COMPLAINTS PROCEDURE. Version: 1.4. Date Approved November Interim Complaints Manager. Date issued: November 2014

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1 COMPLAINTS PROCEDURE Version: 1.4 Committee Approved by: Integrated Governance Committee Date Approved November 2014 Author: Responsible Directorate: Interim Complaints Manager Finance and Governance Date issued: November 2014 Review date: November

2 Version Control Sheet Document Title: Complaints Procedure Version: 1.4 The table below logs the history of the steps in development of the document. Version Date Author Status Comment 1.0 September August September 2014 Corporate Risk Manager / Head of Corporate Governance Adam Bassett, Senior Associate Governance and Risk Lorne Thomson Interim Complaints Manager 1.3 2/9/14 Lorne Thomson Interim Complaints Manager /11/14 Lorne Thomson Interim Complaints Manager Approved Draft Approved Draft Approved Procedure updated to take account of recommendations arising from Francis Report Procedure updated following decision to return complaints management function to the CCG and to ensure inclusion of recommendations arising from Francis, Keogh, and Clywd and Hart Reports. Approved by the Integrated Governance Committee. Procedure updated to reflect comments made by the Integrated Governance Committee regarding the role of Healthwatch and mechanisms to ensure impartiality. Further amendment were identified following a review of CCG statutory duties and those related to complaint management. Approved by Integrated Governance Committee on 20 November

3 NHS Wakefield Clinical Commissioning Group COMPLAINTS PROCEDURE Contents Section: Page Section 1 Introduction 4 Section 2 Stage 1 Local Resolution Process 5 Section 3 Stage 2 Parliamentary and Health Service Ombudsman Review 24 Appendices: Appendix 1 Complaints Procedure Flow Chart 26 Appendix 2 Consent and how to Ensure the Complainant has Appropriate Authority to Act On Behalf of the Patient 27 Appendix 3 Matters Excluded from the Complaints Procedure 30 Appendix 4 Process for Avoiding Treating Complainants Adversely 31 Appendix 5 Guidance for Dealing with Persistent or Unreasonable Complainants 32 Appendix 6 Schedule of Standard Template Documents 35 3

4 NHS Wakefield Clinical Commissioning Group COMPLAINTS PROCEDURE Section 1 INTRODUCTION This complaints procedure details NHS Wakefield Clinical Commissioning Group s (CCG) arrangements for dealing with NHS complaints. The procedure has been developed in line with the Local Authority Social Services and National Health Service Complaints (England) Regulations (2009). It should be used in conjunction with NHS Wakefield CCG complaints policy. The procedure applies where the person affected is a person for whom the CCG has responsibility, ie the person is a registered patient within NHS Wakefield CCG. The procedure covers complaints relating to services provided by NHS Wakefield CCG and NHS services commissioned by NHS Wakefield CCG where the complainant has requested the involvement of NHS Wakefield CCG as the commissioner. The majority of patients receiving care within the NHS are happy with the care provided. It is recognised however that there will inevitably be circumstances where the expectations of some of the service users are not met and they will need to voice their feelings through the complaints procedure. Complaints are viewed positively within NHS Wakefield CCG and every effort is made to identify lessons from complaints to make positive improvements in services for patients. The roles and responsibilities of individuals within NHS Wakefield CCG for complaints are detailed in section 4 of the complaints policy. 4

5 Section 2 STAGE 1 LOCAL RESOLUTION PROCESS 2.1 General Principles The local resolution stage of the complaints procedure refers to the period when NHS Wakefield CCG seeks to resolve the issues raised in a complaint locally, to the satisfaction of the complainant. The majority of complaints received by NHS Wakefield CCG are resolved at this local resolution stage. A complaint is an expression of dissatisfaction about any aspect of NHS Wakefield CCG services or those NHS services which it commissions. The complaints process has four main aims: To investigate To explain To apologise (where appropriate) To take action to prevent a recurrence 2.2 Definitions The Complaints Manager is the person responsible for ensuring that the complaints are managed in line with this procedure. The Investigating Manager is the person who will ensure that the complaint is investigated in consultation with the Complaints Manager. 2.3 Format of Complaints NHS Wakefield CCG will receive complaints in any format which the complainant wishes to use to forward the details relating to their complaint Written Complaints letters Any member of staff working within NHS Wakefield CCG could receive written complaints. All written complaints should be forwarded to the Complaints Manager for acknowledging as soon as they are received. This should not delay the investigation commencing in general terms however it is for the Complaints Manager to liaise with the complainant and agree the specific issues of complaint Written Complaints Complaints received via should be viewed as written complaints (see above 2.3.1) and processed in the same manner. Patient sensitive information will not be sent by . All correspondence letters will be sent by post Verbal Complaints telephone Verbal complaints should be viewed as seriously as written complaints. Any member of staff who is approached by a patient or their representative with a complaint should endeavour to resolve the matter there and then. Whenever possible, complaints should be resolved at 5

