Date of review: January Policy Category: Governance CONTENTS:

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1 Title: Patient Complaints Handling Policy Date Approved: 18 January 2012 Approved by: Executive Management Committee Date of review: January 2015 Policy Ref: Issue: 3 Division/Department: Corporate / Improving Patient Experience Author (post-holder): Director, Customer Experience and Engagement Policy Category: Governance Sponsor (Director): Executive Director of Nursing & Quality CONTENTS: 1. Introduction 2 2. Policy Statement 2 3. Definitions 3 4. Roles and Responsibilities 3 5. Scope of Policy 4 6. Consultation 4 7. Handling Complaints 5 8. Evidence Base 5 9. Compliance Training requirements Distribution 6 12.Communication 6 13.Author and Review Details 6 Appendix 1 Procedure for Handling Complaints 7 Appendix 2 Complaints process overview 12 Appendix 3 Procedure Following Receipt of a Formal Complaint 16 Appendix 4 Complaint officer actions standard operating procedures 19 Appendix 5 Divisional Procedure for Handling Formal Complaints 22 Appendix 6 Procedure if Not Satisfied with Initial Response to Complaint 27 Appendix 7 Policy for Intractable Complaints 29 Appendix 8 Guidelines for Staff on Writing a Statement 31 Appendix 9 Consent form for complainant 32 Appendix 10 Consent form for clinicians 33 Appendix 11 Complaints monitoring form 34 1

2 1. Introduction 1.1. The Trust s Complaints Policy is based on The Local Authority Social Services and National Health Service Complaints (England) Regulations This policy is issued and maintained by the Executive Director of Nursing & Quality (the sponsor) on behalf of The Trust, at the issue defined on the front sheet, which supersedes and replaces all previous versions. 2. Policy Statement 2.1. Patients, relatives and carers have a right to have their views heard and acted upon the Trust welcomes feedback on all aspects of service and recognises the value of complaints in improving service provision for patients and the public. The Trust s policy: Regards complaints positively as an aid to improving services Ensures easy accessibility for persons who wish to complain Ensures simplicity Ensures fairness for both staff and complainants alike and encourages communication on all sides Promotes the speedy resolution of complaints at the most appropriate level in the organisation Ensures an approach that is honest, thorough and has the prime aim of resolving the complaint satisfactorily Aims to ensure learning takes place and improvements are made based upon complaints feedback The Trust is committed to ensuring that none of its policies, procedures and guidelines discriminate against individuals directly or indirectly on the basis of gender, colour, race, nationality, ethnic or national origins, age, sexual orientation, marital status, disability, religion, beliefs, political affiliation, trade union membership, and social and employment status. An equality impact assessment (EIA) of this policy has been conducted by the author using the EIA tool developed by the diversity and inclusivity committee. Patients, relatives and carers are able to request information in an alternative format or different languages and this would be facilitated by the Improving Patient Experience Team Patients, relatives and carers are able to request information in different languages and formats. An interpretation service is also available. Any requests will be coordinated by the Improving Patient Experience Department All complaint paper records are kept in a locked office and subject to the retention and destruction of records policy. Electronic records are stored on the trust s Datix system which is password protected This policy has been designed to provide staff with advice and guidance when they are involved in handling complaints, and should be read in conjunction with a number of other policies and procedures, including: Risk Management Policy Claims Handling Protocol Root Cause Analysis Guidance and Procedure 2

3 Incident Reporting Policy 3. Definitions 3.1. In this Complaints Handling Policy, The Trust - means the Sherwood Forest Hospitals NHS Foundation Trust. Staff - means all employees of the Trust including those managed by a third party organisation on behalf of the Trust. A complaint - means an expression of dissatisfaction that requires a response, whether verbal or written. A complainant - means any person dissatisfied with any aspect of service provision provided by the Trust and requests a formal investigation under the Trust s Complaints Procedure. Divisional Link - means the individual within the operational Divisions who has responsibility for complaints handling. 4. Roles and Responsibilities 4.1. The Chief Executive is the responsible person with responsibility for overseeing the management of complaints The Executive Director of Nursing & Quality is accountable for ensuring compliance with the arrangements under the Local Authority Social Services and National Health Service Complaints (England) Regulations The complaints lead is accountable to the Executive Director of Nursing & Quality for the management of the complaints service Divisional Directors of Nursing / Divisional Clinical Lead are responsible for the quality, timeliness and performance of the complaint response. They are also responsible for demonstrating learning from complaints 4.5. Patient Experience Coordinators are responsible for managing the systems that allow for the effective management of complaints All staff employed by the Trust have a role in addressing complaints as and when they arise and are also responsible for: Implementing/suggesting changes in practice that prevent the complaint event from happening again. Learning lessons from complaints and incorporating these into working practices. 5. Scope of Policy 5.1. This policy deals with all complaints, both formal and informal, made against the Trust, by a patient or a patient s representative, including complaints to other organisations where the Trust is implicated Complaints not required to be dealt with, in accordance with the Local Authority 3

