Chesterfield Royal Hospital NHS Foundation Trust THE ADVICE CENTRE AND COMPLAINTS POLICY

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1 Chesterfield Royal Hospital NHS Foundation Trust THE ADVICE CENTRE AND COMPLAINTS POLICY 1. INTRODUCTION 1.1 The aim of the Advice Centre is to support the Trust s Service Experience Strategy by providing a high-profile, professional, front-of-house service giving information and advice, focusing on speedy resolution of issues, concerns and complaints as and when they arise. The service aims to be accessible to patients, relatives, visitors or staff. The Advice Centre will be open from 08:30 to 16:00, Monday to Friday. 1.2 Enquiries may be made to the Advice Centre in person, by telephone ( ), by and via the Trust s website, using a feedback form. Users of the hospital s services can also use the Have Your Say forms to pass on suggestions, comments and compliments. These forms are available throughout the Trust and can be returned via Freepost. Information on how the Advice Centre can help resolve concerns, including information on how to make a formal complaint will be made available Trust-wide via leaflets in all patient areas. Information will also be available from the Advice Centre on how to contact the Independent Complaints Advisory Service (ICAS) and the Health Service Ombudsmen. 1.3 The Trust welcomes complaints, using them whenever possible to improve the quality of the Trust s services. The Trust welcomes the co-operation of the Independent Complaints Advisory Services (ICAS) and The Parliamentary & Health Service Ombudsman to ensure that complaints are resolved to the satisfaction of the complainants. 2. POLICY STATEMENT 2.1 The core functions of the Advice Centre will be to: Provide literature, information and general advice on health-related issues; Receive compliments and thanks and pass them on to the individual, team or department concerned; Arrange clinical meetings to assist patients who are concerned about their care plan; Give information about the Trust s services or other NHS services; Signpost to other services as appropriate; Provide on the spot help to service users, working with other staff in the Trust to ensure that concerns and problems are resolved speedily; Listen to comments and suggestions about the Trust s services, and ensure that these are passed on to the appropriate area; In conjunction with directorates, work towards the resolution of formal complaints; Provide training to staff on how directorate staff and Advice Centre staff can work together to improve the experience of service users and resolve issues which arise. 2.2 Where a concern is expressed or a complaint is made about care or treatment, the individual must not be discriminated against in any way or treated any differently as a result of having raised their concern or complaint. Information relating to a formal complaint must not be placed in the patient s healthcare record. 2.3 Staff must ensure that groups who may find it more difficult to access the Advice Centre and/or the complaints procedure (for example children, patients with communication disabilities or for whom English is not their first language) are supported in accessing and using the complaints procedure. Interpreting services can be accessed via the Clinical Governance Office.

2 3. DEFINITIONS Category Definition Action to be taken Suggestion Compliment General enquiry Signpost to other services Clinical Meeting Pre-complaint notification A comment or observation to be passed on to the appropriate service which does not necessarily require a response to be made. Commendation, praise and thanks to be passed on to the appropriate service. A request for information or advice about general services, health care or a health related issue. Giving information about other services outside the Trust, e.g. Primary Care Trust, advocacy services. A request to meet with a clinician for an explanation of care or treatment given or planned, by either the patient or relative (with consent if appropriate). Notification from a patient or relative (or via a member of staff), of an intention to make a formal complaint. Advice Centre staff (ACS) will ensure that the suggestion received is passed on to the appropriate manager for the area/service. ACS will ensure that the compliment received is passed on to the appropriate manager for the area/service. ACS will arrange for the individual to be provided with the information requested. This may be in the form of a leaflet, other written information, or may be in the form of a return telephone call to the individual either from the ACS or from another member of Trust staff as appropriate. ACS will arrange for the individual to be provided with the information requested and as above. ACS will agree with the service user and the directorate, the arrangements for facilitating the meeting, and whether or not an audio recording is to be made of the meeting. ACS will ensure that, if the service user is not the patient, the appropriate consent of the patient is obtained prior to any meeting taking place. ACS will record this on the Datix risk management database. Complaint resolved on the spot Level 1 concern Complaints and concerns resolved on the spot by staff in directorates that have been sent to the Advice Centre. An issue which has been raised orally and which can be resolved to the complainant s satisfaction by no later than the end of the next working day. ACS will record these concerns as Level 1 or Level 2, according to the timescale within which they have been resolved on the Datix risk management database. ACS will agree with the complainant who is to address their concern and what feedback they will receive advising that, if not resolved immediately, they will be contacted by the end of the next working day.