6 the time. Any verbal complaint that cannot be resolved at the time should be handled in the same timescale as written complaints. If the matter remains unresolved, the member of staff receiving the complaint should prepare a clear record of the details as soon as possible and refer this to the Complaints Manager. It may be appropriate for the entire process to be resolved verbally, without any written communication. Where this occurs a complaint contact sheet should be completed and forwarded to the Complaints Manager to ensure the information is recorded for monitoring purposes. However, where the complainant indicates that they are not satisfied with the verbal response, then the complainant should be referred to the Complaints Manager for formal investigation Verbal Complaints face to face As for Verbal Complaints telephone (see above 2.3.3). If a complainant attends the premises, wishing to make a complaint, they should be facilitated to do so. A suitable room should have a table and chairs, have ease of disabled access, and good lighting. In addition, staff safety must be considered when taking details of a complaint on a face toface basis. Staff must always be accompanied by a colleague and the room used must be easily accessed by other colleagues. No meeting can commence until a senior member of the team in informed that the meeting is going ahead and they must know where it is being held Out of Office Hours Should a written complaint be received out of office hours, the complaint should be passed to the Complaints Manager as soon as possible within working hours. Should a verbal complaint be received out of office hours, relevant details should be taken and the complaint should be passed to the Complaints Manager as soon as possible within working hours. Where applicable, complainants should be advised that NHS 111 is available for out of hours clinical advice. 2.4 Status of the Patient / Complainant Complaints received from a Third Party There are many occasions where a complaint is made indirectly through a third party (eg parent or sibling, MP). The process and investigation will normally follow the same procedure as a complaint that is made directly by a patient (see Appendix 2). In all cases, when a letter of complaint is received by a third party, the Complaints Manager will acknowledge the letter and gain consent from the patient to investigate. When drafting 6

7 the response, the Complaints Manager should always be aware of the confidential nature of the response. In all cases the status of the complainant should be confirmed and each request should be considered on a case by case basis. If it is evident from the complaint that the patient is unable to consent to the investigation, the Complaints Manager will require documentary evidence of an appropriate relationship between the patient and the complainant. Occasionally, a complaint will be received where the complainant has no apparent connections with the patient concerned. In such cases, before any investigation commences, the following points should be clarified: Does the patient know a complaint has been made on their behalf? Has the patient authorised the complainant to make enquiries or can an acceptable connection be established? Letters received from solicitors raising a complaint on behalf of an individual should be dealt with in the same way as all other complaints (ie evidence of the solicitors authority to act on behalf of the complainant will be required in addition to appropriate evidence that the complainant has the authority to act on behalf of the patient). If the complaint is of significant concern (see below a) an investigation may need to be undertaken without consent (as an internal investigation). However, if consent is not given, the findings of that investigation cannot be shared Complaints Regarding a Deceased Patient When a complaint has been received regarding a deceased patient consent will be sought from the appropriate family member (or appropriate other see Appendix 2) on a case by case basis, depending on the circumstances of each complaint Complaints Received from a Disabled Person NHS Wakefield CCG seeks to facilitate complaints from disabled people and will seek to assist as appropriate to that individual s disability. For example if a complainant has a sight disability the complainant should be invited to submit details in Braille, or an audio format and the Complaints Manager should arrange for this communication to be transcribed and verified by the complainant. 2.5 Complaints Relating to Specific Organisation Types or Services Complaints about Family Health Service Practitioners (FHSPs) Complaints regarding independent contractors (eg GPs, dentists, opticians, pharmacists and commissioned services) are the responsibility of NHS England or the provider concerned. Where it is identified via complaint triage that the complainant wishes to complain about these services they will be informed in writing that they should contact either the provider concerned or NHS England Complaints about Treatment Provided by any other NHS Service 7