4 Social Services and National Health Service Complaints (England) Regulations 2009, are as follows: a) A complaint made by a responsible body; b) A complaint made by an employee of a local authority or NHS body about any matter relating to that employment; c) A complaint which is made orally and is resolved to the complainant s satisfaction not later than the next working day after the day on which the complaint was made; d) A complaint, the subject matter of which is the same as that of a complaint that has previously been made and resolved in accordance with paragraph c); e) A complaint, the subject matter of which has been previously investigated under i. the Regulations; ii. the 2004 Regulations; iii. the 2006 Regulations; iv. a relevant complaints procedure f) A complaint the subject matter of which has been investigation by the Parliamentary and Health Service Ombudsman; g) A complaint arising out of the alleged failure to comply with a request for information under the Freedom of Information Act 2000; and h) A complaint which relates to any scheme established under section 10 (superannuation of persons engaged in health services, etc) or section 24 (compensation for loss of office, etc) of the Superannuation Act 1972, or to the administration of those schemes; i) Where it is decided that a complaint applies to one of the categories listed above, the complainant will be notified of the decision and the reason for the decision; 6. Consultation 6.1. The policy has been developed in consultation with Divisional representatives and the Local Negotiating Committee it has been formally endorsed by the Executive Board Committee. 7. Handling Complaints 7.1. The Trust s Procedures for Handling Complaints are attached at Appendix The Trust s Policy for Intractable Complaints is attached at Appendix Guidance for staff on writing statements is attached at Appendix 8. 4

5 8. Evidence Base 8.1. This policy has been developed with reference to the following guidance: The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 Department of Health, Making Experiences Count: A new approach to responding to complaints, 2007 Department of Health, Listening, Responding, Improving A guide to better customer care, 2009 The Parliamentary and Health Service Ombudsman, Principles of good complaint handling, 2009 Apologies and Explanations, NHS Litigation Authority, Compliance 9.1. Compliance with this policy will be monitored by: The Board of Directors on an annual basis-via the annual report Divisional Clinical Governance Groups- Via the Complaints, Litigation, Incidents and Complaints (CLIP) joint report 9.2 The Care Quality Commission internal team will assess the standard of the complaints service as part of its assessments against outcome 17 of the essential standards of quality and safety Criterion Method of monitoring Timescale Lead 1.2.3a Duties-All complaint responses performance monitoring Weekly Director of Customer to be received on time to the divisions Experience and 1.2.3b 1.2.3c 1.2.3d 1.2.3e 1.2.3f How the organisation listens and responds to concerns and complaints from patients, their relatives and carers How joint complaints are handled between organisations How the organisation makes sure that patients, their relatives and carers are not treated differently as a result of raising a concern or complaint How the organisation makes improvements as a result of a concern or complaint How the organisation monitors compliance with all of the above Engagement Reports to divisions Monthly Director of Customer Experience and Engagement Communication with other organisations. Responses combined. PALS and complaints monitoring - Divisions Lessons learnt reported to the board. Annual complaints report CLIP report to Clinical Governance meeting Annually to Board Monthly / Adhoc Quarterly Annual Director of Customer Experience and Engagement Director of Customer Experience and Engagement Director of Customer Experience and Engagement 6 monthly Director of Customer Experience and Engagement 5

6 10. Training Requirements Training on the implementation of this policy is provided by Patient Experience staff to managers and staff groups through customised training sessions The complaints lead is responsible for providing awareness training on complaints handling to Heads of Service, Service Line Directors, Heads of Nursing and Directors of Nursing in line with the Trust s mandatory training programme Training includes: Statutory requirements. Trust procedure for handling complaints. Individual responsibility within the complaints process, including the Trust s commitment that patients, relatives or carers who make a complaint or raise a concern must not be discriminated against in any way Patient Experience staff have access to ongoing professional development in relation to national guidance. 11. Distribution This policy is available on the Trust s intranet site This policy will be notified to all personnel through the Trust s team brief process. 12. Communication Approval of this policy will be communicated to all relevant staff and key stakeholders via the Trust s communication systems. 13. Author and Review Details Date issued: January 2012 Date to be reviewed by: January 2015 To be reviewed by: Executive Sponsor: Complaints lead Executive Director of Nursing & Quality 6

