1 Concern / Complaints Flowchart INFORMAL CONCERN (usually verbal) A concern can be made to any member of staff or the Patient Advice and Liaison Service Staff/PALS will try to resolve the issue within 1 working day (Using the PALS procedural guidance) Concern resolved No need to handle through the complaints regulations Concern not resolved Proceed through to the Complaints Procedure under the Complaints Regulations and pass to the Complaints Department Refer to the Complaints Flowchart Appendix A
2 North Staffordshire Combined Healthcare NHS Trust Listening, Responding, Improving PALS Operational Protocol/Guidance 1. Functions of PALS The Patient Advice and Liaison Service, PALS, has a variety of functions which are available to service users, patients, their carers and family members: 1.1 Providing accurate information to patients, carers and families, about the Trust s services, and other health related issues, using accredited, reliable sources. 1.2 Providing on the spot help with the power to negotiate immediate solutions or speedy resolution of problems. PALS listens and respond, providing relevant information and support to help resolve service users concerns quickly and efficiently. When needed, staff responding to concerns will liaise with the PALS Office, care team colleagues, service managers, and, where appropriate, other health and related organisations, to facilitate a resolution. 1.3 Acting as a gateway to appropriate independent advice, advocacy and support from local and national sources, including independent advice and support if they wish to pursue a complaint. The PALS Office has well developed links to organisations able to provide these services. 1.4 Receiving and recording people s comments and compliments about any aspect of the trust s services or activities. 1.5 Acting as a catalyst for change and improvement. PALS is a key source of information and feedback and an early warning system for the Trust. The PALS office monitors concerns and proactively seeks patients experience of healthcare, including problems arising, and highlights gaps in services by: developing and maintaining a database of PALS cases capable of collating and analysing all issues dealt with by PALS. providing information, advice and training on their service and issues raised by service users to staff. meeting weekly with colleagues from, health and safety, legal services and complaints management to review the array of concerns and incidents that have been recorded in the previous 7 days. submitting quarterly anonymised reports to the Quality and Governance Committee, and liaising with service managers, on policy issues that involve PALS and customer care/service user issues. feeding back emerging themes to the Quality and Governance committee and individual departments and services.
3 1.2 Service ethos PALS is part of our service culture, a function of the organisation not a department. All members of staff have a role to act as a PAL regardless of where they work or what they do. The provision of the PALS management office does not mean that other staff within the organisation transfer responsibility to it to respond to concerns and issues raised directly with them PALS is identifiable, accessible and well-promoted to patients, their carers, friends and families via booklets, leaflets, posters and the trust s website It is a confidential service that treats people accessing it with dignity and respect The service operates in a local network with other PALS in North Staffordshire and works across organisational boundaries to ensure a seamless service for patients who move between and use different parts of the NHS and other care services The PALS office supports staff at all levels within the organisation to develop a responsive culture and build on good practice currently taking place in the Trust in providing opportunities for patients, their carers and relatives to influence every level of the service Those responding to requests for information and support are expected to: act with determination and persistence on behalf of the individual receiving support; maintain the involvement of those they support; initiate action on the basis of a person s fundamental needs and rights; treat the people they support with respect and dignity PALS is not about: creating a substitute for making existing services more accessible, acceptable and effective; bypassing user involvement in the planning and delivery of services; avoiding the need to provide person-centred services; deciding or advising on a course of action, which might be seen to be in the best interest of the service user; addressing complaints that require the appointment of a complaints investigation officer, (see policy section. 1.3 Access to PALS The functions of PALS are carried out by individuals throughout the organisation and promotional material advises people accordingly. Trust training emphasises the responsibility of all staff to listen and respond to the best of their ability, ensuring that clients are advised of how they can contact the PALS and Complaints team, if required. Service users can make direct contact with the trust s PALS and Complaints team via freephone, freepost, text and .