8 Complainants can choose whether to complain to the provider or the commissioner of NHS services. In the case of the NHS services for Wakefield district residents this would be NHS Wakefield CCG. Where a complaint is received, then the Complaints Manager will inform the complainant of their options (for the CCG or the provider to lead) and facilitate the complainants choice Complaints about a Continuing Care Decision / Individual Funding Request It is important to recognise that the review procedure for continuing care or individual funding request is not a complaints procedure. The fact that someone has had their case considered by a continuing care review panel or individual funding request panel, does not affect their rights under the NHS complaints procedure. They can complain about the original decision of the continuing care review / special referrals process, through the NHS complaints procedure Complaints about NHS Choice The NHS Constitution sets out choice as a right and includes the right to information to support that choice. If a patient complains to NHS Wakefield CCG that they have not been offered a choice, and the complaint is upheld, NHS Wakefield CCG is required to make sure the patient gets that choice. This does not apply to prisoners (or those on temporary release from prison), serving members of the armed forces and persons detained under the Mental Health Act (1983). Certain services are also excluded: Where speed of access to diagnosis and treatment is particularly important, eg: emergency attendances/admissions; attendances at a Rapid Access Chest Pain Clinic under the two week maximum waiting time; attendance at cancer services under the two week maximum waiting time. Maternity services; Mental health services; and Public health services commissioned by local authorities Complaints about a Failure to meet the 18 week Referral to Treatment Target The CCG is required to notify NHS England in writing where it receives notification from the patient (or complainant) that they have not, or will not, commence treatment within 18 weeks Complaints about Multiple Organisations A requirement of the Local Authority Social Services and National Health Service Complaints (England) Regulations (2009) is that complainants should, if they wish, receive one coordinated response to their complaint where it concerns a number of organisations. Where a complaint involves more than one NHS provider, or one or more other bodies (eg Social Services), there should be full co operation in seeking to resolve the complaint as 8

9 outlined in the Local Authority Social Services and National Health Service Complaints (England) Regulations (2009). If a complaint is made to NHS Wakefield CCG regarding more than one provider the Complaints Manager will (with the agreement of the complainant) liaise with each organisation and request that a response is forwarded back to NHS Wakefield CCG who will then arrange a combined response. NHS England has advised in the Guide to Good Complaints Handling for CCGs that where a complaint concerns primary care this should be forwarded to them. NHS Wakefield CCG will therefore liaise with NHS England regarding the response. Where complaints are about both NHS and Local Authority services, the Complaints Manager will liaise with the Local Authority to co ordinate a joint response. Where NHS Wakefield CCG takes the lead on a multi organisation complaint all organisations will be copied in to the final response to facilitate their learning and service improvement functions. 2.6 Contact from other Sources MP letters When a complaint has been received from an MP, relating to a specific patient, NHS Wakefield CCG will seek consent on a case by case basis from the patient or an appropriate family member. This will be treated as a complaint received from a third party (see above 2.4.1). When an MP raises concerns, or asks a question in general terms, this will be dealt with as an MP Enquiry. Although following a similar investigation pattern it will not include any reference to a named patient and hence consent will not be necessary Correspondence from Media Organisations If correspondence is received from media organisations regarding a complaint, the Communications Manager should be contacted in the first instance Coroner The fact that a death has been referred to the Coroner s office does not mean that investigations into a complaint should not be commenced (nor should it be suspended if already commenced prior to the Coroner s involvement). It is important for NHS Wakefield CCG to initiate proper investigations regardless of the Coroner s inquiries, and where necessary to extend these investigations if the Coroner so requests. Responses to a Coroner request do not necessarily match those required in relation to a complaint and hence the Investigating Manager will be asked to provide a separate response to the complaint. 2.7 Advocacy and Patient Support Healthwatch 9

