Policies and Procedures. Policy on the Handling of Complaints

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1 RMP. South Tyneside NHS Foundation Trust Policies and Procedures Policy on the Handling of Complaints Approved by Trust Board December 2006 (revised version approved by RMEC May 2010) Policy Type Policy Number Version Issue Date Review Date 2 May 2010 May 2012 Contact Person Executive Director of Business Development and Corporate Services/ Head of Risk and Compliance Risk Management RM0013.v2 Page 1 of 18

2 Contents Page No 1 Introduction What are the objectives of the Complaints Procedure? What do we mean by a complaint? Who can complain? Are there any time limits for receiving a complaint? Providing prompt and fair access to the complaints procedure Outcome of a complaint Who is responsible for handling complaints? Support for those making a complaint Key points regarding Customer Service 8 2 The Complaints Procedure Local Resolution Receiving the complaint Acknowledging the complaint Investigating the complaint Responding to the complainant Completion of Local Resolution Performance targets 13 3 If the complainant remains unhappy with the way the complaint 13 has been handled 3.1 The role of the Health Service Ombudsman Clinical Governance Monitoring of the policy 14 Page 2 of 18

3 1 Introduction We are here to provide a service for people who need the care and support we offer. They may be anxious, upset or in need of help and reassurance. Above all they have a right to expect an excellent standard of service. It is our job to make sure that we know if there are things we could have done better and to learn lessons across our organisation to continually improve the services we provide. There are lots of things we can learn from complaints including: - Putting things right where they have gone wrong Preventing the same thing happening again Learning how to do things better We should, of course, always look to prevent things becoming a problem in the first place. 1.2 What are the objectives of our complaints procedure? It will be easy to use and widely accessible to all patients and members of the public It will be fair and impartial to all involved It will be honest and thorough in looking into concerns It will be efficient and quick, with time limits for action and procedures to keep everyone informed It will deal with complaints as close as possible to the point at which they arise It will deal with all of the points raised and provide a full response It will respect confidentiality and privacy It will provide for the option to further review ongoing concerns It will help us to monitor and improve our standards It will help us to learn and make improvements in services to benefit patients and staff Page 3 of 18

4 It will identify changes made as a result of the complaint, and make sure the person making the complaint, and staff, are told about the changes It will make sure that improvements are recognised and adopted across the organisation. 1.3 What do we mean by a complaint? A dictionary would define a complaint as, an expression of dissatisfaction or grievance with regard to an individual(s) and service(s) which requires an investigation and/or explanation to be made to the complainant. In reality, a complaint is a statement made by someone who is unhappy at the service we have provided. Complaints can be expressed in a number of ways in person, by telephone, in writing, by or through a third party. What we must do is understand why that person is unhappy, and then do something about it. 1.4 Who can complain? A current or former patient Someone on behalf of a patient ( for example a relative, carer or advocate) where the patient has given their consent Someone on behalf of the patient where the patient has died, is a child or is unable, because of physical or mental incapacity to make the complaint themselves Visitors to the hospital who are unhappy with the service they receive When a complaint about a patient s care is made on behalf of a patient, the patient will be asked to sign a Form of Authority, confirming their consent to disclose information about their care to the complainant. Exceptions will be made if the patient is a child or because of physical or mental incapacity, is unable to make the complaint themselves. 1.5 Are there any time limits for receiving a complaint? Patients, or an appropriate representative complaining on their behalf, are encouraged to make their complaint as soon as possible after the incident giving rise to the complaint. Normally, this should be within 6 months of the incident or the time when the patient became aware of the cause of complaint, whichever is the earlier. Page 4 of 18

5 We can 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 it is still possible to investigate the facts of the case Our policy is to be as helpful and supportive as possible in resolving concerns. 1.6 Providing prompt and fair access to the complaints procedure From the outset, patients, relatives and carers must be reassured that the patient s care and treatment will not be adversely affected by making a complaint. Wherever possible any concerns raised should be dealt with on-the-spot, in a helpful, understanding and supportive way by those who are involved in the patients care. If appropriate issues should be escalated within the department concerned to try to resolve the issues quickly and the satisfaction of the person making the complaint wherever possible. Wherever possible the person making the complaint should be given the option of speaking to the manager of the service in an effort to resolve the issues. It is at this point an explanation of how the complaints procedure works should be given and it is important to check the complainants understanding of the process it before giving them a leaflet. If local resolution cannot be achieved it would be necessary to begin a formal complaints process. Leaflets explaining how people can comment on our services are available on all of our wards, departments and public areas. Information can also be found on the Trust internet site. These contain the names and contact numbers of the Customer Services Team, the Chief Executive and other sources of help and support such as the Independent Complaints Advocacy Service (ICAS). It is important that we assure access to all those who use our services, patients who have communication difficulties due to English not being their first language, physical impairments and psychological needs may need help to raise their concerns. Services are available to help interpret for patients available to people from ethnic minority groups and can be contacted through the Customer Services Department or information provided on the intranet. Page 5 of 18