4 1.4 Service provision PALS provides help and support on the spot, hence the emphasis on collective responsibility. For a Trust of our size and nature, located on dozens of sites, this help and support will be provided by frontline staff, whether they are doctors or domestics In addition, the PALS Manager provides a direct service to members of the public who choose to contact the service via the methods in 1.3. The PALS Manager will also be directly involved in service provision when contacted by frontline staff for support or involvement In order to enable front-line teams to provide their PALS, service teams identify appropriate staff as PALS Leads (see Policy, section 4.5). The role of PALS Lead will include: receiving Trust PALS training briefing/training colleagues within their team about the service and how it operates providing guidance to colleagues about how to approach issues and requests raised by service users carrying the PALS culture - encouraging colleagues to understand the potential of PALS as a catalyst for change and improvement helping to promote the service by working with the PALS Manager to provide appropriate publicity and information to potential users liaising with the PALS Manager to ensure that PALS clients receive the best possible response from the Trust It is the responsibility of service managers to ensure: the appropriateness of staff to carry out the lead role that sufficient Leads are identified within each team to enable the team to provide the service adequately. 2. Listening and responding guidelines to staff A detailed practice guide is available to all staff via the Staff Information Desk. The following is a step-by-step guide for listening and responding. Members of staff who are approached for information, support or with a concern or complaint are expected to carry out the following steps at the initial contact: Step 1 - Welcome Welcome or greet the person respectfully, treating all individuals equally. Introduce yourself to them. Ensure that you have, and that you offer them, somewhere private to talk. (If you are not in a position to do this for whatever reason, for example, the nature of your job or the fact that you are urgently leaving the building for an appointment, explain why you cannot immediately listen to them and introduce them to an appropriate colleague). Step 2 - Inform Enhance their awareness of PALS through conversation and printed information, if appropriate, bearing in mind their communication needs. Ensure that they understand that PALS is a confidential service but that the Trust wishes to record their personal and
5 other details in order to monitor the service and be able to contact them if needs be. However, it will be the client s decision to decline should they wish. Step 3 - Listen Identify the person s needs by actively listening, attending to the detail of what they have to say. Treat your enquirer with respect. Be friendly and encouraging, yet remain dispassionate. The emphasis should be on empathy, sensing the feelings of the other person and showing you understand through your body language and verbal responses. Be aware of what your client's body language is telling you. You need to give them time to explore and explain. Once you feel you have a clear sense of the issue(s), summarise back to them to check the accuracy of your understanding. However, if it becomes clear early on in this process that you will need to involve a colleague, for whatever reason, explain this to the client as soon as possible as it could otherwise be annoying if they go through a lengthy explanation or enquiry only to have to repeat it to someone else. Step 4 - Respond People may approach you with one or more of a whole range of needs or requests. From simple requests for information to complex concerns, you should do you best to facilitate a satisfactory response, knowing how and when to introduce clients to other people or agencies as necessary. Avoid using jargon or abbreviations that may not be understood - for example, BA (Benefits Agency) or OT (Occupational Therapist). Keep language plain and simple. Depending on the nature of their needs or request there is a range of possible responses and you should use your judgment in deciding the most appropriate. A request for information, for instance, may be responded to on the spot verbally or with printed information. However, if you do not feel that, by the nature of the client s issue or request, it is possible for you to make an immediate and satisfactory response, you should openly explain why. There are several reasons why you may not feel able to respond immediately and effectively. For example, you may: need to find out some information not readily accessible to you prefer to involve someone else, seek support, etc feel that the nature of their concern is, or maybe, a complaint but do not have the training or knowledge to advise or inform them further think they need some specialist advocacy to support them. In any such case, where you don t feel able to give on the spot help, you should openly explain the reason and explore with them how they can get the support, information or advice they wish. If you simply need time to locate information, for instance, arrange to forward or give it to them within an agreed timetable. If you feel you cannot respond effectively to their needs because you don t feel adequately informed, trained or experienced, ask them if you can introduce them to a colleague, if available, who you think will be able to help. Alternatively, if they wish to speak to the PALS and Complaints team, give them details of the PALS & Complaints team FREEPHONE number, which should be on the service information literature. If they would like you to make an appointment for them, take contact details shown on section 1 of the PALS Contacts Form and phone or them to the PALS Manager or Complaints Manager straightaway.