3 Level 2 Level 3 Level 4 A non-complex issue of low severity/risk, relating to a single directorate. An issue of moderate severity/risk, or where there are a number of concerns or factors requiring investigation. An issue of high or extreme severity/risk where serious harm has occurred/could have occurred or where there is a complex care pathway involving external healthcare agencies. There may be a potential claim against the Trust or damage to the Trust s reputation. Level 2 to 4 categories will be managed as identified in sections 4 and 5. As above As above 4. LISTENING, RESPONDING AND INVESTIGATING 4.1 On each contact with the Advice Centre a member of the Advice Centre staff (ACS) will be allocated to deal with the enquiry, concern or complaint. Where information is received or advice is given this will be acted upon as described in section The ACS will be allocated specific responsibility for L1 concerns and L2-4 complaints: Level 1 concerns - Advice Centre Officers Level 2 - Advice Centre Officers / Assistant Advisers or Senior Adviser Level 3 - Assistant Advisers Level 4 - Senior Adviser. 4.3 The ACS will acknowledge the concern or complaint and agree with the person, via a telephone call or letter: How their concern will be dealt with (taking into account the requirements of the Trust s complaints procedure see section 5.3); The communication method between the person and the ACS; The timescale within which the person can expect the issue to be dealt with; How the outcome of the investigation will be communicated with them. Each concern or complaint will be allocated one of the categories identified in section 3 and will be recorded on the Datix risk management database. 4.4 The Trust endorses the principles of openness (see the Being Open Policy Organisational Policy 1.22) and encourages the use of complaint resolution meetings as an opportunity to address problems and to achieve a satisfactory resolution to formal complaints. 4.5 L1 concerns and Level 2-4 complaints will be subject to an appropriate level of investigation by the Directorate Investigating Officers according to the complexity and/or severity of the issues or issues raised. Communication with the complainant, directorate investigators and other staff involved in the process will also be recorded on the Datix risk management database. 4.6 Level 1 concerns The appropriate clinician(s) or other staff will be contacted immediately to ensure that the person is provided with the information requested and a resolution by no later than the end of the next working day. The outcome will be recorded on the Datix risk management database. Issues not resolved to the complainant s satisfaction within this timescale will be automatically escalated to Level 2 and will be managed as a formal complaint as identified in section 5.3.

4 4.7 L2-4 complaints (see also section 5.3) The information provided will be assessed and a category allocated. Where there are immediate concerns about the severity/risk/implications for the Trust the ACS will inform the: Head of Communications and Senior Matron Patient Safety. 4.8 Where complaints involve other healthcare organisations/agencies the Senior Adviser will liaise with the complaints team or relevant manager for that organisation to agree a process of investigation and to agree who will prepare the co-ordinated response. 5. FORMAL COMPLAINTS (Level 2 4) 5.1 The statutory framework of the Trust s Complaints Procedure is the Local Authority Social Services and National Health Service Complaints (England) Regulations The procedure has 2 stages: Local Resolution; The Parliamentary & Health Service Ombudsman. 5.2 Standards Formal complaints should be made within 12 months of the incident or within 12 months of the time the incident was recognised as a cause for complaint. The Trust may decide to investigate a formal complaint which lies outside of this timescale, if there is a good reason for doing so see also appendix 1, guidelines for dealing with unreasonable, unreasonably persistent or vexatious complaints Acknowledgements will be made within 3 working days, and can be either in writing or telephone call from the Advice Centre. In the case of an acknowledgement by telephone, Advice Centre staff will ensure that the complainant receives the Advice Centre leaflet Resolving your Concerns and information regarding the services of the independent complaints advocacy services The 2009 Regulations state that the Trust must agree a response period within which the investigation will be completed and a response given, with the complainant. The 2009 Regulations also state that if the Trust is unable to provide a response to the complainant within six months of receipt, it must notify the complainant accordingly explaining the reason why, and ensure that a response is sent as soon as reasonably practicable thereafter The Trust recognises the importance of resolving concerns as promptly as possible. Advice Centre staff will agree with the complainant, as part of the acknowledgement of the complaint, the timescale within which they can expect to receive a response, taking into account factors such as the complexity of the complaint and unavailability of key staff, up to a maximum of 60 working days for the most complex issues. Complaints should be totally resolved, including those which are re-opened, within 90 working days of being received All efforts will be made to ensure that the timescale is adhered to but, in rare circumstances, a longer timescale may be requested of the complainant in writing, giving a reason for the delay. 5.3 Procedure There is no need for the complainant to write a letter unless they wish to do so. Verbal and written complaints receive the same attention. Where the complaint is verbal, the member of Advice Centre staff taking details of the complaint will make a written summary and send it to the complainant to approve The Advice Centre will acknowledge all formal complaints, either by letter or by telephone. The