7 SHERWOOD FOREST HOSPITALS (NHS) FOUNDATION TRUST APPENDIX 1 Procedure for Handling Complaints 1. Introduction 1.1. This procedure should be used in conjunction with the Trust s Policy for Handling Complaints, which has been developed with reference to The Local Authority Social Services and National Health Service Complaints (England) Regulations It is recognised that the Trust is a complex organisation offering a wide range of services to a wide range of people. However diligent and skilful we are, there will inevitably be circumstances where the expectations of some of the users of our services will not be met and they will feel a need to voice their feelings. In these cases, complainants need to be reassured that their care or treatment will not be adversely affected as a result of raising a complaint. 2. What is a Complaint? 2.1. There is no precise definition of what constitutes a complaint, however, for the purposes of this procedure a complaint can be interpreted as: An expression of dissatisfaction that requires a response The vast majority of concerns can, and should, be settled as soon as they arise, at the latest by the end of the next working day, by staff in direct contact with the patient or representative. It is where a person remains dissatisfied, or where the member of staff dealing with them feels that he/she is unable to satisfy the concerns, that the following procedures should apply Some clinicians may receive letters of complaint directly from patients, carers and/or relatives. All formal complaints should be referred to the Improving Patient Experience Department for advice and if necessary, formal investigation If a complaint is relating to a serious untoward incident (SUI) or an untoward incident the relevant division will be asked to ensure an incident from is logged and any SUI s are escalated by the division to the clinical governance lead. 3. Openness of approach to Complaints Handling 3.1. The Trust has an open and transparent approach to handling complaints and staff involved should be non-defensive. Patients, relatives and their carers must not be treated differently as a result of raising a concern or a complaint with the Trust. They must continue to be treated according to their clinical needs and care must not be compromised. Acknowledgement letters explain this to the complainant On rare occasions, where there may be a mutual loss of confidence and trust to 7

8 the extent that the patient/clinician relationship is no longer sustainable, the Trust will ensure that arrangements are made for the patient s ongoing clinical care In the event of a complainant reporting a concern that they have been treated differently as a direct result of making a complaint, this will be reported to the Medical or Nursing Executive Director, who will ensure that corrective actions are implemented. This will be recorded on the complaint record on the Datix Risk Management System. 4. Time Limits to make a Complaint: 4.1. In accordance with The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, a complaint must be made not later than 12 months after - the date on which the matter which is the subject of the complaint occurred; or if later, the date on which the matter which is the subject of the complaint came to the notice of the complainant The time limit above shall not apply if we are satisfied that 5. Confidentiality the complainant had good reasons for not making the complaint within that time limit; and Notwithstanding the delay, it is still possible to investigate the complaint effectively and fairly The request to maintain confidentiality is absolute during the complaints process. Any information must be shared on a need to know basis. 6. Publicity 6.1. The Trust is keen to promote awareness of the NHS Complaints Procedure and the arrangements for the delivery of the local complaints service. All complainants are told where they can obtain further advice and help Leaflets explaining the Complaints Procedure are available in wards and departments Information on making a complaint in a different language or format is available on request Staff members are able to access the Complaints Policy and Procedure via the hospital intranet. Members of the public are able to access advice on how to make a complaint, and register a complaint, via the SFHT website People can make a complaint either face to face, via the post, or telephone. 7. Separation of Complaints and Disciplinary Procedures 8

9 7.1. The Trust ensures a clear separation between its Complaints Procedure and its Disciplinary Procedure, so that the Complaints Procedure remains focused on the resolution of complaints to the satisfaction of complainants. 8. Possible Claims for Negligence 8.1. If at any point before a complaint has been resolved, notification is received from a complainant that they are intending to pursue a clinical negligence claim, the Trust s Improving Patient Experience Team will liaise with the NHS Litigation Authority to consider whether dealing with the complaint might prejudice the potential defence of the claim. Where the NHS Litigation Authority advises that dealing with the complaint might prejudice the legal action, resolution of the complaint would be delayed until after the legal case has concluded. The complainant would be informed why the complaints process had been put on hold. 9. Role of the Patient Advice & Liaison Service (PALS) 9.1. The PALS service is available to assist service users who wish to raise a concern and is able to assist in the early resolution of concerns. It is the responsibility of all front line staff to assist complainants and any formal complaints should be referred to the complaints process. 10. Role of the all staff In addition to the PALS service, all staff are able to assist in dealing with concerns informally and on the spot, avoiding the need for the formal complaints procedure. 11. Role of the Independent Complaints Advocacy Service (ICAS) Complainants are advised of the role of ICAS, an independent body which provides support to complainant s free-of-charge, and their contact details, in their letter of acknowledgement from the Chief Executive. 12. Independent Review by the Parliamentary & Health Service (PHSO) The Trust ensures that complainants are notified about the ombudsman via a complaints leaflet when they first register their complaint. If complainants are not happy with their letter they are reminded of their right to refer the complaint to the PHSO for an Independent Review of their complaint. Further information is available by accessing their website, Investigations by HM Coroner The fact that a death is being investigated by a Coroner does not mean that all investigations into a complaint need to be suspended. The Improving Patient Experience Team will liaise with the complainant, the Coroner s office and the Divisional Link in this situation. 14. Requests for Access to Health Records 9

