Complaint and Concern handling and learning

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1 TAUNTON & SOMERSET NHS FOUNDATION TRUST Complaint and Concern handling and learning Report to: Trust Board on 25 September 2013 Purpose of the Report: (Please type in Bold) This report sets out how the Trust has worked with the Patients Association to gain feedback from complainants, the work to date to improve concern and complaint handling and next steps. Sponsor: Author: Contact Details: Financial/Resource Implications: Risk Implications Link to Assurance Framework or Corporate Risk Register: Legal Implications: Link to CQC Essential Standards Freedom of Information Status: Previous Considerations: Action Required: (Please type in Bold) Carol Dight, Executive Director Nursing and Governance Martine Price, Head of Patient Experience None identified None identified None identified Indicative Timings (Mins) Outcome 1 Respecting and Involving Patients Outcome 16 Assessing Quality Outcome 17 Complaints Tick if one of the following apply: Data protection staff or patient detail Commercially sensitive Stakeholder management Early stage of discussion Potentially prejudicial to staff morale or partnership working The Trust Board receives a monthly report about complaints and PALs concerns as part of the clinical quality report. Each quarter provides more detail on the effectiveness of complaint handling and key issues and learning arising from complaints and concerns. The Trust Board is asked to consider the feedback from complainants and support the further work outlined. It is recommended that progress is monitored by the Governance Committee. Trust Board, Part A Page 1 of 6 Enclosure M

2 Complaint and Concern Handling and Learning Background How we listen to and act upon concerns and complaints of patients and their families is fundamental. As a Trust we take the handling of complaints and concerns very seriously. This paper sets out how the Trust has worked with the Patients Association to gain feedback from complainants, the work to date to improve concern and complaint handling and next steps. The lack of responsiveness to the complaints made by patients and relatives forms an important part of Robert Francis analysis of the failings at the Mid-Staffordshire NHS Trust, and there are 13 recommendations in his report that relate directly to complaints and their handling. The Trust has taken these recommendations and they have informed how we go forward. Alongside this a national review of complaint handling that was announced by the Prime Minister in his response to the Robert Francis report is due to report in the autumn. In 2011 the Patients Association developed a Complaints Survey to measure complainants satisfaction with a Trust s complaints process. This was delivered as part of the Speaking Up project which is aimed at improving complaints handling across the NHS. The survey allows Trusts (10 Trusts currently in England) to compare performance with other participating Trusts. It is sent to all complainants at participating Trusts, following local resolution of their complaint. What complainants tell us about how their complaint was handled. The Trust took the opportunity to be part of this project and up to the end of February 2013, the Trust issued 256 surveys, and 113 were returned. This is a response rate of 44%. Results are analysed by the Patients Association. There are 22 questions within the survey which cover all aspects of the handling of the complaint. Results for 4 key questions are shown in chart form as an appendix to the report. Key messages from complainants Complainants want to know what we have learnt and what action has been taken as a result of a complaint made. 38.4% of those complainants that responded to the survey felt their complaint was very well / well handled. When compared to the other 9 participating hospitals whilst this Trust is the second highest performing with the highest result being 50%, there is there is significant improvement required in the way complaints are handled in the NHS. Patients and their families do need to be confident that raising a complaint will not affect the quality of their on-going or future care and treatment. Complainants want a more personalised approach to the handling of their complaint. Below are a few examples of comments given as part of the survey: Over a 12 month period, I contacted PALs on 4 occasions. The first was whilst in hospital and was mainly due to lack of communication between different areas. Once PALs were contacted my care continued problem solved. Once out of hospital, I contacted PALs on 3 further occasions, mainly due to lack of information, referrals not being passed on, delays in Trust Board, Part A Page 2 of 6 Enclosure M

3 processing important information. Although PALs assisted and were very helpful, the same mistakes and delays were repeated. I feel lessons were not learnt Although my original complaint was dealt with within the timescale agreed, there are further questions and information regarding what happened which I have still not received. This is despite numerous phone calls and a letter from me asking for it Initially I was looking for assistance in getting a response from a consultant s secretary. When I contacted them four times in a 2 week period and never received a response. What started out wanting clarification has developed into a complaint against the consultant because of the process and I now believe it has affected my treatment plan Complaint was handled well in terms of escalated to senior person, my mother was treated by someone else, things were explained to me and most importantly to my Mother. I received explanations in writing. I am still unclear as to whether the doctor was concerned/understood that part of the issue was basic - all down to communication with patient at time of the procedure and that my mother felt he did not speak or understand English totally What action has been taken to improve how we handle complaints and concerns In 2011 responsibility for complaints came within the remit of patient experience an initial review of complaints and the PALs service led to changes and development of the service as summarized below. This work has been informed by the feedback from complainants who participated in the surveys. Increase in staffing resource for the PALs service from 1.6 Wte to 2.6 Wte. Relocation of the PALs office into the main building of the hospital so it is more accessible with rebranded leaflets and posters that are more visible. Proactive response to concerns has reduced formal complaints by 43% in the year 2012/13 and increased PALs activity by 40%. Formal training for key staff involved in formal complaint response, 39 staff received training delivered by the Patients Association in December This is in addition to on-going in-house training provided. More responsive formal complaint handling with evidence of more local resolution meeting being held. Complaint reporting improved to include information about the effectiveness of complaint handling. Review of complaint policy commenced, to align policy to Patient Association standards for good complaint handling and recommendations from the Francis report, to be completed in October. First peer review audit of complaint handling against the Patient Association standards held at the beginning of September. This will inform policy review and improve joint working on complaints across organisations in Somerset. Strengthened learning outcomes from complaints and development of action plans. Further work and emphasis required to share learning across the wider organisation. Going forward There is no doubt there is more to do to take forward how we respond to and learn from concerns and complaints. This aligns with the Trust values and the culture of an open and learning organisation. Increasingly patients and their families are seeking reassurance about a level of independence and the quality of the investigation of their complaint. Trust Board, Part A Page 3 of 6 Enclosure M

4 There is clearly a need to further improve on how we inform complainants what we have learnt as a result of their complaint and how we share that learning as a result and improve. The Somerset approach led by the CCG in partnership with the Patients Association has all providers organisations working together to improve complaint handling. This started in September and is a positive step forward to be open to sharing and improving across Somerset. Alongside this there is the opportunity to improve how we work together to improve the handling of cross organisational complaints. The results from the first peer review audit will directly inform improvements required in complaint handling. There is a further peer review panel planned for February Alongside this the Trust will continue to participate in the Patient Association survey programme giving all complainants the opportunity to give feedback on how it was to raise a complaint. Recommendation The Trust Board is asked to consider the feedback from complainants and support the further work outlined. It is recommended that progress is monitored by the Governance Committee. Trust Board, Part A Page 4 of 6 Enclosure M

5 Appendix 1: Results of Patient Association Surveys (113 participants up to February 2013) Do you feel you have been told the truth in the response to your complaint? Do you feel the response to your complaint explains how the Trust will take appropriate action to prevent the same thing happening again? Trust Board, Part A Page 5 of 6 Enclosure M

6 How satisfied were you with the final response to your complaint? Overall, how well do you feel your complaint was handled? Trust Board, Part A Page 6 of 6 Enclosure M

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