6 If you feel you have responded fully and to the best of your ability to their concern or request but they are not satisfied by your response, offer the last two options bulleted above. Step 5 - Record It is important for the development of the PALS and the Trust as a whole that we record PALS activities, (see 1.5 above). By providing the PALS Office with contact details we will be able to get in touch with them, offer future support and ask them about their experience of PALS, etc. It will also give us opportunities to invite PALS users to involve themselves further in Trust development activities, if they choose. However, it must be the person s express decision for you to forward their personal details to the PALS Office. The PALS Contacts Form, is available to all staff via the Staff Information Desk. It has been designed for ease of use and should be self-explanatory, however, it would be useful to get acquainted with it. Fill it in and forward it to the PALS Office within the timetable shown on the form. Registering details of the client s request or concern, gender, ethnic origin, etc, will help us to monitor the service. But most of all, it will help us to develop insights into the patient experience and be a powerful lever for change. When not to use the form It is recognised that we regularly give people information in the course of our work for the Trust and that, if we have to fill in a form whenever we do so, it will create a lot of time-consuming bureaucracy. It is therefore not appropriate to use this form if you have successfully given printed or verbal information on the spot to the full satisfaction of the enquirer. If in doubt ring the PALS office for advice. However, if you received an information request that has required some research on your or a colleague s part, it would be useful if you fill in the form with a brief summary of what the information was and where you sourced it from.
7 3. Complaints Procedure This procedure is in line with the principles for good complaint handling as set out by the Parliamentary and Health Service Ombudsman:- Getting it Right Being Customer Focussed Being Open and Accountable Acting Fairly and Proportionally Putting things Right Seeking Continuous Improvement Complaints and expressions of concern should be dealt with quickly and, where possible, by those on the spot, or via support by PALS however it may be necessary for the complaint to be dealt with by the person in charge or an identified senior person. They should be dealt with according to their urgency but in any event within 24 hours (1 working days). In the event that they remain dissatisfied and this extends beyond the timescale identified above, the matter should be brought to the attention of the Trust s Complaints Manager and the person raising the concern given the opportunity to pursue this through the Trust s Complaints Procedure. Clients should be given the opportunity to understand all possible options for pursuing the complaint or concern, and the consequences of following any of these. The aim should be to resolve the complaint or concern at this stage. The conclusion of all complaints or concerns must be that the client is asked whether they are satisfied with the outcome of the action taken in relation to their issue. Complaints can be made in writing, via or verbally. Complaints are currently accepted by this method but emphasis is placed on choice for those wishing to complain. It is always best where complaints are written by those wishing to complain as this reduces the risk of misinterpretation. Complainants should always be advised of their options and should not be pressed into writing in with their complaint if they do not wish to do so. Appropriate confidentiality measures will be put in place in accordance with how the complaint is submitted. There will be occasions when verbal complaints of a serious nature are made. All such complaints should be given immediate attention by a senior manager of the business division and the complainant encouraged to put their concerns in writing or where appropriate, a statement taken and signed by the complainant. The complaint will then be dealt with as part of the Complaints Procedure as described below. 4. Timescale for Making Complaints 4.1 Complainants should normally make a complaint within 12 months of the event(s) concerned or within 12 months of becoming aware that they have something to complain about.
8 4.2 Complaint Managers in NHS organisations have discretion to consider longer time periods subject to the circumstances. 5. Complaint Acknowledgement 5.1 All complaints will be acknowledged in writing within 3 working days of receipt whether by the recipient or the Complaints Department dependent upon the point of receipt. 5.2 All complaint acknowledgement letters will inform the complainant that: their concerns have been received and will subsequently be investigated once a plan has been agreed in terms of how the complaint will be investigated and timescale for doing so; they will receive a response from the Chief Executive; they will receive a reply within the timescale agreed and a subsequent explanatory letter if this deadline cannot be met. they will receive information on independent support available to assist them with their complaint. 6. Complaint Investigation 6.1 Each complaint will be assessed and triaged and will not automatically be responded to within a set timescale. Anyone raising a complaint will be offered t he opportunity to discuss and agree an appropriate timescale for investigation and response. However, only for very complex complaints will responses be expected to take longer than 30 working days 6.2 A request for a an investigation will be sent to the appropriate Divisional Manager within 2 working days of receipt by the Trust Complaints Manager. The request will enclose relevant correspondence and give a date by which an investigation report is required which is usually within 15 working days. 6.3 On receipt of a complaint directly by front-line staff, once acknowledged it will be copied to the Chief Executive and Divisional Manager. On receipt of correspondence from the front-line team, the Complaints Manager will write to the Divisional Manager giving a date by which an investigation report is required. 6.4 The investigation report is usually required 15 working days from receipt of the complaint. Those nominated to act as the Investigating Officer by the Divisional Manager should make every effort to adhere to the deadlines set. The Complaints Manager will work closely with the Investigating Officer to support them in achieving the deadline required. 6.5 Where it is considered appropriate, and to resolve complaints as quickly as possible, the Investigating Officer, or an appropriate senior manager, should arrange to meet with the complainant with a view to understanding and resolving the complaint. For complaints of a clinical nature this should, where appropriate, involve the relevant member of clinical staff.
