Guide to the NHS Complaints Procedure

Transcription

1 CLINICAL NEGLIGENCE NHS COMPLAINTS PROCEDURE Guide to the NHS Complaints Procedure

2 2 Most medical care is safe and effective. However, mistakes and systemic errors will occasionally occur, especially where nurses and doctors are over-stretched. Index PRACTICAL GUIDES FROM TEES LAW Step by step MAKING A COMPLAINT UNDER THE NHS COMPLAINTS PROCEDURE What can the NHS complaints procedure do? 3 What can the NHS complaints procedure not do? 3 Making a complaint 3 How long will it take 5 What if I am not satisfied 5 Who can help me make the complaint? 6 How can we help? 7 How much does 7 Most medical care is safe and effective. However, mistakes and systemic errors will occasionally occur, especially where nurses and doctors are over-stretched. Complaining about medical treatment can be overwhelming, distressing and upsetting but you should not feel guilty for doing so. It is important that Healthcare providers are made aware of what has happened in order to improve patient safety. You have the right to complain if you are not happy with the care, treatment or service you have received from a NHS trust or NHS body; a family health service provided for the NHS, including those provided by GPs, dentists, opticians and pharmacists; primary care trusts (PCTs) and private hospitals where the treatment is paid for by the NHS. You have the right to have your complaint fully and efficiently investigated and to receive a full response.

3 3 Anyone who is receiving or has received NHS treatment or services can complain. You can complain for yourself, but if you complain for a friend or a relative or a child, you must have their consent to represent them. MAKING A COMPLAINT UNDER THE NHS COMPLAINTS PROCEDURE STEP 1 What can the NHS complaints procedure do? Under the NHS Complaints procedure, the organisation may: Provide an explanation for what happened Offer an apology Take steps to review procedures to avoid similar incidents in the future. STEP 2 What can the NHS complaints procedure not do? Under the NHS Complaints procedure, the organisation will be unable to: Sack or strike off a doctor (although disciplinary action may occur as a result of information obtained during the complaints investigation) Fine a doctor Assist you with a claim for compensation STEP 3 Making a complaint Who can make a complaint? Anyone who is receiving or has received NHS treatment or services can complain. You can complain for yourself, but if you complain for a friend or a relative or a child, you must have their consent to represent them. When can I make a complaint? Complaints should be made as soon as possible. Normally they should be made within 12 months of the event, or as soon as the matter first came to your attention. Complaints after this time may still be considered but only under certain circumstances. For example, provided it is still possible to do so, a complaint may be investigated if it would have been difficult to complain earlier (perhaps due to illness, trauma or grief). Who should I make the complaint to? You can complain either to the service that you are unhappy with, or you can complain to your local Primary Care Trust (PCT) that commissioned the service.

4 4 hard and professional Your work on this is much appreciated. For sure I will contact you for any future legal issues. Mrs R, Chelmsford How do I make an informal complaint? It might be that you decide to make an informal complaint by talking to a staff member. If so, you should ensure that you note their name, the date and the time that you made the complaint and how they indicated that the complaint would be dealt with. How do I make a formal complaint? To make a formal complaint, you should first ask your healthcare provider for a copy of its complaints procedure which will explain how to proceed. The first step is normally to raise the matter orally or in writing with the practitioner concerned, or the complaints manager or Chief Executive of the NHS organisation. You can also raise the matter with your local PCT. You should be clear who or what you are complaining about, where and when the events happened, what you have already done about the complaint and make it clear what you want to happen. Be specific. Focus on the main issues. Relevant dates, times and names will make it easier for the hospital to investigate your complaint. Keep copies of anything you post and make a note of dates you send them. It is better, where possible, to make the complaint, or at least follow up the complaint in writing wherever possible. What happens when I make the complaint? The organisation is required to investigate and respond to your complaint. They should acknowledge your complaint within three working days either in writing or by telephone. They should discuss with you how they can resolve your issues. You should be offered an opportunity to meet to discuss your complaint; you should be advised of how your complaint is going to be investigated and be advised how long it will take for the complaint to be investigated and when you are likely to receive the response to your complaint. If it is appropriate you may be invited to come in for a meeting to discuss your concerns in more detail. If you do attend a meeting it is important to prepare properly and think about the questions you would like to be addressed. You may talk to the Complaints Manager beforehand about, for example, what form the meeting will take, who will attend, where it will be held, how long it will take, who will take notes etc. You can take a friend, relative or advocate to the meeting for support. At the meeting you should not agree anything that you are unsure about. At the end you should remind the Complaints Manager that you would like a written response to your complaint.