10 Healthwatch England is the independent consumer champion for health and social care in England. They ensure that the voices of consumers and those who use services reach the ears of decisions makers. At a local level, Healthwatch Wakefield works to help people get the best out of health and social care services, whether it is improving them today or helping to shape them for tomorrow. Healthwatch Wakefield is all about local voices being able to influence the delivery and design of local services; not just people who use them, but anyone who might need to in future NHS Complaints Advocacy Service Each geographic area has a NHS Complaints Advocacy Service, which offers free, independent and confidential support to guide people through the NHS complaints process. Advocacy caseworkers support complainants in drafting letters, represent them or attend meetings with then. The level of support varies according to the complainants personal needs. The complainant will be made aware of the relevant Advocacy team for their geographical area at the point of acknowledgement Patient Advice and Liaison Service Support for making a complaint can also be provided by the West Yorkshire Patient Advice and Liaison Service (PALS) who can be contacted on Procedure A flow chart for the complaints procedure is attached (see Appendix 1) Receiving Complaints Triage Any member of staff receiving a complaint must notify the Complaints Manager and a copy of all correspondence should be forwarded immediately to ensure appropriate acknowledgement. All written complaints, and subsequent documentation, should be stamped with the date of receipt. The Complaints Manager will maintain a register through the NHS Wakefield CCG records system in which each complaint is recorded (a minimum data set which will develop in response with any changing monitoring requirements) and given a unique identifier. The central register will be maintained to provide statistical returns to the Department of Health, HSCIC, to facilitate the completion of the Complaints Annual Report, report to internal committees and the Governing Body and data for quality monitoring. At the time of receipt each complaint will be reviewed and triaged to ascertain if there are any matters of concern that require immediate action, to risk grade the events, to identify the subjects of the complaint and to identify any matters which should be excluded from investigation. All of this information will be recorded. 10

11 a Complaints Concerning a Safeguarding Concern, Incident or Immediate Care Issue Where a complaint concerns either: A possible criminal offence; A safeguarding concern; A serious untoward incident involving harm to a patient; A matter of concern relating to the immediate care of the patient or A matter which should be referred to one of the professional regulatory bodies. The appropriate Head of Service must be informed immediately. This notification may be made at any point during any stage of the complaints procedure as soon as it becomes apparent that the complaint fulfills one of the above criteria. The Head of Service must refer to the safeguarding policy in relation to the alleged incident and follow the agreed procedure. On receipt of a complaint in which is becomes apparent that a serious incident may have occurred the relevant Head of Service will be notified and provided with advice from commissioning support services (Governance Team). If an immediate care issue is identified verbal consent should be sought as a matter of urgency to contact the appropriate provider. If this is not possible the matter should be discussed with the appropriate senior manager to agree actions required in the best interests of the patient. Other matters may need to be referred to the police and the Chief Officer if a possible criminal offence has been committed. This should be reported to the next Private Governing Body meeting. If an issue is referred to the police, any investigation must stop. The complainant must also be informed. The Investigating Manager must involve the Chief Financial Officer in any possible financial offence. Where a serious complaint is received about any NHS commissioned service for Wakefield district patients NHS Wakefield CCG will liaise with the provider and ascertain if the matter should also be reported as a serious incident. Please also refer to section regarding counter fraud measures. b Risk Grading All complaints will be graded in line with the standard risk matrix, being graded either low, moderate, high or severe. (See standard triage template form). c Subject of complaint All complaints will be reviewed and the subjects of complaint (as defined for the purposes of the K041 annual return) will be identified and recorded (see standard triage template form). 11