6 1.7 Outcome of a complaint We are committed to resolving complaints fairly and consistently for the complainant and the staff involved. All complaints will be investigated by staff that have a thorough understanding of the complaints process, including full awareness of their responsibilities in responding appropriately to a complaint. The complainant will receive an explanation and where appropriate, an acknowledgement and apology for what went wrong. This process may include a meeting with a senior manager and clinical staff so that concerns can be discussed and explanations given. The main purpose of the complaints procedure, is to put problems right, learn from them, and try to ensure that they do not happen again. The purpose is not to apportion blame amongst staff. Clearly, should a complaint investigation reveal a potential disciplinary offence, a further review would need to be undertaken, but this would be through the disciplinary procedure and entirely separate from the complaints procedure. 1.8 Who is responsible for handling complaints? You Every member of staff has a responsibility to ensure that the people who use our services as patients, carers or visitors are treated with courtesy and consideration. Every effort should be made to make their health care experience as relaxed and informal as possible. Everyone must be aware of their responsibilities within the Complaints Procedure. This information is an essential part of the induction process and additionally, everyone will receive training in essential customer relation skills and techniques as identified by their manager. Investigating Officers On receipt of a formal complaint, the Chief Executive will nominate an investigating officer not associated with the area of concern, who will investigate how the complaint has arisen. The Investigating Officer will report the findings of the investigation to the Chief Executive and the Customer Services Team so that a letter of explanation can be sent to the complainant. Page 6 of 18

7 Customer Services Team The Customer Services Team will manage the complaints system on behalf of the Chief Executive, maintaining an accurate log of all complaints received, liaising with investigating officers and reporting back to the Chief Executive, so that the response to a complaint can be provided in full and within the time limits. The Customer Services team will prepare reports for the Risk Management Assurance Group so that trends and outcomes can be monitored. The Customer Services team will be readily available to meet members of the public and will facilitate the Complaints Procedure, providing support and advice to all staff. The Executive Director of Business Development & Corporate Services The Executive Director of Business Development and Corporate Services is the nominated executive officer who will oversee the effective handling of complaints. The Chief Executive The outcome of investigations will be reported to the Chief Executive by the Customer Services team. The Chief Executive is responsible to the Trust Board for the effective handling of all complaints and will review any action taken as a result of the complaint, and ensure that the person making the complaint receives a response in writing within the time scales contained in the Complaints Procedure. The Trust Board The Trust Board has specific responsibility for monitoring the complaint arrangements, reviewing the effectiveness of investigations, compliance with procedures and standards, overall trends and any remedial or managerial action taken. This information is provided via the Risk Management Assurance Group which is a sub-committee of the Trust board. 1.9 Support for those making a complaint PALS The Patient s Advice & Liaison Service This service is for people who would like on-the-spot help to sort out any difficulties they may encounter as a patient or carer. Sometimes people do not want to complain but they are experiencing problems that they just want to have sorted out. Often matters can be resolved quickly without the patient and carer wishing to proceed to making a formal complaint. Page 7 of 18

8 However, if they do wish to proceed within the Complaints Procedure, PALS will listen to and record their concerns so that the complaint can be properly processed. Independent Complaints Advocacy Service The Independent Complaints Advocacy Service (ICAS) provides independent and confidential information, advice and support for local people wishing to make a complaint about National Health Services. ICAS will provide the complainant with a case worker who will give impartial advice and assistance throughout the complaints process. The Helpline for the local Independent Complaints Advocacy Service is Key points regarding Customer Service Please remember these key points: - We welcome comments and complaints, and can use them to further improve our services. We must make it as easy as possible for people to raise complaints and then we must respond as quickly as possible. Everyone has a responsibility to deal with complaints, but nobody is on their own. The Customer Service team has the specific role to manage the complaints system properly and to support the patients, carers and staff involved. Don t be concerned that a complaint always leads to blame - it usually doesn t. Remember, just because something has always been done in a certain way, doesn t mean that it is always right! Complaints are often the catalyst for reviewing and improving the way that services are provided. Page 8 of 18