5 acknowledgement will include information about the issues that are being investigated and the timescale for response, and will include an opportunity for the complainant to discuss these or to negotiate how any aspect of the complaint will be dealt with. If acknowledgement is made by telephone, the content of the discussion will be documented by Advice Centre staff A copy of the complaint, with a request for an investigation and report will be sent to the Directorate s Investigating Officer The Investigating Officer will determine which staff need to be asked to contribute to the response and will be responsible for obtaining any reports or comments which are necessary In the case of complaints about junior grade medical staff or locum medical staff, the appropriate consultant should always be asked to discuss the complaint with the individual concerned and contribute their comments to the response Staff required to provide a response to a complaint may be on leave, or may no longer work for the Trust. Investigating Officers must ensure that even in these circumstances, complaints are responded to fully and promptly. This may involve the Investigating Officer seeking a clinical report or opinion from a different clinician, or contacting staff no longer employed by the Trust if this is thought to be appropriate The Advice Centre will agree with the investigating officer and the complainant, whether a response is to be provided in by telephone, in writing or at a meeting with the appropriate clinician(s) or manager. For Level 3 and Level 4 issues a formal response will always be given either in writing or at a meeting For written responses where one directorate is involved, directorates will be provided with a template response letter to the complainant, which they should complete and return to the Advice Centre For Level 2 or Level 3 issues where more than one directorate is involved, a lead directorate will be appointed by the ACS (this will be the directorate that has the majority of issues or the main issue to answer), who will be asked to liaise with the other relevant directorate(s) and prepare a joint response For written responses to Level 4 issues where more than one directorate or more than one organisation is involved in the investigation, directorates will be asked to provide a report to the Advice Centre. The Senior Adviser or Assistant Adviser will then amalgamate all the reports received into a draft response from the Chief Executive In all cases, the response will include a report of the investigation which has taken place and any remedial steps which have been, or will be, taken as a result of the complaint For level 3 and 4 responses, draft letters will be reviewed by the Head of Communications and passed to a Director for final review and signature. The Head of Communications can sign off complaints When a response is given to a Level 2 issue by telephone, this will be followed up by a letter from the Chief Executive explaining the options available to the complainant if they are dissatisfied with the response When a meeting is held to resolve the complaint the meeting will usually be recorded and provided to the complainant on an audio CD. Alternatively, when recording a meeting is inappropriate (for example if the issues raised are of a sensitive or distressing nature) a written report will be agreed with the Investigating Officer and clinical staff present at the meeting and sent to the complainant, setting out the conclusions All correspondence to a complainant will be sent in a format which meets the complainant s individual needs. This may include, for example, a response dictated on to audiotape, or letters