12 d Exclusions Any matter will not be investigated where: A complaint has been made by a responsible body (organisation to organisation / professional to professional) A complaint by a member of staff which relates to their employment A verbal complaint which is resolved to the complainant s satisfaction no later than the next working day after the complaint was made A complaint which has previously been fully investigated A complaint which is being considered by the PHSO A complaint arising from an alleged failure by a responsible body to comply with a request for information under the Freedom of Information Act 2000 A complaint which relates to section 10 or 24 of the Superannuation Act 1972 The complaints procedure cannot deal with complaints about non disclosure under the Freedom of Information Act. These are dealt with under a separate policy and should be referred to the Information Governance Team. Staff grievances cannot be reported through the complaints procedure but should be dealt with through NHS Wakefield CCG s Grievance Procedure (or via the HR Department of the relevant NHS organisation). Further advice can be obtained from Human Resources. For further details see Appendix 3. Where these matters are the only issues within the complaint, the Complaints Manager will notify the complainant, via an appropriate acknowledgement, that the complaint cannot be investigated and the reason for this. Where there are other issues of complaint which do require investigation, the Complaints Manager will provide a standard acknowledgement of those issues and an explanation of which matters cannot be investigated and why. A complaint should normally be made within twelve months of the incident that caused the problem, or within twelve months of the date of discovering the problem. NHS Wakefield CCG has discretion to extend this time limit where it would be unreasonable in the circumstances of a particular case for the complaint to have been made earlier and where it is still possible to investigate the facts of the case. Where NHS Wakefield CCG decides not to investigate a complaint because it is out of time the complainant must be informed of their right to refer this to the Parliamentary and Health Service Ombudsman (PHSO) Acknowledging Complaints All complaints will be acknowledged, in writing, within 3 working days of receipt by NHS Wakefield CCG. Where possible, for written complaints including e mails, the complainant will be telephoned to clarify the issues of their complaint and to verify facts prior to the formal written acknowledgement being issued. 12

13 The acknowledgement letter will include: Date their complaint was received Condolences if appropriate Apologies that they have found it necessary to complain about a service Details of the issues of complaint A summary of the investigation plan A confirmation of what the complainant wants to happen as a result of their complaint A request for consent An explanation of how their information will be used Details of the appropriate advocacy service Details of how to receive documents in a different format / language Details of how to get back in touch with the Complaints Manager Enclosed with the acknowledgement letter will be: Leaflet explaining the NHS Complaints Procedure Consent form Leaflet explaining consent and use of personal information Equality Monitoring form Leaflet explaining reason for collection of equality monitoring information The Complaints Manager will coordinate the acknowledgement of the complaint and complete the complaints register. A copy of the complaint will be sent to the relevant Head of Service and senior officers within the CCG for information purposes. No documentation will be sent outside of the CCG until the written consent has been received Patient Confidentiality Complaints information is handled in line with data confidentiality and should only be shared on a need to know basis. This should be undertaken in line with the Information Governance Policy. Health Service Circular 1998/059 NHS Complaints Procedures: confidentiality states the use of the patient s personal information to investigate a complaint is a purpose for which it is not necessary to obtain the patient s express consent. However, as a large proportion of complaints managed by the CCG relate to care provided by other NHS organisations, consent must be obtained to allow the concerns to be shared with these organisations. Care must be taken at all times throughout the complaints procedure to ensure that any information disclosed about the patient is confined to that which is relevant to the investigation of the complaint and only disclosed to those people who have a demonstrable need to know it for the purpose of investigating the complaint. Even so, it is good practice to explain to the patient that information from his/her health records may need to be disclosed to the Investigating Manager, to clinical assessors, and possibly to the convener and panel members. If the patient objects to this, then the effect on the investigation will need to be explained. 13

14 Equality Monitoring As part of the acknowledgment process, complainants are asked to complete an equality monitoring form. The collection of this data on written complaints is valuable in gauging fair and equal access to health care across the local population. There is no obligation on patients or staff members to respond to these questions and no pressure should be put on them to answer, or on staff to obtain an answer. Should the patient or staff member not respond to the question, this should be classified as not stated Investigating Complaints Upon receipt of appropriate consent a further letter will be sent to the complainant acknowledging consent and confirming when they should receive a formal response. This timescale is based on the risk grading undertaken as part of the triage process (see above b). At the same point the investigation template will be sent to the appropriate Investigating Manager / provider requesting a response by a specific deadline Timescales These timescales are from the point at which consent has been received and are provided as a guide only. The timescales for each case should be set on a case by case basis giving due regard to the complexity or the case and number of providers involved. The proposed response date will be recorded as a benchmark for the case. Grade Investigation timescale Response timescale Low 2 weeks 4 weeks Moderate 3 weeks 5 weeks High 4 weeks 6 weeks Severe 5 weeks 8 weeks The Regulations also state that the final response should be sent to the complainant within 6 months of receipt. The CCG will endeavour to ensure that a final response is sent within 3 months (of consent being received). Any case that may breach this threshold will be brought to the attention of the Chief Officer and an action plan developed to prevent any further delays. a Holding Letters In exceptional circumstances, where there is any delay in receiving back the investigation template or where it has not been possible to contact all those involved to enable a full response, a holding letter will be sent to the complainant if it is anticipated that these delays will impact on timescale set for the final response. Further contact will be made by telephone and holding letters will be sent as required. The Investigating Manager will also be contacted and required to provide a reason for the delay and asked to provide a revised timescale. 14

