NHS Kirklees Complaints, PALS and Claims and FOI Annual Report for the reporting period 1 April 2011 to 31 March 2012

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1 NHS Kirklees Complaints, PALS and Claims and FOI Annual Report for the reporting period 1 April 2011 to 31 March 2012 Customer Liaison Service (PALs) Complaints 1. Introduction This report will provide a summary of the Customer Liaison Service (CLS) which now includes complaints and the previous PALS service. All enquiries received by NHS Kirklees during the reporting period 1 April 2011 to 31 March 2012 an overview of all the NHS Kirklees active claims and Freedom of Information requests (FOI). Complaints concerning Kirklees Community Health Services (KCHS) now known as Locala are included with NHS Kirklees complaints total. Locala Community Partnerships provides NHS community services to the Kirklees locality. Locala are a Community Interest Company (CIC) not for profit social enterprise. Complaints received at NHS Kirklees about independent contractor services such as GP practices, dental practices, opticians and community pharmacy s are also included in this report. The complaints service works across organisational boundaries and in partnership with other organisations. The CLS team also shares information with staff and managers when we receive a compliment about delivery of services. Compliments from service users can improve the morale of those involved and these testimonials can be included in staff personal records. 2. Strategic context The CLS has been designed to be accessible to all patients, service users and their representatives and intended to offer an opportunity to resolve concerns at the point of contact before the enquiry becomes a complaint. The CLS handles all enquires which can range from signposting to other services to dealing with serious complainants. Complaints are an opportunity for service users to express their concerns about the delivery of healthcare, in some cases these complaints can be of a serious nature and involve more than one organisation. These are termed multi-agency complaints i.e. involving secondary care, Yorkshire Ambulance Service (YAS), Local Care Direct (LCD) and primary care services, indicating the potential complexity of enquiries which the CLS may encounter. 1

2 The management of complaints requires a professional, independent, nonjudgmental and impartial, effective approach. The complaints process has been written with a view to engaging with all parties involved and developing strategies for identifying learning and training needs and methods for implementing recommendations and service improvements. Ensuring complaints are fed into organisational clinical governance processes and risk management strategies is key to ensuring that lessons are learned and actions disseminated across the Trust. Where complaints and concerns do not fall within NHS Kirklees jurisdiction they are referred to the appropriate authority. 3. Implications and risks NHS Kirklees must be able to demonstrate effective complaints handling and that lessons learnt will lead to change and service improvements. The CLS comprises a full time Complaints Manager and a part time (30 hours) CLS officer line managed by the Head of Patient Safety and Risk. The CLS telephone is manned daily from10am till 12noon and 1pm to 3pm Monday to Thursday and 10am until 1pm each Friday. An answer phone is available outside these hours and a central facility also supports the service. All answer messages and enquiries and complaints are responded to within one working day. 4. Process The Trust s complaints policy and procedure is intended to ensure complaints are resolved promptly, effectively and that complainants are treated sympathetically and with respect throughout the process of making a complaint. The policy supports the principle that complaints should positively influence the way services are delivered in the future. The guidance and procedure defines what a complaint is and explains who is entitled to make a complaint and how the complaint will be dealt with from initial receipt to its conclusion. Anyone involved in the handling of a complaint, at any level, has an obligation to comply with this policy and procedures and to ensure confidentiality of information at all times. The Complaints Manager and the Customer Liaison Officer will process complaints that cannot be handled at the point of receipt, with a view to achieving 2

3 local resolution, and inform complainants of the role of the Independent Complaints Advocacy Service (ICAS). The CLS can also refer patients and families to specific local or national-based support agencies if deemed appropriate. The Head of Patient Safety and Risk and CLS team support training and attend events with a view to education, improvement and promotion of the service. 5. Conciliation Whilst in some cases it is helpful for the CLS to be able to offer a conciliation services to complainants in order to help resolve their complaint, at the present time NHS Kirklees do not have a Lay Conciliator to draw upon. Should a conciliator be required this service would be sourced independently to ensure impartiality. The Complaints Manager can offer a facilitation service to complainants and the complained about in order to achieve resolution, in some cases this proves to be of value in offering an opportunity for all parties to discuss the complaint in an informal, safe environment which can be beneficial in achieving local resolution. 6. Investigation of Complaints When it is identified that a complaint raises serious clinical concerns, a relevant clinician is asked to review the case and report their findings to the Complaints Closure Panel (CCP) and the Performance Advisory Group (PAG). Where necessary the PAG will consider if the Trust is able provide any help, guidance or support to the practitioner. If the PAG is unable to handle the case it will be referred to the Decision Making Group (DMG). 7. Complaints Closure Panel (CCP) The Complaints Closure Panel (CCP) meets quarterly where the Complaints Manager having analysed and summarised all complaints, presents them to the CCP. The Complaints Manager will categorise any recommendations and learning from the complaint which allows the CCP to identify any further intervention/action. Members to the panel include a representative from PCT Contracting Team, senior corporate staff, CCG s and the Medical Director and Responsible Officer. 8. The Parliamentary and Health Ombudsman (PHSO) The Trust is aware of 12 cases that have been notified to the PHSO in 2011/12. One complaint was upheld as follows: 3