10 14.1. Where a complainant requests copies of the Health Records under the Complaints Procedure, these will be released in accordance with the Data Protection Act 1998 but without charge. The Patient Administration Department will be responsible for organising the release of the relevant records and will ensure the relevant redaction is undertaken in accordance with the Access to Health Records Procedures. 15. Filing of Complaints correspondence Complaints correspondence must not be filed within patients health records. The master files of all such correspondence are retained by the Improving Patient Experience Department, and are destroyed in accordance with the Trust s Retention and Destruction of Records Policy. 16. Intractable Complaints There are exceptional circumstances when a person may pursue a complaint to the point where it becomes unreasonable, despite every effort by the Trust to try and resolve the issues/perceived issues. In these circumstances, the Trust s Intractable Complaints Policy please refer to Appendix 7 - will be followed. 17. Response periods A complaint may be made orally or in writing (including electronically). Upon receipt of a complaint, it must be acknowledged, orally or in writing, not later than three working days after the day on which the complaint is received. The complaint will be categorised and an appropriate response period will be determined by the improving patient experience officers. The Improving Patient Experience Team will contact the complainant to agree how their complaint will be handled. They will form a list of questions to be answered and discuss the response period, whilst to seek the expectations of the complainant If it becomes apparent during the investigation of a complaint that the agreed response period cannot be achieved, due to extenuating circumstances, the Improving Patient Experience Team will advise on the reason for this and agree an extended response period with the complainant. 18. Recording initial complaint The legislation makes it clear that all NHS complaints, however handled within an organisation, need to be appropriately recorded not least because complainants must be advised of the right to approach the PHSO if not satisfied with the outcome locally. This requirement extends to oral complaints that may be received by PALS that are not resolved to the complainant s satisfaction by the next working day. 19. Using Complaints as an Aid to Improvement The Trust ensures effective feedback mechanisms to ensure that issues highlighted in complaints are used openly and in a positive way as an aid to improving services. This is facilitated using the Datix Risk Management software system. 10

11 19.2. This will be supported by: The provision of regular supporting information relating to complaints management. The close involvement of Senior Managers and Clinicians in the investigation and resolution of complaints and resultant follow-up action. Each Division will report on complaints management as part of the monthly quality performance management meetings. 20. Learning from Complaints Changes to improve service delivery as a result of complaints will be included in the Clinical Governance Performance Management process. Where appropriate, Divisions will be required to take remedial action and develop action plans to ensure organisational learning and prevent future occurrences. Each division will produce monthly lessons learnt reports to be collated by the improving patient experience team and published in the Complaints, litigation, incidents and PALS joint report. Information will be collated on the complaints monitoring form (appendix 11) by the divisions who will then send the lessons learnt to the Improving Patient Experience team via the agreed excel spread sheet. 21. Staff Support Support may be obtained from a colleague, a line manager, a member of the Improving Patient Experience Team, the Human Resources Department, or a representative of a professional body/trade Union Improving Patient Experience Department staff and Divisional Links should ensure that all staff members directly named in complaints receives appropriate feedback once a response has been provided Staff are able to consult the policy for maintaining staff wellbeing and reducing work related stress. 11

12 SHERWOOD FOREST HOSPITALS (NHS) FOUNDATION TRUST APPENDIX 2 Local Resolution COMPLAINTS PROCESS OVERVIEW 1. Can the complaint be resolved at source? 1.1. Wherever possible the Trust aims to deal with complaints at the point in which they arise. This is the responsibility of all members of staff, with the support of line managers. 2. Role of Frontline Staff 2.1. Frontline staff members are defined as those staff in direct contact with service users. It is likely that most expressions of dissatisfaction will be voiced orally in the first instance with frontline staff on wards, in clinics, on reception desks or with departmental managers. On the ward the nurse in charge provides a point of contact and support for the early resolution of complaints The Trust s policy is that frontline staff should aim to deal with these oral concerns or complaints rapidly and wherever possible, on the spot and in an informal and sensitive manner, while making sure that the immediate health care needs of the person concerned are being met Every effort should be made and every avenue explored to resolve any dissatisfaction at this point If the concern or complaint is raised verbally and can be resolved by the end of the following working day, the response does not need to be in writing. However, the nature of the concern or complaint and resolution should be documented by the member of staff responsible. 3. Role of PALS Service and Heads of Nursing & Midwifery and Heads of Sevice 3.1. The Patient Advice and Liaison Service (PALS) and Heads of Nursing & Midwifery and Heads of Service will assist front line staff in the early resolution of concerns Where matters are resolved and the person concerned registers his/her satisfaction, no further formal action needs to be taken, other than making a note of the conversation and the outcome in the appropriate record Where a complaint is received by PALS, and this is not resolved to the complainant s satisfaction by the end of the following day, this should be recorded as a complaint and forwarded to the Improving Patient Experience Department Where it is not possible to deal with these matters to the person s satisfaction, 12