15 Investigation Process Any change to the planned response date will be recorded and will be monitored as part of the monitoring process. The Complaints Manager will determine how the complaint is to be investigated and by whom, and will issue an investigation template, supported by the original complaint, for completion by the Investigating Manager. In the majority of cases the Investigating Manager will be the responsible manager within a provider organisation. The investigation template requires the Investigating Manager to provide the following information: Names and job titles of all parties involved in the investigation Details of all documentation referred to in order to respond to the concerns For each issue of complaint: A detailed investigation of what happened An explanation of what happened / an explanation of what should have happened Specific apologies where appropriate Confirmation of actions taken and lessons learnt The investigation must be independent and the Investigating Manager must have the relevant skills to undertake the task and be selected according to the importance and seriousness of the complaint. It is anticipated that the Investigating Manager will normally be the senior manager responsible for the area concerned. It is desirable that the complaint is dealt with as close to the point of delivery as possible to ensure a prompt reply and that appropriate remedial action is taken. This also ensures that the team accepts ownership of any shortcomings identified. The Investigating Manager may request a confidential statement from staff members involved in the complaint. If a complaint directly concerns an individual this person must not be the Investigating Manager. If a complaint involves a member of staff who is no longer working for NHS Wakefield CCG, a report should be obtained from the ex staff member from their last known home address. Similarly, if a complaint involves a temporary member of staff who is no longer working for NHS Wakefield CCG, a report should be obtained from the ex staff member, via the agency from which they were employed. Where this is not possible, an investigation should be undertaken obtaining as many details as possible and an explanation provided to the complainant of why any issues have not been fully investigated. Investigating managers should ensure that staff are aware of their special responsibilities towards patients who would have difficulty in making a complaint on their own. They should also instruct staff to take any necessary action to protect the patient's interests. On completion of the investigation, the Investigating Manager should send the completed investigation template to the Complaints Manager. The full details of the investigation should also be provided including notes, minutes of meetings, statements and all 15

16 information included as part of the investigation. This will then be retained within the complaint file Documentation All aspects of the investigation will be clearly recorded and all documentation, including staff statements, how the facts have been ascertained etc, will be forwarded to the Complaints Manager and retained within the complaint file. In the event that the complainant subsequently requests an independent review, NHS Wakefield CCG will require copies of all documentation. Staff should be aware that, should the matter proceed to PHSO review or litigation, all the complaint documentation is subject to disclosure. Copies of complaint correspondence must not be held on the patient s health records Outcomes from Investigation a Complaints Involving Litigation or Requiring Legal Advice Where a complaint investigation identifies the possibility of litigation ensuing, the Commissioning Support Unit (Governance Team) should be asked to make contact with the NHS Litigation Authority on the CCG s behalf. Where a complaint is already a case of litigation and particularly where the approach is made by solicitors acting on behalf of the patient, the matter should be referred immediately to the Complaints Manager who will notify the Chief Officer. A letter acknowledging receipt of the complaint should be sent. Investigation of a complaint should not be delayed as a result of legal advice being sought. The Investigating Manager should initiate enquiries immediately but any correspondence with the complainant should be agreed with the Complaints Manager who will seek legal advice as necessary. Following consultation, the Investigating Manager may wish to explore with the complainant the options available, which could prevent the possibility of litigation ensuing (eg an apology, admission of liability). The NHS Litigation Authority will also be notified. Complaints received, where litigation has commenced, are not excluded from the NHS complaints procedure. Where a complaint investigation is being undertaken in parallel with a claim investigation advice will be sought from the NHS Litigation Authority. b Investigation, which could lead to Disciplinary Action Where it is likely that a complaint, if found to be justified, may lead to disciplinary action being taken against a member of staff, the Investigating Manager should ensure that the appropriate manager is notified of the complaint. The member of staff may be asked to take part in the investigation and should be kept informed of the progress being made with the investigation 16