9 2 COMPLAINTS PROCEDURE 2.1 Local Resolution Introduction Everyone has a right to make a complaint about NHS treatment they receive if they feel dissatisfied with any aspect of their care. The purpose of Local Resolution is to do all that is possible to resolve complaints as early in the Complaints process as possible. Each issue raised in the complaint will be fully investigated before responding in writing to the complainant. This should be undertaken as quickly as is sensibly possible in the circumstances, aiming to satisfy the patient, whilst also being fair to the staff involved. The process must be open, fair, flexible and conciliatory. The process must encourage two way communication and understanding. The aim of the process is to resolve the complaint, and should not be seen simply as a run-up process to the complainant seeking further external review and redress. The primary purpose of Local Resolution is therefore to provide a comprehensive response that satisfies the complainant by addressing all issues of the complaint. Inflexible, legalistic approaches are to be avoided at all stages of the complaint process, but particularly during this stage. 2.2 Receiving the complaint Complaints received in a ward or department Complainants should be encouraged to speak openly and freely about their concerns and should be reassured that whatever they may say will be treated sensitively and in confidence. Complainants may first wish to speak to the Ward Sister or Doctor about their concerns in order to resolve them quickly and effectively. If they wish to speak with someone not personally involved in the complaint, they should be advised how to contact the Customer Services team or, if they prefer, the Chief Executive. It may not be possible to resolve the complaint immediately because:- The complainant has stated from the outset that they want the complaint to be addressed within the NHS Complaints procedure (formal complaint). Page 9 of 18

10 The complaint issues are complex and will require investigation before a response can be made The issues relate to clinical judgement and further review may be necessary The issues relate to concerns about a patient s care and well-being and several members of staff may need to contribute to the investigation The issues relate to the health, safety or well-being of any patient, carer, visitor, member of staff or the public and further risk assessment may be necessary The issues relate to Trust policies or procedures which may require a corporate view The issues require an explanation to be given in writing All concerns, even if resolved at ward level, should be forwarded to the Customer Services team for monitoring purposes. Complaints may be made to the Trust in person, by telephone, in writing or by . In any event, they should be addressed promptly, sensitively and in confidence. The details of complaints made verbally must be recorded accurately on the Record of Complaint Proforma (Annex 1). When a complaint is referred on to be addressed through the Complaints Procedure, information should be given to the complainant about the Complaints Procedure and what to expect. The Record of Complaint should be forwarded to the Customer Services team and the complaint will be logged into the Complaints Management System Complaints received by the Chief Executive or Customer Services Team All complaints received by the Chief Executive or Customer Services team will be date stamped and entered into the electronic complaints management system. Oral complaints received will be recorded in a Record of Complaint Page 10 of 18

11 All complaints will receive an individual identity and a file will be created for each complaint. If a complaint relates in part to social care, primary care or treatment provided by another NHS Trust, the Complaints Manager will ask the complainant if he wishes the details to be sent to the relevant organisation and if so, will send the details within 2 working days. The Complaints Manager will confirm to the complainant which matters will be dealt with by the Trust and which by any other relevant body. The Trust has a duty to cooperate with any other NHS body or Local Authority, with a view to the complainant receiving a co-ordinated response to the complaint wherever possible. 2.3 Acknowledging the complaint Any complaint received by the Trust must be acknowledged by the Chief Executive in writing within 2 working days of receiving it. The acknowledgement letter will contain a leaflet which outlines how the Trust s complaints process works, and where help and support in pursuing the complaint can be obtained. An individual record will be maintained of all correspondence, documentation and events relating to the complaint. 2.4 Investigating the Complaint The Chief Executive s office will forward a copy of the complaint to the Customer Services team and to an Investigating Officer who will be appointed from an area of the organisation with which the complaint is not associated. A preliminary discussion or meeting should be held with the complainant in order to clarify their concerns prior to the investigation commencing. Each issue raised must be thoroughly investigated and discussed with the staff involved. Reference will be made to any records that are relevant to the complaint. Matters relating to clinical judgement will be referred to the relevant Consultant, Nurse Manager or Clinical Manager for their information, professional consideration and comments. Page 11 of 18