4 NHS Kirklees - regarding the Expert Patient Programme and the removal of a non member from the panel; the process did not follow procedure and was not recorded appropriately. 9. Independent contractors Complaints relating to independent contractors are referred (criteria permitting) to the practice concerned for local resolution. This enables the complainant the opportunity to seek a response directly from the service provider. The Trust is not directly responsible for investigating independent contractors complaints. The Trust can support and offer guidance to independent contractors whilst remaining impartial in order to facilitate resolution of the complaint. The independent contractor is at liberty to contact their defence union for advice whilst investigating the complaint. Independent contractor complaints received by the Trust are facilitated by the CLS and monitored for potential trends and areas of concerns. 10. Activity The CLS enquiries and complaints for this reporting period recorded 1,095 individual contacts from members of the public. CLS (PALs) received 916 enquiries (Table 1) Complaints handled 179 formal complaints of which 56 complaints related to independent contractors (Table 2) and 123 complaints involved NHS Kirklees commissioning and KCHS/Locala (Table 3). 4

5 Table 1 The tables below shows the number of enquiries made by the public to the Trust for the period 1 April 2011 to 31 March 2012 and the services enquired about. Total number of CLS (PALs) enquiries 2011/12 Service enquiry 2011/12 CHFT 36 Choose and Book 2 Child & Adolescent mental health services 1 CASH 1 Child health 3 Continuing Care 0 Community Dental Service 2 Community Hospital 24 Continence Service 2 Data Protection 0 Dermatology 0 Diabetes 0 Dieticians 0 District Nursing 0 Dental Service 266 Drug and alcohol action team 4 Expert Patient Program 0 Estates 1 General Practice 256 GP Specialists 1 Health Centre/Clinic 24 Health Visiting 1 Individual funding requests 5 Immunisation Team 1 Infection Control 0 KICES 1 KMC 4 KCHS/Locala 2 LCD 6 LINK 0 Long term conditions 1 Maternity services 1 Mid York s 25 NHS Kirklees 90 NHS Kirklees HQ 84 5

6 Nursing Home 5 OT 0 Optician 4 Orthodontic services 9 Out of Hours Service 2 Other PCT 7 Primary Care Extended Service 5 Pharmacy 10 Phlebotomy service 0 Physiotherapy 0 Podiatry 9 Prescribing 0 Residential home 4 School Nursing 1 SWYMHT 5 Vulnerable Adults 1 WYCSA 10 Total 916 6

7 Table 2 Formal Complaints 2011/12 by service area Formal Complaints 2011/12 Medical 56 Dental 24 Evening and Night Nursing Service 1 Optical 1 Pharmacy 2 Out of hours 3 Other Acute Trusts 2 Choose and Book 2 Community Rehabilitation 1 NHS Kirklees 3 Community Dental 1 Child Health 1 CHFT 14 Community Hospital 5 District Nursing 16 Health Centre 14 Health Visiting 2 Health Care Commission 1 Kirklees Metropolitan Council 1 Local Care Direct 6 KCHS/Locala 3 Mid York s 5 Multi Agency 2 Nursing Home/Residential Home 6 other 4 Orthodontics 1 School Nursing 2 Total 179 The emphasis of complaints has been on secondary and community care services including health centres. There were more GP practice complaints than dental complaints and an even spread of the other areas emerged. 7

8 Table 3 The tables below shows the number of formal complaints received by the Trust for the period 1 April 2011 to 31 March 2012 and the comparison against the previous two years. 2011/ / /09 Medical Dental Optical Pharmacy GP out of hours Dental out of hours Other Trusts Total

9 Table 4 NHS Kirklees commissioned services and KCHS and Locala 2010/ / /09 AVC CaSH Choose and book Commissioning Community dentistry Orthodontics Corporate Services Diabetic Screening District Nursing - KCHS District Nursing - Locala Estates ECC FOI Health centre parking Health Visiting/School HVMH Maple Ward HVMH Podiatry Intermediate Care Lifeline Interpretation service Moorfields PCC Phlebotomy Imms & Vaccs Resource Centre Therapy Services Walk In Centre Total Dental waiting list The Trust processed and posted 1,838 dental waiting list information letters to Kirklees residents who enquired about the availability of NHS places in this reporting period. 11. Themes emerging There has been particular emphasis on the availability of NHS Dental places; this has placed a demand on the service to provide information to 1,838 service users. There is a lack of capacity at the present time although this 9