17 Any member of staff involved in a complaint must be informed of any allegation at the outset and must be advised of their right to seek the help and advice of a professional association or trade union before commenting on the complaint. In cases of this nature the Investigating Manager remains responsible for investigating the complaint, but the decision on whether disciplinary action is called for is a decision for the line manager in consultation with the Investigating Manager or the professional Head of Service. This decision is made in accordance with the normal disciplinary procedure and must be kept separate from the complaints procedure so that the latter is only concerned with resolving complaints and not investigating disciplinary matters. c Counter Fraud Measures Where a complainant or the subsequent investigation raises a concern about potentially fraudulent activity or practice, then the Complaints Manager should, in accordance with the NHS Wakefield CCG Anti fraud, bribery and corruption policy, inform the nominated Local Counter Fraud Specialist (LCFS) or NHS Wakefield CCG s Chief Financial Officer immediately, unless the Chief Financial Officer or LCFS is implicated. If that is the case, they should report it to the Chair or Chief Officer, who will decide on the action to be taken. An employee can contact any executive or lay member of NHS Wakefield CCG to discuss their concerns if they feel unable, for any reason, to report the matter to the LCFS or Chief Financial Officer. Employees can also call the NHS Fraud and Corruption Reporting Line on free phone This provides an easily accessible route for the reporting of genuine suspicions of fraud within or affecting the NHS. It allows NHS staff who are unsure of internal reporting procedures to report their concerns in the strictest confidence. All calls are dealt with by experienced trained staff and any caller who wishes to remain anonymous may do so. d Ex Gratia Payments and Re Imbursement of Costs There may be occasions when, having investigated the complaint, the Investigating Manager believes there are grounds for making an ex gratia payment (without accepting liability) or a re imbursement of costs. An apology and gesture of goodwill may avoid subsequent litigation and offers the opportunity to deal with certain circumstances in a fair and responsible manner. It is recommended that, before any financial redress is offered in respect of a complaint involving a member of staff, that member of staff should be involved in the discussions when the subject of compensation is raised, to ensure that he does not feel compromised by the decision to award redress. Any payments should be made having regard to NHS Wakefield CCG Prime Financial Policies and with the approval of the Chief Financial Officer. Compensation cannot be offered as this falls within the responsibility of the NHS Litigation Authority. 17

18 2.8.4 Responding to the Complainant Meetings The Complaints Manager will, in consultation with other senior staff involved, decide whether it is appropriate to offer the complainant a local resolution meeting. Where the Complaints Manager arranges a meeting with the complainant, the staff involved will be consulted to determine how the meeting will be structured. The Complaints Manager will conduct the meeting and will arrange for the meeting to be recorded and ensure that notes are taken. Two members of NHS Wakefield CCG staff should normally attend any meeting and the complainant should be offered the opportunity to have someone else present at the meeting to assist them. The meeting must be formally recorded and a copy of the notes, and the recording, forwarded to the complainant. If required by the complainant, meetings should take place on neutral premises or at the complainant s residence and at a location with suitable access. If necessary, the complainant can request for an interpreter to be present and the CCG will arrange this Written Response All written complaints concerning NHS Wakefield CCG (and any verbal complaints, which are felt to be sufficiently serious) must receive a formal response in writing. Other than in exceptional circumstances or where previously agreed with the complainant, the final response should be dispatched within the timescale agreed with the complainant. (See above ) Upon receipt of the completed investigation template(s), and supporting evidence, the Complaints Manager will prepare a draft response to the complainant. The Complaints Manager will be impartial in their response, referencing the original complaint and the issues previously agreed with the complainant. Comments will be qualified by reference to evidence and where this is not possible opinion will be attributed to the individual who gave that opinion. Dependent on the quantity of information to be shared, this will be in the form of a letter from the Chief Officer or a formal report supported by a letter from the Chief Officer. The Complaints Manager will define, on the basis of the evidence provided, the outcome of the complaint, ie whether the complaint has been upheld (failings have been identified in a significant proportion of the issues raised, or one major failing was identified), partially upheld (failings have been upheld in a small proportion of the issues raised, none of which were significant) or not upheld (no failings were identified). Where it is clear that there has been a mistake or failure in procedures, this should be clearly stated and an appropriate apology given. Details of the action being taken to prevent a recurrence should also be described. Where a mistake or failure in procedures constitutes an admission of negligence or legal liability, the matter must be referred to the NHS Litigation Authority for advice. Where it is clear that there has been no mistake or failure in procedures, this should be clearly stated, to ensure that the complainant is properly informed. 18