13 the member of staff concerned should contact his/her Line Manager in order that further resolution of the complaint can be attempted Where a complainant remains dissatisfied with endeavours to deal with the matter informally, they may request that their concerns are dealt with formally under the Trust s Complaints Procedure. 4. When to contact the Improving Patient Experience Department 4.1. Should a complainant wish to complain to someone who has not had direct involvement in his/her care, or should a complainant remain dissatisfied following attempts to resolve the complaint, he/she should be advised to address the complaint in writing to the Chief Executive. However, if the complainant prefers to make a verbal formal complaint, the person dealing with it should make notes and forward these to the Improving Patient Experience Department immediately. Alternatively a Patient Experience Coordinator should be called, who will speak to the complainant and make a written record of the complaint. A draft copy of the written record will be sent to the complainant, together with a letter of acknowledgement The Patient Experience Coordinators can be contacted from 8.30am 5.00pm Monday to Friday and an answering machine is available, should staff be away from their desk. If somebody wishes to make a verbal complaint out-of hours, all staff members can record the complaint and forward this, with contact details, to the Improving Patient Experience Department on the next working day or request that the complainant addresses their complaint in writing to the Chief Executive or that the complainant contacts the Improving Patient Experience Department during office hours. In cases of extreme urgency, the Manager on call can be contacted for support and advice in dealing with complaints outside normal office hours. This should not however, absolve staff involved in the original delivery of care from their responsibility in attempting to resolve the issues raised Any person contacting Trust Head Quarters via telephone to make a formal complaint should be put through to the Improving Patient Experience Department immediately. The Trust HQ staff do not need to take a file note 4.4. Any letters received in Trust HQ relating to a complaint are to be collected by the Improving Patient Experience Department on the same day as received 4.5. Any s addressed to the Chief Executive regarding a complaint should be forwarded to the complaints inbox on the same day 4.6. If any person arrives in Trust HQ wanting to make a complaint please call the Improving Patient Experience Department and someone will come and see them 4.7. The Improving Patient Experience Department will acknowledge all complaints 4.8. If the person insists on speaking to the Chief Executive put them through to the Improving Patient Experience Department in the first instance who will take a file note and arrange a mutually convenient time for the Chief Executive to call them back. 5. Contact Details 13

14 5.1. The Improving Patient Experience Department Coordinators can be contacted on the following numbers: Extension 3034 Direct Line Extension 3777 Direct Line Informal Complaints or Concerns: 6.1. The Improving Patient Experience Department predominantly deals with formal complaints. When a complainant indicates that they would like their concerns to be addressed informally the Improving Patient Experience Department will arrange contact for the complainant with the PALS Department for informal or local resolution. 7. Referral of a complaint from the PALS Department to the Improving Patient Experience Department 7.1. Complaints may be referred to the Improving Patient Experience Department from PALS if it becomes evident that the formal complaints procedure is required, such as when a complainant, subsequent to an initial complaint/query, wishes to make a formal complaint. The results of the PALS investigations to date, including full details of the complaint, are forwarded to the Improving Patient Experience Department On occasion, the PALS Department may deal with a case which is of a complex/serious nature, but the person initially advises that they do not wish the matter to be registered as a formal complaint and referred to the Chief Executive. In this situation, if, at the end of this process the person indicates that they wish the matter now to be regarded as a formal complaint, the PALS Department will forward the correspondence to the Improving Patient Experience Department. The Patient Experience Coordinators will then review the correspondence and assess whether any further investigation is required. If no further investigation is recommended, the Chief Executive will write to the complainant, to notify them of this Enquiries handled by the PALS and Improving Patient Experience Departments are recorded on the Datix Risk Management System. 8. Joint Handling - a duty to co-operate when handling mixed sector complaints 8.1. Where a complaint involves one or more providers, in addition to SFHT, consent needs to be sought from the complainant to forward their complaint to the other parties Once consent has been obtained, the Improving Patient Experience Team will liaise with the other provider (s) and co-ordinate the handling of the complaint in order to ensure that the complainant receives a co-ordinated response. The bodies involved will agree which body will take the lead in co-ordinating the handling and communicating with the complainant Where SFHT receives a complaint, which is concerned solely with services provided by another health body or a body outside the NHS, the complaint 14