9 6.6 If the complaint relates to matters of clinical judgement, the Complaints Manager will copy the correspondence to either the Trust s Medical Director or Director of Nursing for advice, and where appropriate, to the Director of Operations for complaints that require close attention or urgent action ahead of the response. 6.7 The Divisional Manager will be responsible for ensuring that the complaint is investigated thoroughly and objectively. They will ensure that all relevant professionals are given the opportunity to comment on the content of the complaint. 6.8 Where a complaint relates to a patient and is made by a third party, the Investigating Officer will ensure that they are acting in the patient s best interests and with their knowledge and where possible their consent. Where a patient indicates that they do not want personal information disclosing to a third party, a decision will be taken by the Complaints Manager and Investigating Officer as to whether a complaint investigation is still possible and whether the provision of general information could answer the complaint. 6.9 The Investigating Officer will ensure that all the points raised by the complainant are covered in their investigation. Where a complaint primarily relates to one area / service / organisation, but involves issues relating to others, the Investigating Officer will need to discuss the complaint with the relevant professionals and include all relevant information in the investigation report. Where learning outcomes have been identified, the Investigating Officer will write an action plan in conjunction with the Complaints Manager. It is the responsibility of the Complaints Manager to keep the action plan under review and discuss progress at complaint monitoring meetings Any investigations under supervision of the Investigating Officers (rather than the Investigating Officer themselves) should be undertaken by a senior member of staff and should ensure an independent and thorough approach It is recognised that there will be occasions when, due to the complexity of a complaint, for example, an agreed deadline cannot be met. If it is evident that there will be a delay, the Investigating Officer shall notify the Complaints Manager and the relevant Divisional Manager who in turn, where necessary, will discuss this with the Chief Executive Where a delay in responding is anticipated or known, the Complaints Manager, on behalf of the Chief Executive and Investigating Officer, will write to the complainant explaining the position and will agree with the complainant a revised response date which is acceptable to them. 7. Responding to the Complaint 7.1 On receipt of the Investigating Officer s investigation report, the Complaints Manager will draft a response for the Chief Executive s consideration. If the complaint relates to clinical judgement, or has been requested by the Medical Director or other professional lead, the draft response will be sent to the Medical
10 Director/Professional Lead and Investigating Officer, for comment. The deadline for their comment is usually 5 days. 7.2 All final responses from the Chief Executive will offer the opportunity, where appropriate, to discuss any outstanding concerns with representatives of the Trust and will include an information leaflet informing the complainant of their right to pursue the matter further and that they can seek an external independent review of their complaint with the support of an independent complaints advocate. The response will also consider fully and seriously all forms of remedy, such as an apology, an explanation or remedial action, as set out in the Principles for Remedy, Parliamentary and Health Service Ombudsman (March 2007). 7.3 A copy of the final response will be sent to the Divisional Manager, Clinical Director and Investigating Officer for their files and if related to professional issues, to either the Medical Director or the Executive Director of Nursing who will liaise with other professional leads as appropriate. The Divisional Manager will be responsible for ensuring that the response is brought to the attention of the professionals involved. 7.4 Where a complaint relates to a particular member(s) of staff the Investigating Officer should ensure that the member of staff is notified of the outcome of the complaint. 7. Further Action 7.1 If the complainant remains dissatisfied, as mentioned they will be offered the opportunity to meet with a senior representative of the Trust and the relevant health care professional, as appropriate, if this has not already taken place. The outcome of the meeting will be followed up in writing to the complainant with a copy to the Chief Executive. 7.2 If the complainant remains dissatisfied they will be offered the opportunity, where appropriate, to meet with the Chief Executive and Complaints Manager. The details of the meeting will be summarised in writing by the Chief Executive, with a copy to the Investigating Officer. 7.3 If the complaint relates to clinical matters the complainant will be offered referral of their complaint to the Medical Director and/or Executive Director of Nursing who will liaise with the relevant professional lead. Those involved will review the complaint and arrange to meet with the complainant together with the relevant member of clinical staff (if appropriate). The details of the meeting will be summarised in writing to the complainant with a copy to the Chief Executive and Complaints Manager. 7.4 The complainant can request an independent review of their case at any time after receipt of the response from the Chief Executive, i.e. the complainant does not have to meet with senior managers of the Trust.