6 in large print The complainant will be asked to let the Trust know if they are not satisfied with any aspects of the response to their complaint, so that more local resolution can take place. When the Senior Adviser Advice Centre and Investigating Officer feel that all attempts at local resolution have been made, the response to the complainant will include details of how to contact the Parliamentary and Health Services Ombudsman In matters of clinical judgement the clinician concerned will first agree the response. In the case of medical care this will be the consultant Reminders for investigations still outstanding after 15 working days will be sent to the Investigating Officer approximately every 5 working days Written statements and associated documentation (including s) made prior to any indication of legal action may be disclosed to the claimant s solicitors (see Incident Reporting Policy Organisational Policy 2.3). Complaints correspondence will not be filed in the patient s health care record, it will be held centrally by the Advice Centre, Chief Executive s Directorate. 5.4 Capacity and consent Complaints may be made by a third party on behalf of a patient. Individuals are entitled to raise a concern on behalf of another person, but care must be taken to ensure that information given in response does not breach the patient s right to confidentiality. In the following circumstances, a detailed response may be provided which includes disclosure of information relation to the patient s care and treatment: When the patient has given their permission, either verbally or in writing to the Advice Centre, to the disclosure of information regarding their care and treatment, to the named individual Where the complainant holds an appropriate Lasting Power of Attorney, registered with the Office of the Public Guardian, in relation to a patient who lacks capacity To the next of kin (spouse or son/daughter) of a patient who lacks capacity (as confirmed by the staff involved in the patient s care) In the absence of any of the above, a response to a complaint may be made in general terms, but must not include confidential information regarding care or treatment. 5.5 Parliamentary and Health Services Ombudsman The Parliamentary and Health Services Ombudsman undertake the second stage of the national procedure. If a complainant does not feel that the complaint has been satisfactorily addressed by the local resolution procedure he or she can request an independent review, by contacting Parliamentary & Health Services Ombudsman. Information on how to contact the Parliamentary & Health Services Ombudsman will be sent by the Advice Centre with the final response to each complaint If a complaint is investigated by the Parliamentary & Health Services Ombudsman, the Advice Centre Senior Adviser or Assistant Adviser will liaise with the Case Manager to ensure that all the relevant information is available. 6. MAKING IMPROVEMENTS 6.1 As a result of the L2-4 investigation the Directorate Investigating Officer (DIO) may identify: Action to be taken for individual staff members and/or Safety lessons learned and changes required to practice or systems used in the directorate. Where this is the case the change will be described in the final response sent by the DIO to the Advice Centre.

7 6.2 The Advice Centre staff will record information on the Datix risk management database as: No action in the outcome box or List the actions and ensure this information is also recorded in the Lessons learned field in the Investigate section. 6.3 Investigation findings and safety lesson learned will be shared with external healthcare organisations / agencies by the formal response to the complainant from the Trust. 6.4 Any action or change in practice arising from recommendations made by the Parliamentary & Health Services Ombudsman will be: Discussed at the directorate clinical governance group(s); Reported to the Trust Board; Reported to the Clinical Governance Committee. The Chief Nurse and Medical Director (or other Executive Director where appropriate) will be responsible for ensuring that any recommendations identified and documented by directorates as a result of complaint investigations, are acted upon. 6.5 Each month, the Advice Centre will send each directorate an individual summary of the concerns and complaints (Levels 1 to 4) that have been closed during the previous month; from the 26 th of one month to the 25 th day of the following month. This report will be produced as soon as practicable after the 25 th day of the month, but before the first working week of the following month. 6.6 The report will be discussed at the monthly directorate clinical governance meeting to identify the concerns raised and action agreed Any actions arising, for example, changes that have been identified but are not complete will be noted in the minutes and monitored by the group until complete. 6.7 Risks identified as a result of an investigation will be recorded on the directorate and/or corporate risk register(s) detailing risk reduction measures. Progress with the actions identified will be monitored through review of the risk register at the directorate clinical governance group and/or risk committee respectively. 6.8 The number of complaints managed by the Trust is sent to Monitor (the independent regulator of NHS Trusts) via the Trust s Annual Report and a separate report for the Information Authority. 7. COMPLAINTS WHICH WILL NOT USUALLY BE INVESTIGATED UNDER THE TRUST S COMPLAINTS PROCEDURE 7.1 The following complaints will not usually be dealt with by the Trust s Complaints Procedure: Matters arising under the Trust s personnel procedures; Any investigation by 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. Where these apply, a decision will be made between the Advice Centre and the directorate investigating officer (taking advice from the Corporate Secretary if appropriate) as to the most appropriate way to deal with the issue. The complainant will then be informed of this decision. 7.2 The Senior Adviser or Assistant Adviser Advice Centre, will refer in writing any complaints received by the Trust, which are solely concerned with another health body or body outside the NHS to the correct body, after consultation with the complainant. 7.3 If a complaint is received which involves the Trust and other bodies, the Senior Adviser or Assistant Adviser Advice Centre will co-operate with other agencies, to seek to resolve the complaint through each body s local complaints procedure.