5 5 The level of service was extremely exceptional. They kept me informed by mail, phone or all the time and I always knew where I stood with them. Mrs P, Northampton At the end of the investigation, you should receive a formal written response which also tells you what to do next if you are not satisfied. Clearly, it is not possible to turn the clock back. However, the response should provide as detailed an explanation as possible, and should try to answer all your questions. Sometimes the response may offer a (further) meeting. Whilst there is no provision for payment of compensation under the NHS complaints procedure, NHS bodies do have discretion to make ex gratia payments. There is no harm in asking for this BUT where the amount you seek is more substantial you should consider taking legal action. Who can help me make the complaint? Making a complaint can be daunting but there are people who can help you. Citizens Advice Bureaux can offer advice. NHS Direct can give information on making an NHS complaint. The Patient Advice Liaison Service (PALS) can act on your behalf, or offer you confidential advice and support. The Independent Complaints Advocacy Service (ICAS) can also provide support for anyone who wishes to make a complaint. The PALS officers will be able to provide you with the telephone number for your local ICAS department. The charity Action against Medical Accidents (AvMA) can provide free and confidential advice to people who are victims of medical accidents. STEP 4 How long will it take? The organisation should try to agree with you, at the outset, how long it is likely to take to investigate your complaint. Some complaints are complicated and take longer to investigate. If a full reply cannot be provided within the agreed timescale you should be kept updated of progress and the reason for the delay. If the complaint is not investigated within 6 months, you can ask the Parliamentary and Health Service Ombudsman (see beneath) to investigate.

6 6 It may be possible to challenge the final decision on your complaint by taking court action called a judicial review. Judicial review is a procedure which allows a court of law to review decisions made by public bodies. STEP 5 What if I am not satisfied with the response? Local Resolution If you are unhappy with the response, you should attempt to resolve the matter with the organisation concerned. You could ask them to take further steps, such as to investigate further, to obtain or fund independent expert opinion or to hold a meeting to explore the unresolved issues. Following any further investigation or meeting, you should be provided with a further detailed written response. Parliamentary and Health Service Ombudsman If you remain dissatisfied you can refer the matter to the Parliamentary and Health Service Ombudsman who is independent of the NHS and the government. You should do so within 12 months of the incident in question or as soon as the matter first came to your attention. You should ensure that you provide the Parliamentary and Health Service Ombudsman with a summary of the events, details of the main issues of concern and details of what action has been taken so far, why you remain unhappy, why you feel that the NHS organisation will not adequately address these issues, and why you think that a review by the Parliamentary and Health Service Ombudsman would be helpful. The Parliamentary and Health Service Ombudsman should acknowledge your complaint within 5 days and provide you with the name of the person to whom all future correspondence/ communication should be directed. Each case is looked at individually. The Parliamentary and Health Service Ombudsman will consider he details of your complaint, how this was dealt with by the organisation concerned and may take advice from independent medical experts. Usually the Parliamentary and Health Service Ombudsman will deal with complaints within 40 working days. However, this depends on the nature and the complexity of the complaint. If the Parliamentary and Health Service Ombudsman finds that your complaint is justified, (s)he will try to arrange an apology or other remedy for you, for example, requiring the organisation to change procedures to ensure that the event is not repeated in the future. If you remain unhappy, you can ask for a special team who consider complaints about the Ombudsman to review the matter. Judicial review It may be possible to challenge the final decision on your complaint by taking court action called a judicial review. Judicial review is a procedure which allows a court of law to review decisions made by public bodies. You can find out more on judicial review on the Public Law Project s website at

7 7 We offer a complimentary initial consultation, and after listening to your account and understanding your aims, we will provide you with clear, impartial and honest advice about the way forward. STEP 6 How can we help? Tees assists patients who are unhappy with the care or treatment they have received to make a complaint under the NHS Complaints Procedure. We recognise that it is important to you that there is a proper investigation. We listen to your concerns, gather the necessary evidence, including medical records and witness statements, and offer expert advice as to the key issues. We provide a personal, efficient service and, if you do have to pay (see beneath) we will charge you a fair price, with no hidden costs. STEP 7 How much does We offer a complimentary initial consultation, and after listening to your account and understanding your aims, we will provide you with clear, impartial and honest advice about the way forward. The cost of assistance with the NHS Complaints Procedure varies enormously, depending on the complexity of the case and the amount of documentation involved. Generally, patients find that they will need to pay their own legal costs incurred in obtaining assistance with the NHS Complaints Procedure. Most solicitors work on an hourly basis and the cost depends upon the amount of time required. If there is a successful personal injury, medical negligence or Human Rights Act claim thereafter, provided the Court is satisfied that the costs of assisting with the NHS Complaints Procedure overlaps the litigation claim, it is usually possible to recover these costs from the Defendant. If you are considering and wish to explore the possibility of seeking legal advice for your complaint under the NHS Complaints Procedure, please do contact us and we would be happy to give you a free no obligation quote.

8 teeslaw.co.uk Useful contacts Patient Advice and Liaison Service (PALS) See to find the number for your nearest PALS office. Independent Complaints Advice Advocacy Service (ICAS) London South East Bedfordshire and Hertfordshire Cambridgeshire, Norfolk and Suffolk Essex South West West Midlands East Midlands North East North West Yorkshire and Humberside The Parliamentary and Health Service Ombudsman NHS Direct NHS Choices Care Quality Commission This Guide has been prepared to provide useful information but should not be considered as a substitute for advice on any specific case. Tees Law is a trading name of Stanley Tee LLP regulated by the Solicitors Regulation Authority. Registered in England and Wales number OC / Bishop s Stortford Cambridge Chelmsford Great Dunmow Northampton Saffron Walden