11 7.5 Before the complainant refers their complaint for independent review, the Complaints Manager must ensure that every reasonable opportunity has been taken to resolve the complaint at local level. The Complaints Manager should refer to the Ombudsman / Department of Health, best practice toolkit for responding to complaints and consider all opportunities for resolving the complaint locally, e.g. obtaining an independent second opinion. 7.6 The Complaints Manager, taking appropriate clinical advice, will consider whether further investigation, support from internal or commissioned mediators or conciliators may be offered as another way of attempting to resolve the complaint to everyone s satisfaction. 8. Independent Review by the Parliamentary and Health Service Ombudsman 8.1 If the complainant has exhausted all avenues for pursuing their complaint with the Trust they can write to the Parliamentary and Health Service Ombudsman to request further review. The Ombudsman will only normally embark on an investigation when the NHS processes have been completed. This is the final stage of the NHS Complaints Procedure. 8.2 On receipt of a request for a case file from the Ombudsman, the Complaints Manager will act as the lead for the Trust and will notify members of the Executive Board immediately. The Divisional Manager will also be informed, who in turn will inform the member(s) of staff complained against. 8.3 The Ombudsman will not usually take action if the organisation has done all that could reasonably be expected to put things right. 8.4 The Ombudsman will not usually investigate if the complaint is put to them more than 12 months after the complainant first became aware of the problem. However, they will use their discretion, as appropriate. 8.5 If a case is accepted by the Ombudsman their complaints team will liaise with the Trust s Complaints Manager asking for their view and a copy of the case file to help inform their initial review. This should include: Chronology of the case Copies of correspondence Copies of any relevant health records Notes from local resolution meetings Any local investigation documents Relevant/related Trust policies and procedures Final response given to the complaint and the organisation s view on the complaint 8.6 The Complaints Manager will keep Trust representatives informed and share the findings of the Ombudsman which should be brought to the attention of the relevant boards, for discussion and relevant action.
12 8.7 Processes and Procedures for handling complaints and the training and support provided to staff will be reviewed in light of any recommendations made by the Ombudsman. 8.8 Any recommendations following review by the Ombudsman should be reported as per the reporting arrangements in the Trust Policy. 9. Negligence Claims The complaints procedure should not automatically cease unless the complainant explicitly indicates an intention to take legal action in respect of the complaint. However, it should be noted that an initial letter of complaint via a solicitor is not evidence of intention to take legal action. The Complaints Manager in conjunction with the Head of Corporate and Legal Affairs will consider the principles for remedy as set out by the Parliamentary and Health Service Ombudsman (March 2007) in considering fully and seriously all forms of remedy. Where the complainant has indicated the intention to start legal proceedings, the Trust shall ensure that the principles of good claims management and risk management are applied. This will of necessity, involve the Complaints Manager liaising with the Head of Corporate and Legal Affairs and the NHS Litigation Authority. 10. PALS, Complaints and Disciplinary Proceedings The purpose of the complaints and PALS procedures is not to apportion blame amongst staff and therefore should be kept separate from disciplinary procedures. The complaints procedure will not deal with matters relating to any part of the complaint that is currently the subject of disciplinary investigation. If disciplinary action is initiated the complainant will be advised accordingly so that appropriate action under the complaints procedure can be pursued where there are other matters raised in the complaint that do not relate to the disciplinary investigation. If any complaint or concern received by an employee of the Trust indicates a need for referral to: an investigation under the disciplinary procedure; one of the professional regulatory bodies; an independent inquiry into a serious incident under Section 84 of the National Health Service Act 1977; an investigation of a criminal offence; the person in receipt of the complaint or concern should pass it immediately to the Complaints Manager or PALS Manager who will ensure that it is passed on to a suitable person who can make a decision regarding any such action. 11. Working Across Organisational Boundaries As mentioned in the Trust Policy, Listening, Responding, Improving, in accessing NHS services, patients, their carers and families do not necessarily recognise the boundaries