8 8. LINKS WITH INCIDENTS AND CLAIMS 8.1 The process for the analysis and monitoring of individual and aggregated incidents, in conjunction with complaints and claims to enable learning and improvement is identified in the Analysis and Improvement Following Incidents, Complaints and Claims Policy Organisational Policies ROLES AND RESPONSIBILITIES 9.1 The Chief Executive and Head of Communications are responsible for the strategic management and the Senior Adviser is responsible for the daily management of the Advice Centre. 9.2 The Chief Executive has overall responsibility for all complaints. Some complaints will be dealt with personally by the Chief Executive, these include: Serious matters of clinical judgement; Complaints attracting public interest; Complaints which become difficult to resolve to the satisfaction of the complainant; Any complaint in which the Chief Executive takes a personal interest. 9.3 The Advice Centre The Senior Adviser, Assistant Adviser and Advice Centre officers will be responsible for ensuring that all complaints are acknowledged, investigations are undertaken, and an appropriate response made to the complainant (see sections 3 and 4). 9.4 Directorate Investigating Officer Is responsible for ensuring that all aspects of the complaint relating to their own area are fully investigated and answered. In some circumstances, an issue that is the subject of a complaint may need to be considered in conjunction with other Trust policies and procedures. It is the responsibility of the Directorate Investigating Officer to ensure appropriate action is taken. 9.5 Trust groups and committees As identified in the monitoring section Staff Any member of Trust staff is encouraged resolve a concern on the spot on behalf of a patient or service user if they are able to do so. Any member of staff doing so should complete a concern resolved on the spot form and forward this to the Advice Centre for recording on Datix. 10. TRAINING REQUIREMENTS 10.1 The following mandatory training is also detailed in the Risk Management Training Needs Analysis (Risk Management Training Policy, Organisational Policy 2.24): Improving Experiences - People Centred Services (Corporate Induction); First Line Management Development Programme (as identified with line manager) In addition, the following optional / on demand training is provided: Newly appointed consultants and Directorate Investigating Officers will meet the Advice Centre staff as part of their induction programme, to discuss the Trust s policy and approach to resolving issues/concerns/complaints. Advice Centre staff will, with the agreement of their line manager and budget holder, be supported to attend any training education sessions which would enable them to fulfil their diverse role more effectively. Advice Centre staff will deliver sessions, either as part of an established programme or by request on an ad-hoc basis to staff groups Topics covered in the sessions will be presented at a level appropriate to the staff group and

9 include: how issues can be resolved at department level, the role of the Advice Centre, the 2009 Regulations and non-discrimination. 11. MONITORING Policy element Content to be monitored Monitoring process 1. Listening and responding to concerns and complaints Different levels of investigation and how action plans are followed-up The process followed for L1-4 by the: Advice Centre Staff to acknowledge and record information on Datix, send the complaint to the Directorate Investigating Officers (DIOs) and respond within the timescales as per sections 3 and Timely investigation /responses by the DIOs Discussion of complaints reports at directorate clinical governance and completion of actions identified. Annual audit by Internal Audit (IA) of 10 complaints randomly selected per level 1-4 (including 2 that involve joint complaints see no: X below). The results will be reported to the Clinical Governance Committee (CGC) and where there are shortfalls an action plan will be agreed. The action plan will include timescales, responsibilities and plans for sharing any identified learning points. This action plan will be monitored by the CGC until complete. The number of formal complaints received each month and performance against response targets Review of data in the Trust Performance Report by the: Board of Directors Hospital Management Committee Joint Consultative Committee.