15 should be referred to the Improving Patient Experience team who should, in consultation with the complainant, forward this to the correct body. Both the complainant and the body concerned should then be formally advised in writing. 9. Request for Independent Review of a complaint by the Parliamentary & Health Service Ombudsman (PHSO) 9.1. If the complainant is not satisfied with the written response to their complaint, they have 12 months in which they can request an Independent Review by the PHSO. This is explained to the complainant in the complaints leaflet. 15

16 SHERWOOD FOREST HOSPITALS (NHS) FOUNDATION TRUST APPENDIX 3 Procedure Following Receipt of a Formal Complaint 1. Making a complaint 1.1. Complaints can be received in a written, verbal or electronic form. 2. Persons who may make a complaint 2.1. A complaint may be made by: A person who receives or has received services from the Trust; or A person who is affected, or likely to be affected, by the action, omission or decision of the Trust A complaint may be made by a person (referred to as a representative) acting on behalf of a person mentioned in 2.1 above, who has died; is a child; is unable to make the complaint themselves because of physical incapacity; or lack of capacity within the meaning of the Mental Capacity Act 2005; or has requested the representative to act on their behalf. 3. Where a representative makes a complaint on behalf of a child, the Trust must not consider the complaint unless it is satisfied that there are reasonable grounds for the complaint being made by a representative instead of the child; and 3.4 if it is not so satisfied, must notify the representative in writing, and state the reason for its decision. 3.5 In the case of a child, the representative must be a parent, guardian or other adult who has the care of the child. Where the child is in the care of a local authority or a voluntary organisation, the representative must be a person authorised by the local authority or voluntary organisation. 4. Where a representative makes a complaint on behalf of another person The representative must be a relative or other person who, in the opinion of the 16

17 Head of Nursing for Paediatrics or Service Line Director, had or has a sufficient interest and is a suitable person to act as that representative. If any doubt exists advice should be obtained from the Trust s Caldicott Guardian In the case of deceased patients, it is considered good practice to approach the deceased patient s next of kin to obtain consent to investigate the complaint, if it is not the next of kin that has made the complaint For consent to be informed, a copy of the letter of complaint is forwarded to the patient with a request for them to provide signed consent for the Trust to proceed with the investigation If the patient declines to provide consent for a complaint to be investigated, the Chief Executive will notify the complainant that he/she is unable to investigate the complaint, but where applicable, may give a general response to the complaint The response period begins when consent has been received, as the Trust cannot commence investigation of the complaint until this time, although the original date of receipt is recorded. This is in accordance with advice from the Caldicott Guardian. 5. Letter requesting consent to investigate a complaint 5.1. The letter is sent to the patient direct, together with a copy of the letter of complaint An acknowledgement letter is sent to the complainant indicating that consent is being requested Once consent is received, the Chief Executive or designated person will write to the complainant to advise that the Trust will now investigate the complaint. 6. Categorising Complaints 6.1. The following is a guide for categorising complaints and should be used to categorise all complaints thereby giving an indication as to the time a complainant can expect to get a response to their complaint. This must be communicated to the complainant as soon as is possible. Amount of days shown equates to working days and therefore should be calculated as not to include weekends or bank holidays: 20 days to be allocated to complaints where there is only once concern identified. Where there are more than one concern, a 20 day time scale maybe given. 40 days to be allocated to complaints that require more comprehensive response. 60 days to be allocated to complex complaints which involve a number of directorates and/or outside organisations or clinicians who no longer work in the Trust. 17

18 6.2. The Divisional Directors of Nursing, in collaboration with the complaint lead have the authority to re-grade a complaint at the time of receipt should he/she feel that the allocated timescale is unreasonable given the complexity of the questions to be answered. This can be done by contacting the Complaints lead and discussing the expected time to respond. It is then the responsibility of the Patient Experience Coordinator to discuss the proposed response time change with the complainant and agreed both verbally and in writing. 18

19 SHERWOOD FOREST HOSPITALS (NHS) FOUNDATION TRUST APPENDIX 4 Complaint Officer Actions Standard Operating Procedures The following process should be followed when following receipt of a formal complaint to the Trust, informal complaints or concern s should be passed to the PALS team. Complaint comes into Trust Letter Telephone In person Contact complainant by telephone obtaining number from PAS or net based directory. If you are not able to get number send letter/ requesting complainant to contact you direct by phone. (Within 3 working days) Speak to the complainant and ascertain if consent is required to take forward the complaint. Consent Required Yes No Explain to complainant process around consent and arrange to send form for signing. Post consent form to patient. Enter basic details of complaint onto Datix system as pending. Signed consent form received back No Yes Talk to complainant about complaint to ascertain full details taking written notes. This should either be over the telephone or if required in person as one to one interview. As a part of this process ascertain what further action the complainant would like: After 10 working days chase, if no reply within 20 days close. 19