13 of health and social care organisations, nor do they differentiate between various departments. Issues, concerns and complaints are quite likely to relate to more than one area of health and social care, emphasising the need for partnership working across and within organisations and identifying the need to focus on the patient s journey or pathway of care. PALS and the Complaints Manager will work across organisational boundaries, both health and social care, to ensure that they do not provide a barrier to the resolution of issues for patients. The exchange of information between PALS, the Complaints Department and other agencies should be underpinned by the informed consent of the client. Combined Healthcare s PALS Manager liaises with PALS workers from all other local Trusts. Collectively, they have agreed protocols to ensure that patients, their carers and families who make contact with the service regarding an issue relating to another organisation are not passed from one to another. In the case of an issue relating to one other organisation the receiving PALS service will take the lead in progressing the issue, and ensuring that the other organisation responds to the service user raising the matter. It is vital that the PALS service is focused around the patient or service user rather than round the NHS and its structures. Issues that involve multiple organisations in different sectors and potentially crossing geographical boundaries, will need a unified approach with one PALS service taking the lead for co-coordinating a response. Consequently, PCTs with their particular responsibility for commissioning services are ideally placed to address the handling of issues that cover multiple organisations, including Social Services Departments, voluntary or independent providers, the Acute Trust, primary care, and community based services. PCT PALS should take the lead and responsibility for dealing with multi-service issues. This is particularly important in respect of discharge issues that cover inpatient and primary care; staff in Combined Healthcare may have initially responded to the patient, their carer or relatives, but will need to liaise with the appropriate PCT PALS service to ensure that all matters are addressed. This will be achieved by the following: The PALS Office or the Complaints Manager will take basic information, including details of the issues raised, person s name and contact details and approach the agency concerned, with the informed consent and understanding of the service user that information will only be divulged to the relevant organisations. If it becomes clear that the matter raised is multi-organisational and/or has crossboundary issues, the relevant PCT PALS should take the responsibility for cocoordinating responses. The PALS Office or Complaints Manager will make the initial contact with the relevant PCT officer. The agency or other organisations then become responsible for contacting that person, within an agreed timescale. The agency must then respond to the patient or service user within an agreed timescale.
14 Combined Healthcare s PALS would only play a supportive role from this point onwards, possibly if the service user is having difficulties with the agency or experiencing problems with finding relevant information. In order for this to be effective, frontline staff need to explain the situation to the client and ask for their consent in passing information on, which should include details of the issues raised, person s name and contact details. These should be phoned or ed to the PALS Office or Complaints Manager as soon as possible. 12. Respecting Client / Patient Confidentiality 12.1 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 where the patient is the complainant. However, at the point of acknowledging the complaint the complainant will be advised that in order to investigate their complaint, there will be a need to access their health records, but only those records in relation to the episode of care in question. The complainant will be invited to contact the Complaints Manager should they have any questions or concerns about this Where complaints are received from a third party, there will always be a need to establish that they are acting with the patient s knowledge and no clinical information or facts should be released without the patient s consent, other than to those who have a demonstrable need to know for the purpose of investigating the complaint Financial or personal details of a complaint should also be, as far as possible, treated in confidence. 13. Trust Commitment against Discrimination 13.1 As mentioned earlier in the Trust policy, Listening, Responding, Improving, the Trust is committed to ensuring that people who complain should feel confident that their care will not be adversely changed or altered in any way as a result of having made a complaint The Trust communicates this commitment to patient s and their carers in a number of ways: Is highlighted in the information available on PALS and Complaints Is in the Trust policy on PALS and Complaints At the various PALS and Complaints training sessions where education and training is provided for frontline staff, specifically in relation to the expectations of staff regarding discrimination PALS and Complaints staff will lead on reviewing the systems in place to ensure that patients, carers and their relatives are not discriminated against and these systems remain effective.
