexatious, and signed by the appropriate Director. The letter should be copied for the information of those involved in the complaint and a record should be kept by the Facilitator, of the reasons why a complainant has been classified vexatious and the actions taken.
Vexatious complaints may be dealt with in one or more of the following ways:
- Decline further contact with the complainant, either in person, by telephone, fax, letter or electronically (or any combination of these) whilst ensuring that one form of contact is maintained.
- Notify complainants, in writing, that the partners has responded fully to the points raised and has tried to resolve the complaint, that there is nothing more to add and continuing contact on the matter will serve no useful purpose. Complainants should be notified that correspondence is at an end and that further communications will be acknowledged but not answered.
- Inform complainants that in extreme circumstances, the Federation reserves the right to refer members of the public whose complaint is considered vexatious or unreasonable to solicitors and, if appropriate, the police.
Withdrawing Vexatious Status
Once complaints are considered have been determined as habitual or vexatious, there needs to be a mechanism for withdrawing this status at a later date if, for example, the complainant or member of the public subsequently demonstrate a more reasonable approach, or if they submit a further complaint for which the normal complaints procedure would appear appropriate. Discretion should be used in recommending that this status be withdrawn as appropriate.
Where this appears to be the case, discussion will be held with the Director of Operations and Complaints Manager. Subject to their approval, normal contact with complainants of the practice complaints procedure will then be resumed.
If a complainant, or someone with authority to act on their behalf, disagrees with the decision to deem their complaint as being vexatious, they may put their reasons in writing and address them to the appropriate partner. Upon receipt of such a communication the appropriate partner will consider it as a request by the complainant for withdrawal of vexatious status. The appropriate partner will reconsider the decision to impose such status on the complainant and will do so in consultation with the Director of Operations and the Complaints Manager.
PARLIAMENTARY AND HEALTH SERVICE OMBUDSMAN
If the complainant is dissatisfied after the Federation have investigated their concerns and provided a response, they can ask the Parliamentary and Health Service Ombudsman, to investigate their case.
The Ombudsman is completely independent of both the NHS and the Government. As well as complaints about NHS services, he/she can investigate complaints about how the complaints procedure is working.
The Ombudsman is not obliged to investigate every complaint that is put to him/her, and he/she will not generally take on a case, which has not first been through the NHS complaints procedure, or a case which is being dealt with by the courts.
If the Federation receives notification that a case has been referred to the Ombudsman the Customer Services Team will:
- Ensure the Ombudsman is sent copies of the complaint investigation file within the timescale set by the Ombudsman.
- Liaise with the Ombudsman to provide additional information as requested.
- Co-ordinate the formulation of an action plan for any actions identified as needed as a result of the Ombudsman’s review of the complaint.