20 Formal Written Response From conversation with complainant and notes taken, compile a list of questions that the complainant would like answering. Agree these verbally. Type-up a brief synopsis of the complaint into a file note to include the list of questions to be answered. (Split questions into groups dependant on what division is to answer). Enter all information onto Datix system, check previous entrants and link together. Allocate the complaint a response time dependant upon criteria. Post out Acknowledgement letter to complainant with typed synopsis and questions. questions to divisions with response due form. Copy of form enter onto Datix Day before due date of response, check with divisions that they will be ready to respond. Meeting with Division (Contact division and advise that meeting is appropriate action) Find out from complainant any unavailable dates. Agree with Division lead who to attend meeting via . Arrange meeting with attendees (six week target). Send out Complaint Information via Discuss with all parties if the meeting will be recorded or not Tape Copyright form to be signed by complainant: explain this. Check consent form has been signed by Trust employee Record meeting using Winscribe handset Download recording onto disk (see SOP) Send out recording to complainant Notes Take notes of meeting in draft form. Type notes into meeting note template. When typed send to chair of meeting for approval. Send out notes to complainant 20

21 Responses to questions Ready Yes No Complainant happy with outcome of meeting Yes No Escalate to senior manager in division. If legitimate reason agree a new date with complainant and division. Close on Datix Further questions follow Formal letter process or offer further meeting as required 5 Days before new due date: responses to questions Ready Yes No Paste answers into response letter format check grammar and spelling of answers. Send final draft response letter to Chief Executives office for signature. (Allowing 5 days) When received back signed in office, post to complainant (Include feedback form). Close on Datix SHERWOOD FOREST HOSPITALS (NHS) FOUNDATION TRUST APPENDIX 5 21

22 Divisional Procedure for Handling Formal Complaints 1. The complaint and questions to be answered are ed to the Divisional Link(s) at the earliest possible opportunity, normally on Day 1 following receipt by the Improving Patient Experience Department The covering sheet sent by the Improving Patient Experience Department will include the following: The questions the complainant wishes to be answered, gained by the Patient Experience coordinators. The category of the complaint therefore denoting the timescale to respond (20, 40, 60 days). The date the complaint/patient consent was received The date forwarded to the Divisional link(s) for investigation The whereabouts of the patient s medical records The deadline for investigation to be completed by Divisional Link(s) The deadline for results of investigation to be returned to Improving Patient Experience Department 1.2. The patient s medical records are requested by the Improving Patient Experience Team to go immediately to the Division for the purposes of investigation. It is the responsibility of the Improving Patient Experience Team to request the patient s medical records and if initially unavailable, for example, if the patient has a clinic appointment, they should arrange for the notes to be sent at the earliest possible opportunity to the Division. In the unlikely event that the medical records are mislaid; the complainant should be informed that there will be a delay in getting a response and the fact that the notes are unavailable at the earliest possible opportunity Complaints will be sent to the named person for that division and responses will be expected back from that person within the time frame A complaint may involve more than one Division. Each Division to which a complaint relates will have the complaint documentation sent to the Divisional link for relevant investigation. The lead Division will be clearly identified All complaint responses need to be approved by the division before being submitted to the Improving Patient Experience Department (this applies to all divisions) The Divisional Link must send a copy of the complaint to any person identified in it as the subject of the complaint (this applies to all divisions) 1.7. Persons providing statements or reports in response to a complaint may wish to consult the guidance attached at Appendix Complex/sensitive complaints 2.1. For complex/sensitive complaints, the Patient Experience coordinators and/or the Divisional Link may wish to discuss whether an early meeting will be the most 22

23 effective way to resolve the complaint: 2.2. Examples of complex complaints: Several issues requiring detailed investigations More than one Division involved 2.3 Examples of sensitive complaints: A bereavement or serious incident Threat of media action (expressed or implied) 3. The Divisional Link may wish to discuss with Patient Experience Coordinator (plus others) On rare occasions, it may be apparent that others should be involved at the outset, such as the Chief Executive or Executive Medical or Nursing Director On complaints that are complex a root cause analysis will be undertaken, by the appointed investigating manager in division. Guidance is available in the Trust s Guidance and Procedures on Root Cause Analysis Investigations will be undertaken in accordance with the Trust s Guidance and Procedures on Root Cause Analysis. 4. Meeting with the complainant 4.1. Meeting the complainant can quickly assure them that concerns have been taken seriously and acted upon. This can also provide clarity when concerns are not clear The Divisional Link and Patient Experience Coordinators will identify who is required to attend the meeting, who will chair the meeting and an appropriate timescale to ensure that all necessary information is available Information relating to the complaint will be sent to attendees in electronic format (via ) by the Improving Patient Experience Team at time of arranging the meeting. It is the responsibility of the attendees to ensure they have with them all relevant complaint information at the meeting Meetings should be held at the place of the complainant s choice, such as at one of the Trust sites, the complainant s home or a neutral venue. They are invited to have a relative or friend in a non-legal capacity in attendance at the meeting Should a complainant require assistance in meetings, e.g access to an interpreter, this can be facilitated by the Improving Patient Experience Team In order to minimise the potential for further distress for both the complainant and the complained against, front line staff are not included in complaint meetings, unless under exceptional circumstances. This role is normally undertaken by the Head of Nursing and/or Ward Leader and/or Consultant responsible for the patient s care, with a Director in attendance if deemed appropriate. 23