12 Written comments/statements from staff will be included with the Investigating Officer s report when the investigation is complete and will be returned to the Customer Services team to be retained in the complaint file. 2.5 Responding to the complainant The Investigating Officer s report will be forwarded to the Chief Executive, who must provide the complainant with a response in writing within 25 working days. If this is not possible, due to the complexity of the case, or some other proven reason, a delay will be negotiated with the complainant by the Customer Service Team. The reasons for delay will be explained to the complainant. Therefore, some responses may be sent within a longer period. The Chief Executive will complete the response to the complaint. The response letter should give an explanation and acknowledgement for what went wrong and information on action to be taken to put matters right. The letter will advise the complainant that a meeting with Customer Services, the Medical Director and/or clinician involved in the complaint can be arranged if further discussion or explanation is required. If the complainant considers that this would be helpful, the Customer Services team will arrange for the meeting to take place and the complainant will be provided with a written transcript of the meeting. Copies of the completed letter are then sent to the manager of the department involved to ensure that remedial action is taken and an action plan devised address the issues within the department. (Annex 2) 2.6 Completion of Local Resolution If after receiving the Chief Executive s letter the complainant does not agree to a meeting or the meeting fails to resolve the concerns, further options can be offered in order to achieve resolution of the complaint. Where appropriate, the complainant may also be offered the benefit of an independent clinical opinion, mediation or conciliation through independent approved services. If these avenues are rejected or fail to resolve the complaint, the complainant will be provided with information about how to take the matter further and request an Independent Review of the complaint by the Health Service Ombudsman. Page 12 of 18

13 2.7 Performance targets Where targets cannot be met, a delay will be negotiated by the Customer Service team with a revised timetable for resolving the matter. An interim letter will be sent to the complainant apologising for the delay. All complaints should be acknowledged within 2 working days. All complaints should be fully investigated and a response provided within 25 working days. Overall, the Trust will make every effort to resolve the complaint at the Local Resolution stage in order to achieve a simple, straightforward and stress-free outcome for all concerned. 3 If the complainant remains unhappy with the way the complaint has been handled 3.1 The role of the Health Service Ombudsman The Health Service Ombudsman looks into complaints about poor treatment or service provided through the NHS in England. The Ombudsman will look at complaints that have already been addressed by the Trust in the first instance but where a satisfactory conclusion has not been reached. The Ombudsman will first check how the complaint has been addressed and will ask the Trust for details of the case papers and medical records. Clinical experts will advise the Ombudsman in making a decision about whether further investigation is necessary. It may be that by using only the information provided, the Ombudsman will be able to respond to the complainant. If this is not possible, an in-depth investigation may be carried out. This will include interviewing the complainant and the Trust staff. Following the investigation the Trust will receive a report explaining the final decision and making recommendations as appropriate. For more information about the work of the Health Service Ombudsman contact:- Health Service Ombudsman Millbank Tower Millbank London Page 13 of 18

14 SW1P 4QP Helpline : Website : 4 Clinical Governance It is important that the Trust learns from the issues that have been identified from the complaint raised, investigation report and the final letter from the Chief Executive. Therefore once a complaint has been concluded, usually at the end of Local Resolution, a copy of the final letter will be sent to the appropriate senior manager who will work with staff to ensure that measures are put in place to avoid a recurrence of the problem that led to the complaint. All actions will be reported to the Complaints Manager using the Complaints Action Proforma (Annex 2) and included in the complaint file. The action proforma will be entered onto the DATIX system. While recognizing and protecting confidential matters, staff who have contributed to the investigation process should be made aware of the outcome of the complaint so that they have the opportunity to learn from the findings of the investigation. A review of the complaints received should be undertaken as part of the Risk Management process and opportunities taken to share good practice and to improve patients experience throughout the Trust. Information about the action the Trust has taken in response to complaints and lessons learned as an organisation will be reported to the general public as part of the Choose Communication Zones. 5 Monitoring 5.1 Investigating officer reports, complaints action plans and minutes of the following meetings will be used to monitor the effectiveness of this policy Board of Directors Minutes Risk Management Assurance Group Minutes Risk Management Executive Committee Minutes Clinical Incident Review Group Minutes Page 14 of 18

15 Record of Complaint Name of Complainant Address of Complainant Telephone Number Ethnicity Relationship to patient Name of Patient Address of Patient Telephone Number PAS No: Date of Birth Ethnicity Consent given by patient Yes No Any barriers to understanding from the Patient or Complainant. Date of Complaint Date of Incident Description of complaint (continue overleaf) Description of complaint (continued) Page 15 of 18

16 Complaint details taken by Action taken Completed form to be returned to Assistant Divisional Manager Annex 1 Page 16 of 18

17 Please in fill all areas. Please circle appropriate Consequence None Minor Moderate Major Recurrence Rare Unlikely Possible Likely Priority High/Med/Low Issue Action Start Date Review date Completion Date Annex 2 Page 17 of 18

18 This sheet should be used to record the names of staff members, and that they have read and understood the above policy document. Name (please print) Job Title Date Signature Page 18 of 18

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