15 13.4 Where it is highlighted that discrimination has occurred, PALS and Complaints staff should follow the Trust s incident reporting process to ensure that the matter is recorded and action is taken accordingly. 14. Independent Support for Complainants 14.1 Independent Complaints Advocacy Service (ICAS) The Independent Complaints Advocacy Service (ICAS) supports patients and their carers wishing to pursue a complaint about their NHS treatment or care. This statutory service was launched on the 1 September 2003 and provides a national service delivered to agreed quality standards. ICAS empowers clients by providing information, support and guidance helping them to articulate their concerns and navigate the complaints system. This may include assistance with constructing a complaint letter or attendance at meetings. ICAS supports the principle of local resolution and aims to help clients find a solution as close as possible to the point of the service that has caused dissatisfaction, maximizing the chances of the complaint being resolved quickly and effectively. POhWER provide Independent Complaints Advocacy Services in the West Midlands area, which includes North Staffordshire. The contact details for this service are: Tel : (calls charged at local rate) Fax : Minicom : POhWER ICAS Units 25 and 32 Stafford Business Village Dyson Way Staffordshire Technology Park STAFFORD ST18 0TW POhWER ICAS is free, independent, confidential and flexible. They are able to meet at a venue to suit the client. They offer a home visiting service and are able to access interpreters in a range of languages Patient s Advocates In addition to ICAS, patient s advocates are available to help complainants in expressing their concerns. Asist is an independent voluntary group offering advocacy for people who feel unable to express their view or are in need of support. If a complainant requires such assistance they should be advised of how to contact Asist:
16 Tel : ASIST Advocacy Services FREEPOST ST2 030 STOKE ON TRENT ST4 7BR October 2010
17 Complaints Flowchart Complaint Received (Timescale is within 12 months of event or becoming aware of the event) via Chief Executive (letter or ) via another director (letter or ) via Clinical Director/ Business Manager (letter/ ) via clinical team e.g. Ward, Resource Centre via advocate (letter/ telephone) via complainant (letter, , telephone: patient, relative, carer) via Solicitor via Patient Advice and Liaison Service previous concern via another Trust or Local Authority Conduct Initial Enquiries e.g.: obtain demographics of patient appointments/ services accessed inpatient? Which Division/ Business Manager/ Next of Kin Is it a 3 rd party complaint? Capacity status of patient? Is the patient detained under the Mental Health Act? Allocate a Complaint Number on the Complaints Register Acknowledgement Letter Write to complainant within 3 working days to acknowledge receipt of complaint Inform relevant Business Manager of new complaint Using info from initial enquiries above, inform the relevant Business Manager of new complaint received: - include copy of original letter or or details of phone call - request an Investigating Officer Diary to chase place on bring forward to chase if necessary Set up Complaint File Audit front sheet storage X drive file Hard copy file Appendix C
18 Complaints Flowchart Progress with Business Manager if an Investigating Officer is still required Once Investigating Officer appointed: Link to this person and offer support Place on bring forward for obtaining update and investigation report Investigating Officer conducts investigation (ensuring all points of complaint are covered) Liaison possible meeting with complainant Review of medical notes/ CHIPS etc Talk/ interview staff if applicable Interview witnesses if applicable Send out any holding letters if applicable - e.g. if delays Investigating Officer produces Investigation Report forward to Complaints Dept Investigation Report received by Complaints Department Holding letter to complainant to advise report received and now under review with the Chief Executive Investigation report reviewed by Complaints Manager - highlight any gaps/ additional queries Start of a draft response letter by Complaints Manager using info from initial enquiries and investigation report Draft response letter ed to Chief Executive, Business Manager and Investigating Officer and relevant Director and any other interested personnel as appropriate Appendix C
19 Complaints Flowchart Draft received by Chief Executive and others sometimes feedback/ changes and amendments Chief Executive provides confirmation draft response letter acceptable Print Final Response Chief Executive personally signs final response letter Post final response letter to complainant Copy of final response ed to Business Manager, Investigating Officer and Clinical Director Requesting to share with staff/team as appropriate To action any learning points identified If complainant is dissatisfied, the offer of a meeting with key personnel within the trust is offered to help achieve local resolution to the complaint. If complainant remains dissatisfied they have the opportunity to refer their complaint to the Parliamentary Health Service Ombudsman. Appendix C