Counter Fraud and Security Management Service complaints handling policy and procedure

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1 Counter Fraud and Security Management Service complaints handling policy and procedure The NHS Counter Fraud and Security Management Service (NHS CFSMS) s complaints policy has been taken from the NHS Business Services Authority (NHSBSA) s complaints policy. The NHS CFSMS version retains all the key elements of the NHSBSA policy but has been amended to make it directly applicable to customers of the NHS CFSMS. 1. Introduction The NHSBSA s policy is that complaints should be resolved locally, quickly and informally wherever possible. If your complaint cannot be locally resolved, i.e. if it is of a complex nature, this procedure aims to ensure there is consistency across the NHS CFSMS for the handling of formal complaints. The responsibilities for specific aspects of the formal complaints procedure are outlined where appropriate throughout this document. 2. Policy It is the responsibility of each member of NHS CFSMS staff to provide you with good customer service and to try to resolve your concerns as quickly, fairly and thoroughly as possible. The NHS CFSMS views your complaints as an opportunity to learn how we can continue to improve the services that we provide. Where applicable, action is taken to ensure that the problem does not occur again. The principles underpinning the NHS CFSMS complaints process are that it is: easy to access and understand speedy, with time limits for action, keeping you informed at all stages of the process informative so that feedback from your complaints can be used to review our practices effective, ensuring all points raised are addressed positively and suitable remedies are provided regularly monitored fair to complainants and staff alike. 1

2 3. Definition of a complaint: An expression of dissatisfaction that requires a response This includes dissatisfaction about the service provided, including the conduct of staff, or about the process involved in deciding what action to take (or not to take). The following are examples of things that are treated as complaints: claims of unfair treatment dissatisfaction about how we have dealt with a situation (for example, timeliness, clarity of information, confidentiality) claims that a poor standard of service has been provided (for example, losing documents, resulting in time delays and extra effort for our customers) claims that staff have been unhelpful or rude dissatisfaction with the outcome of a decision that has been properly made. 4. Procedure 4.1 Informal or formal complaint? One of the underlying principles of the NHS CFSMS s complaints system is that wherever possible, complaints should be resolved at the earliest opportunity at a local level without escalating to the formal procedure. Such claims are referred to as informal complaints. In deciding whether your complaint is informal, the NHS CFSMS applies the following criteria: Can your complaint be easily resolved, either at the point of contact or via referral through service management? Can resolution be reached amicably? If the answer is yes, your complaint constitutes an informal complaint. If the answer is no, it will be dealt with as a formal complaint. It should be noted that any informal complaint may escalate to become a formal complaint. 4.2 Informal complaints An informal complaint will be resolved in five working days, other than in exceptional circumstances, when you will be kept informed of progress. We will look to identify any opportunities for improvement as a result of any informal complaints that we receive. These will be reported to the NHS CFSMS complaints lead, the Head of Communications and Business Development Unit. All locally resolved complaints will be recorded for reporting and learning purposes. 2

3 4.3 Formal complaints Where attempts at local resolution have been exhausted, or where your complaint is complex and cannot be easily resolved at the local level, your complaint will be treated as a formal complaint. In such cases, a response will be provided to you by the Managing Director of the NHS CFSMS. Oral complaints If you wish to make a formal complaint over the telephone or in person, or if you need assistance putting your claim in writing, you should contact the NHS CFSMS complaints lead, the Head of Communications and Business Development, who will do his best to assist you. The Head of Communications and Business Development will send you a letter acknowledging and summarising your complaint within two working days of receiving it. This will give you the opportunity to add any further comments or information that you consider to be relevant. A substantive reply will be sent by the NHS CFSMS Managing Director within 25 working days of receipt of your complaint. Written complaints, including The Head of Communications and Business Development will acknowledge your written complaint within two working days of receipt. You will be notified in writing that a substantive reply will be sent by the NHS CFSMS Managing Director within 25 working days of receipt of your complaint. Investigation The Head of Communications and Business Development will carry out any further investigation required into the circumstances surrounding your complaint with the appropriate members of staff and prepare a draft response for the Managing Director. Response The Managing Director will review the draft response and the way in which your complaint has been handled and will send a substantive written response to you within 25 working days of receipt of your complaint. The response will address all issues raised and will notify you of the appeals process should you remain dissatisfied. Delays If it is not possible to provide you with a response within 25 working days, you will be informed of the reason for the delay as soon as possible (but no later than 25 working days after receipt of your complaint) and a revised response date will be set. 3

4 It should be noted that if your complaint relates to an ongoing NHS CFSMS investigation or legal proceedings, we will be unable to respond to it until the investigation or proceedings have been concluded. 4.4 Appeals Stage 1: If you remain dissatisfied with the response that you receive from the NHS CFSMS Managing Director, you will have the right of appeal to the Chief Executive of the NHSBSA. This appeal process will be made clear to you within the Managing Director s letter outlining his response to your complaint. We will acknowledge your appeal within two working days of receipt. The Chief Executive of the NHSBSA will allocate your complaint to a senior member of staff, independent of the issue being complained about. Your appeal will be investigated within 10 working days. The senior member of staff will report their findings and provide a draft response to the Chief Executive within 10 working days. If any extension to this timescale is required, the Chief Executive will notify you of the reason for the delay soon as possible (but no later than 10 working days after receipt of your appeal) and a revised response date will be set. The letter from the Chief Executive will also detail the further redress options available to you should you remain dissatisfied (i.e. referral to the Healthcare Commission). Stage 2: If you remain dissatisfied with the Chief Executive s decision on your complaint, you have the right to appeal to the Healthcare Commission. The NHS CFSMS Head of Communications and Business Development and Managing Director will provide any information that the Healthcare Commission may request in relation to the complaint. Stage 3: If you remain dissatisfied with the review provided by the Healthcare Commission, you have the right to appeal to the Health Service Ombudsman. The NHS CFSMS Head of Communications and Business Development and Managing Director will provide any information that the Health Service Ombudsman may request in relation to the complaint. 5. Evaluation and reporting Evaluation Complaints evaluation is carried out on a regular basis to determine whether recent complaints have been justified or not consider whether any improvement opportunities have been identified as a result of recent complaints. make recommendations for remedial action to prevent recurrences. 4

5 Reporting The NHS CFSMS Head of Communications and Business Development will report to the NHS CFSMS Senior Management Team and the NHSBSA s Corporate Secretary on volumes, nature and outcomes of complaints on a quarterly basis. A composite end-of-year report will be produced by the NHSBSA Corporate Secretary for review by the NHSBSA Leadership Team. Updated Oct

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