10 Policy element Content to be monitored Monitoring process 2.How the Trust shares safety lessons with internal and external stakeholders Numbers of contacts with the Advice Centre for the last four quarters (on a rolling basis) highlighting trends and summarising action taken / safety lessons learned Review of quarterly data by the: Board of Directors Council of Governors Patient & Public Involvement Committee The above information is also included in the Trust s Annual Report 3. Handling joint complaints that involve the Trust and other organisations 4. How the organisation makes improvements The process followed as noted in no.:1 above Identification of changes made as per directorate clinical governance minutes and completion of actions identified. See monitoring for no. 1 above See monitoring for no. 1 above 5. Non-discrimination Complainants views on the handling of their concern/complaint 6. Training Completion / attendance reports received by: Directorate clinical governance groups (quarterly) Hospital Management Committee (senior managers) (quarterly) Where there are shortfalls an action plan will be agreed to include any instances of persistent non-attendance 7. Roles and responsibilities The monthly review of role of directorate clinical governance groups in the Level 2-4 complaints linked to individual consultants as the employee complained about or as the lead consultant Annual survey of a minimum of 200 complainants by the Clinical Governance Team. The results with be reported to the Clinical Governance Committee and where there are shortfalls an action plan will be agreed. The action plan will include timescales, responsibilities and plans for sharing any identified learning points. This action plan will be monitored by the CGC until complete. Annual risk management training report produced by Senior Matron Practice Development as detailed in the Risk Management Training Policy Organisation Policy To be included as part of the annual audit described in no.1 above. Data is provided to the Head of Clinical Governance for incorporation into consultant appraisal data

11 12. KEYWORDS 12.1 Enquiries, concerns, Ombudsmen. 13. REFERENCES Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 Mental Capacity Act 2005 NHS Litigation Authority (2007) Risk Management Standards for Acute Trusts Care Quality Commission Standards for Better Health, Standard C RELATED POLICIES Analysis and Improvement Following Incidents, Complaints and Claims Policy (Organisational Policy 2.25) Being Open Policy (Organisational Policy 1.22) Claims Management Policy (Organisational Policies 4.19) Incident Reporting Policy (Organisational Policy 2.3) Risk Management Training Policy, (Organisational Policy 2.24) Safeguarding Adults Policy (Organisational Policy 2.16 Date ratified: Hospital Management Committee June 2012 First issued: January 2009 Version no.: 1.0 Date issued: June 2012 Review date: June 2014 For review by: Head of Communications Senior Adviser Advice Centre Director responsible: Medical Director Chief Nurse

12 Appendix 1 DEALING WITH UNREASONABLE, UNREASONABLY PERSISTENT OR VEXATIOUS COMPLAINTS 1. Introduction 1.1 The Trust aims to ensure that all complaints are dealt with sensitively and in accordance with the Local Authority Social Services and National Health Services Complaints (England) Regulations The Trust recognises that effective and timely resolution of all concerns and complaints is an important aspect of maintaining a reputation as a provider of high quality health care services. 1.2 Unfortunately, in a small number of cases, the complaint may be unreasonable or vexatious because the complainant: is seeking an investigation or outcome which is disproportionate to the issue being raised; continues to reiterate or re-make their complaint despite the trust having provided a detailed response and given confirmation that there is nothing further which can be done to remedy the matter is motivated, in pursuing the complaint, by malicious intent towards the trust or a member of staff. 1.3 These types of complaints place significant amounts of pressure on the trust s resources and the staff involved in attempting to resolve them. 1.4 Staff in the Advice Centre and those involved in investigating complaints should be given clear guidance to be able to make an informed and balanced judgement as to whether, and at what stage, individual complaints fall into these categories. 1.5 Staff should also be given clear guidance on how to deal appropriately with the small number of complaints which fall into these categories, to ensure that they are dealt with in a fair and balanced way. 1.4 Equally, it must be recognised that, even when a complaint has been deemed unreasonable or unreasonably persistent, the complainant may at any point in the future raise further concerns which may have substance. Each complaint from the complainant should, therefore, be assessed on its individual merits. 1.5 This policy will only be invoked in exceptional circumstances and after considered discussion between the Advice Centre staff and the relevant investigating officer(s). The decision to invoke this policy will be taken by the Head of Communication after consultation with the Chief Executive, the Corporate Secretary or the executive on-call. 2. Purpose of this procedure The purpose of this procedure is to: Identify when complaints fall into the category of unreasonable, unreasonably persistent or vexatious; Give guidance on how these complaints might be dealt with; Ensure that all complaints are dealt with in a fair and proportionate way, and that no material elements of a complaint are inadequately addressed.