24 4.7. The complainant may wish to bring a friend, relative or a member of ICAS with them to the meeting. This is acceptable The complainant may wish to bring a solicitor to the meeting. This is acceptable but it should be stressed, by the chair of the meeting, to the solicitor and the complainant that the solicitor is in attendance in a supportive role and is unable to question or challenge staff A recording system is used for meetings, with prior consent of all parties. A consent form is sent to the complainant before the complaint meeting outlining the copyright (appendix 9). A consent form will also be sent to the clinician before the meeting for him/her to complete (appendix 10). A CD recording of the meeting is subsequently sent to the complainant, together with a letter and any action plan, from the Chief Executive Any errors or shortcomings are openly acknowledged and an apology is provided wherever indicated. An apology does not constitute an admission of liability. Guidance on this was issued by the NHS Litigation Authority in a letter Apologies and Explanations in See being open policy. 5. Personal apologies by staff directly involved in complaints 5.1. Written personal apologies are not provided by individual staff members - any written apologies are provided on behalf of the organisation from the Chief Executive. 6. Request by complainant for a copy of complaints correspondence 6.1. A complainant has the right to see all correspondence related to their complaint, including statements provided. Staff members are advised of this in the letter that is sent to them by the Divisional Link, asking for them to provide comments on the complaint In the event of such a request, the Improving Patient Experience Department may need to approach third parties identified in correspondence to notify them of the request and request their consent to disclose. In order to maintain an open and transparent approach to complaint handling, we would wish to comply with any requests by complainants to have sight of complaints correspondence 7. Anticipated delays in responding to complaints 7.1. If during investigation, the Divisional Link identifies a reason for a delay in response, such as study/annual leave, the Divisional Link will review whether it is possible for someone else to provide a response and if not, the Improving Patient Experience Department will contact the complainant to agree an amended response period. If required, a holding letter will be sent, confirming the reasons for delay and giving a timescale for the response On an occasion where a member of staff involved in a complaint has since left the Trust, wherever possible, the senior clinician/head of Nursing should provide an overview of the care provided All complaints should be resolved within six months. Where this is not possible, 24

25 the complainant will be informed of the reasons why and advised when the response can be expected. 8. The role of the Divisional Link 8.1. The Divisional Link must ensure that every effort is made to ensure that the response period, agreed with the complainant at the outset, is achieved. If upon initial investigation it is clear that this will not be possible, the Improving Patient Experience Department must be notified at the earliest opportunity Following investigation, the Divisional Link will provide to the Improving Patient Experience Department written evidence, where practicable, from all staff involved The investigation reports provided by the Division should: Be reviewed by the Divisional Link prior to submitting them to the Improving Patient Experience Department, to ensure that all questions are answered fully. Be written in plain English and explain any medical terminology in layman s terms. Specifically answer the questions raised by the complainant. Clearly indicate any lessons learned as a result of the issues raised by the complainant. Give an appropriate assurance that issues have been addressed and any remedial action taken. Provide an action plan where appropriate. Offer appropriate apologies. 9. Preparation of an overview by the Divisional Link 9.1. The Divisional Link determines whether a Divisional response needs to be prepared, based on whether a response could be sent directly to the complainant. This would be the case for complex complaints, in order to collate a number of different elements or responses from various members of staff; or where the complaint was very serious. On occasion, minor amendments to statements may be required to make the response appropriate and sensitive to send directly to the complainant. 10. Draft letter of response from Chief Executive Once the Divisional Link has provided the Improving Patient Experience Department with the answer to the questions following their investigation, the Patient Experience co-ordinator will check the draft response to the complaint and ensure it is in the name of the Chief Executive The letter will include all questions and answers, an explanation of how the complaint has been considered; the conclusions reached in relation to the complaint, including any matters for which remedial action has been needed. The letter should be checked by the Patient Experience Coordinators to ensure it is written in plain English; answers all questions and issues raised by the complainant and offers apologies where appropriate. 25

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