Subject: Independent NHS Complaints Advocacy (Bradford and District) Data and Outcomes April 2013-March 2014

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1 Report of the Independent NHS Complaints Advocacy Team to the meeting of the Health and Social Care Overview & Scrutiny Committee to be held on 31 July 2014 E Subject: Independent NHS Complaints Advocacy (Bradford and District) Data and Outcomes April 2013-March 2014 Summary statement: In April 2013 Bradford and District Metropolitan District Council became responsible for the provision of the independent NHS Complaints Advocacy Service (ICAT).Following a competitive tendering process Bradford and Airedale Mental Health Advocacy Group and Choice Advocacy were jointly awarded the contract. This report provides information on the first year of operation of the ICAT services, covering referrals, demographics and analysis of the areas of concern or complaint. Report Contact: David Rosser Director Choice Advocacy Phone: (01274) david@choiceadvocacy.org.uk Portfolio: Adult Services and Health

2 Report to the Health and Social Care Overview & Scrutiny Committee 1. Summary 1.1 The attached report (Appendix 1) provides analysis of the work undertaken by the Independent NHS complaints advocacy team during the course of its first year of operation April March 31 st Background 2.1 Before April 2013 the Independent NHS Complaints Service was commissioned by the NHS and provided on a regional basis. The commissioning role was transferred to Local Authorities in April 2013 along with the commissioning of Healthwatch. Local Authorities had the option of working together and continuing to commission regionally or to commission the service locally. Bradford Metropolitan District Council chose the local option. Commissioning Councils also had the choice of commissioning the independent advocacy and Healthwatch together or separately and BMDC chose to do it separately primarily to ensure an advocacy focus and clear independence of the new Independent Complaints Advocacy Service. 2.2 Bradford and Airedale Mental Health Advocacy Group and Choice Advocacy, two long standing advocacy charities based in Bradford, were successful in winning the tender and began operation on 1 April 2013 having recruited a full-time co-ordinator and two full-time advocates. 2.3 A number of on-going cases were transferred from the previous provider and the service was widely advertised and quickly attracted new referrals. 2.4 The service covers complaint about services provided by the NHS and those it commissions. 3. Report issues 3.1 The report only deals with complaints referred to the ICAT service. There a number of other routes that complaints can follow, NHS England, Healthwatch and the individual NHS providers themselves. It is therefore important that the analysis of the data is placed in that context. 3.2 Where there are a number of complaints about the same provider service or there is a common theme we have worked with Healthwatch who have then made further enquiries or investigations to see if any action is required. 3.3 The report does not cover the complaint outcome. The role of ICAT is to provide advocacy around the complaints process ensuring complaints are appropriately dealt in terms of time-scales, responses, local resolution meetings and escalation to the Parliamentary Ombudsman. 4. Options 4.1 Members may wish to comment on the content of the report and Appendix 1. 2

3 Report to the Health and Social Care Overview & Scrutiny Committee 5. Contribution to corporate priorities 5.1 The work of the Independent Complaints Advocacy Team contributes to the Councils goals to improve health and to ensure that support is available to the most vulnerable adults, children and families. 6. Recommendation 6.1 That the Health and Social Care Overview and Scrutiny Committee note the content of the report. 7. Background documents None 8. Not for publication documents None 9. Appendices 9.1 Appendix 1 - Independent Complaints Advocacy Team (Bradford and District) Data and Outcomes April2013-March

4 Independent Complaints Advocacy Team (Bradford & District) Data and outcomes April 2013 March 2014 ICAT have been providing a service for one year, the team consists of two full time advocates and one full time service co-ordinator who also undertakes advocacy work. Referrals are taken from a wide range of sources at one central phone number. All callers have the opportunity to discuss their concerns with the service co-ordinator in the first instance, signposting and short pieces of advocacy work will be undertaken at this point. For more longer term advocacy support needs clients are allocated to an advocate based on the advocates particular expertise, caseload numbers etc. Full advocacy support requires a large amount of admin work, face to face work where necessary and numerous meetings, each case can be open for a number of months and even years, depending on the complexity of the complaint and the number of agencies involved. ICAT have developed a good working relationship with representatives of NHS providers in the area and gained a good understanding of NHS provision and how it is managed following the restructure in April A new database system is being developed for managing the caseload that will benefit the collection and communication of information for day to day work as well as improved reporting. On the whole feedback from clients is very positive and many feel that they would be unable to negotiate the complaints process without advocacy support. Service User Comments I m so glad you re here, I wouldn t even know where to start without you. You have helped me and my family a lot. You were professional, organised, structured, polite and reassuring throughout the process. A big thank you to you and the team. I m very happy with where things are at now and wanted to thank ICAT for all your help. I thought it must be me, like I was going mad or something because no-one seemed to take any notice. After taking to you I felt lighter, really listened to.. like I have a safety net or something. After we talked on the phone, I went and spoke to my psychologist and got it all sorted out... I wouldn t have done that without talking to you first, so I wanted to say thanks I decided to speak to the matron after talking to you, she was good, made a time to see me and listened to me and things have been good since then.

5 26 of the people who contacted ICAT felt that their complaint/concern had been resolved. Although not all received the outcome that they had desired from raising a concern or complaint, all but one felt that having contacted ICAT had increased their knowledge about their rights and the complaints process and had increased their ability to speak out for themselves and get their voice heard. Due to the lengthy nature of the complaints process many clients are still in the process, whilst still receiving support or having had early support from ICAT. A feedback gathering process will take place in the first quarter of 2014/2015 to obtain further information from those who received support from ICAT prior to or in the early stages of their complaint. Referrals / Enquiries Received April 2013 March 2014 Total received referrals / enquiries over the period 178 Enquiries work undertaken but no case file opened 44 Resulted in a complaint about an NHS service 134 Referrals able to independently pursue own complaint after an initial 22 discussion with ICAT Referrals requiring full advocacy support. 112.Referral Demographics April 2013 March 2014 Female: 92 Male: 86 White British 97 European 8 Asian 56 Unknown 8 African/ Caribbean 9.Referral Sources April 2013 March 2014 Self-referred 76 Social Workers 5 Choice/BAMHAG 15 GP Practise Manager 4 Complaints Depts 11 Support Workers 2 Previous ICAS 11 PHSO 1 PALs : 10 Informal Advocate 1 Healthwatch 9 MP 1 Other Complaints Advocacy Providers 6

6 Inappropriate referrals Out of Area 14 Not NHS concern/complaint 5 Signposted to other services including out of area complaints advocacy providers and other appropriate support agencies e.g. PALs, other types of advocacy, CAB etc. 38 Areas of concern/complaint Multiple complaints or a single complaint that covered multiple agencies 26 Bradford Teaching Hospitals Foundation Trust Total 71 Of Which: Outpatient: 20 Surgery: 15 Inpatient: 14 A&E: 11 Maternity: 6 Children s: 5 Airedale NHS Trust Total 6 Of Which: Inpatient 5 Outpatient 1 Bradford District Care Trust Total 34 Of Which: Mental Health Outpatient 21 Mental Health Inpatient 7 District Nursing 4 CAMHS 2 Clinical Commissioning Groups Total 57 Of Which: GP Practices 41 Ambulance & Dental Practises 3 Safehaven 3 Continuing Care 2 Care homes 2 Yorkshire Clinic 2 Out of area Total 18 Of Which: Leeds 12 Other 6

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