13 2.2 For ease of reference, the consistent use of one gender should be taken to refer to both, and the consistent use of the singular should be taken to refer also to the plural. 3. Definition of an unreasonable, unreasonably persistent or vexatious complaint 3.1 An individual complaint (whether made by the patient or by a representative acting on their behalf) may be deemed unreasonable, unreasonably persistent or vexatious, when two or more of the following criteria apply. The complainant continues to press the complaint after the complaints procedure has been properly implemented and exhausted, i.e. a full investigation has been carried out and as much information as is available has been provided to the complainant, or alternatively the concerns raised happened too long ago for any investigation to be meaningful and the complainant has received written notification to this effect. The complainant is unwilling to accept documented factual evidence (e.g. medication records), or alternatively refuses to accept that facts cannot be verified after a period of time has elapsed. The complainant changes the substance of a complaint during the investigation or following receipt of a response. The complaint does not specify anything which can realistically be investigated, despite the best efforts of the Advice Centre staff and, if appropriate, the Independent Complaints & Advocacy Service to identify specific issues. The complaint focuses on a minor or inconsequential issue to an extent that is out of proportion to its significance, and he continues to focus on this in spite of any investigation undertaken or information provided. The complaint forms part of a pattern of other complaints made by, or on behalf of, the same individual which focus on minor or inconsequential matters to an extent that is out of proportion to the significance of the issues being raised. The complainant makes inappropriate or unreasonable demands as to the outcome he wants to the complaint, and he is unwilling to accept that these may be unreasonable. The complainant has threatened or used physical violence against staff or their families or associates. In such an event, there will be no further personal contact with the complainant or his representative and the complaint will be dealt with solely in writing. (In these cases, all such incidents must be documented.) The complainant has more than once harassed, or been personally abusive or verbally aggressive towards, staff dealing with their complaint or their families or associates. In such an event, there will be no further personal contact with the complainant or his representative and the complaint will be dealt with solely in writing. (In these cases, all such incidents must be documented.) During the course of the complaint, the complainant has an excessive number of contacts (by phone, by letter or in person) with the Trust, placing unreasonable demands on staff. (Care and discretion must be used when determining whether the number of contacts made is reasonable.)

14 4. Options for dealing with a complaint when any two of the above criteria are considered to apply 4.1 When a complaint has been identified as unreasonable, unreasonably persistent or vexatious, the Head of Communications, after consultation with the Chief Executive, the Corporate Secretary or the executive on-call, will determine what action to take Pending any decision, the Head of Communications may decide to restrict communication with the complainant to one method only (i.e. letter, telephone, fax or ) or restrict communication to liaison through a third party. 4.2 The Head of Communication may try to resolve matters by arranging a meeting between the Advice Centre, the complainant and appropriate members of staff with an agenda and time limit agreed beforehand and adhered to by both parties. (In these circumstances, the complainant may be advised to seek support from ICAS if they have not already done so.) The Head of Communications, after consultation with the Chief Executive, the Corporate Secretary or the executive on-call, may temporarily suspend all contact with the complainant or investigation of a complaint while the Trust seeks advice from the Trust s solicitors or any other relevant agency. 4.3 If the action at 4.3 above does not resolve the matter, or if it is felt that the action at 4.3 is not feasible, the Chief Executive should write to the complainant to explain that the Trust has tried to resolve the complaint but there is nothing further which can be done The Chief Executive should advise the complainant of any external right of redress if he still feels that the complaint has not been addressed. The letter should clarify that the trust will not enter into any further correspondence about the complaint and that any further letters on the subject from the complainant will be acknowledged but not answered.

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