19 Where appropriate the Complaints Manager will seek advice from clinical professionals not previously involved in the complaint (such as the clinical advisor, medicines optimisation, etc) to give a view on the appropriateness of clinical actions. Where appropriate and practical, replies to complaints will be shared with the relevant Head of Service before the reply is sent. Staff who may be the subject of a complaint can be anxious about the process and their position. It is important that they are kept informed about progress with the investigation by the Investigating Manager and that they are offered the opportunity to discuss the matter with a professional colleague. Wherever possible, they should have the opportunity to comment on the accuracy of the draft response to the complainant and they should be shown a copy of the final response to make them aware of its content. Where it has been agreed that NHS Wakefield CCG will lead on a complaint investigation, concerning a number of organisations, NHS Wakefield CCG will provide a copy of the final response to each organisation involved. Once prepared the draft response will be reviewed by the Governance and Board Secretary (or a designated alternative senior manager) against a quality assurance checklist (aligned to the NHS England guidance) to ensure all key components of a final response letter are included. They will also act as an impartial critical friend and question the response as necessary. Once quality assured, the Complaints Manager will organise review by the Assistant Clinical Leader with particular reference to any clinical issues but also acting similarly as a critical friend prior to final review and signature by the Chief Officer. The final response will invite the complainant to let the Chief Officer know if they have any outstanding concerns and inform the complainant of the next stage of the complaints procedure should the complainant be dissatisfied. (See below 2.9). A copy of the signed response for CCG complaints will be forwarded to the Investigating Manager for their records. 2.9 Action where the Complainant is Dissatisfied with the Final Response If the complainant is dissatisfied with the final response they should be asked to identify the specific further concerns that they have. Consideration should be given to how the complaint might be resolved. On a case by case basis, either a further investigation by the relevant senior manager or a meeting with staff, could be offered. If the complainant subsequently remains dissatisfied, they should be encouraged to request an independent review of their complaint by the Parliamentary and Health Service Ombudsman Learning from Complaints Learning Lessons from Individual Complaints 19

20 Following investigation of the complaint, the Investigating Manager will be responsible for identification of lessons learnt and ensuring that actions have been completed within a reasonable timescale. NHS Wakefield CCG must be able to demonstrate that following investigation of a complaint any changes, which are identified and will reduce risk, are considered and implemented if appropriate. Investigating managers are routinely requested to consider and document any lessons learnt as part of the management of complaints using the Complaints Learning Lessons Form. A key part of the complaints process is to identify how services can be improved as a result of patient feedback and ensuring that lessons are learnt at all levels. The form should be signed by the relevant Head of Service and retained within the complaint file. The Complaints Manager will also log these. These lessons learned are anonymously reported within the reporting process to both the Quality Intelligence Group and the Integrated Governance Committee. Where these are not forwarded the Complaints Manager will pursue them from the relevant Head of Service to ensure completeness of the governance cycle Learning Lessons from all Complaints The Complaints Manager has a responsibility to have an overview of all complaint cases received by the CCG. If the Complaints Manager becomes aware of issues being repeated they must bring this to the attention of the appropriate Head of Service and Quality Lead for further investigation, including root cause analysis, to ensure that action is taken quickly Reporting Arrangements All reporting will be in line with the Good Complaints Handling Guidelines. A monthly report detailing compliments, complaints, areas of concern and links with the Patient Advice and Liaison Service (PALS), Risk Management and Claims will be presented to the Integrated Governance Committee. Response times will be regularly monitored and any delays reported to the Governance and Board Secretary. Each month all new complaints will be discussed (in an anonymous form) in the Quality Intelligence Group, along with data from other sources, to identify any trends and to triangulate intelligence. The information provided will include the risk grading, brief description, provider, and subject of complaint. For those cases which have been closed during the month the outcome of the case (where the complaint was upheld, partially upheld, or not upheld) and any learning will be provided. An annual report is presented to NHS Wakefield CCG Governing Body. A complaints report will also be included in NHS Wakefield CCG s annual report. This will include specific information on: The number of complaints received 20

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