10 problem is currently being addressed by the Dental Contracting Team. In February and March additional services were commissioned which resulted in a decrease of enquiries. Once these places were taken the demand again increased and these service users have been signposted to NHS Direct for emergency cases and encouraged to keep in contact with their local dental practices for a vacancy. The enquiries concerning information about orthodontic treatment has reduced significantly and the number of complaints in this area has reduced. There has been a significant change in the complexity of complaints, which has resulted in challenges to achieve local resolution between the practitioner/service and the complainant. The Complaints Manager has actively engaged with the Medical Director seeking a review of complaints cases and guidance. Local resolution is always sought as a first action and this has been achieved in all but one case, which was upheld by the PHSO. Communication between GP and dental practices and the Customer Liaison Service is becoming increasingly important. Dealing with a knowledgeable and well informed service user has resulted in a greater challenge to identify areas for learning and training needs. This has resulted in measureable service improvements being delivered and sustained. 12. Learning lessons All complaints handled by the CLS are prepared for submission to the identified service and once the outcomes of the investigation are received these are analysed and scutinised in preparation for review by the Complaints Closure Panel; when these will be inspected and given careful consideration and attention to establish whether there should be further intervention. All learning is shared with the service provider and evidence of improvements to service is sought. 13. Service Improvements Identified Communication between service providers and their patients/complainants has been identified as an area for constant improvement, particularly when patients are referred to oncology and for tests that may result in life changing/shortening conditions. The delivery of palliative care has highlighted the need for better communication between practitioners and their patients and families. These improvements can result in those involved being better equipped to cope with 10

11 the loss of a family member and understanding the process of available care both in a secondary care and the community. A letter prepared by the Medical Director was cascaded to all GP practices and nursing practitioners to this effect. The Trust has received 12 requests from the PHSO for information regarding individual complaints cases during the period reported. As a result it has become apparent that more attention should be given to the investigative process, identifying areas for demonstrating concern and service improvements. To evidence to the patient/complainant our undertaking to deliver a high standard of service to the user. 14. Claims NHSLA claims During this reporting period 8 claims were active, of these claims two were discontinued against NHS Kirklees by the claimants solicitors. Of the active claims three have been admitted (2 clinical and 1 non-clinical). The remaining claims are being defended. Other litigious claims One claim has been successfully defended at Small Claims Court by the Risk Team. One Judicial Review has been granted against NHS Kirklees, the Barrister defending NHS Kirklees will represent the other defendants. Claims are investigated and managed by NHS Kirklees Risk Department and NHSLA in accordance with the NHSLA Liabilities to Third Parties Scheme (LTPS) member s guidelines. Learning from claim s investigations is shared with the services involved and where appropriate other services. The majority of claims within this period relate to Locala previously known as KCHS. 11

12 15. Freedom of Information Background The Freedom of Information Act 2000 (FOIA) came into force in January 2005 and gives any person legal rights of access to information which is held by a public authority. Obligations The Freedom of Information Act requires all public authorities to: i) Produce a publication scheme, which outlines the information the authority routinely makes available to the public - such as minutes of meetings, annual reports or financial information. ii) Respond to requests for information promptly and, in any case, no later than 20 working days after the request is received. The PCT endeavours to manage FOI requests in a timely manner, however when for reasons of complexity or operational difficulties in gathering the requested information extensions to response dates can be requested. When information is requested which is held by other organisations, enquirers are advised and where possible provided forwarding contact details. The range and complexity of FOI requests varies considerably. During 2011/12 a total of 251 where received, as indicated in the table below. Each request is reviewed and an appropriate officer nominated to provide the relevant information. The request is forwarded indicating the date for submission and performance managed. Before final response the FOI is reviewed and advice sought where appropriate in terms of the sensitivity and legality. Enquirers are routinely provided information explaining what they can do if dissatisfied. The contact details of the Information Commissioner's Office are also provided. Conditions for re-use of information are clearly indicated with and expectation that if information is to be re used for any purpose and license must be sought. No requests have been received during 2011/12. 12

13 Table 5 FOI requests by Subject and quarter received 11/12 Q1 11/12 11/12 11/12 Q2 Q3 Q4 Total CCG Clinical Stats Communications Contract Information Drug and Alcohol Team Dental Procurement & Estates Financial Information General Practitioners GP Clinical Systems HR Information Infection Control Medicines Management Mental Health / Learning Disabilities Miscellaneous Non Clinical Stats Out of Hours Opticians Policies and Guidelines Practice Based Commissioning PCT Business Plans PCT Comissioning Pharmacy PMS Public Health Staff contact details Totals: