NHS SOUTH DEVON AND TORBAY CLINICAL COMMISSIONING GROUP COMPLAINTS POLICY

Transcription

1 NHS SOUTH DEVON AND TORBAY CLINICAL COMMISSIONING GROUP COMPLAINTS POLICY Version: 1.4 dated 26 March 2014 DATE VERSION CONTROL 01/08/ First draft Phil Stimpson Based upon initial policy produced in August 2012 for CCG authorisation, which was based upon the existing NHS Devon and Torbay Care Trust complaints policies. 01/10/ With comments and feedback from Quality Committee 28 August 2013 included. Page 2 include list of applicable legislation Appendix B 1.1, correction of reference to TSDHCT to CCG 10/01/ Amended to reflect that this CCG has an in-house Complaints team instead of using the NEW Devon CCG PACT these changes made at Sections 2, 3, 6, 10, 12 and Appendices A, B, C. 27/01/ Amended following discussion with NED for PPI, to include reference to initial complaints going to the service provider and defining who can make a complaint: sections 4, 8, 10, App A Approved by Quality Committee 12 March /03/ Further amendments by Patient Experience Lead and Director of Quality Governance to reflect learning and outcomes from Francis and Clwyd reviews and to reflect correct legislation. NHS South Devon and Torbay Clinical Commissioning Group promotes equality, diversity and human rights and is committed to ensuring that all people and communities it serves have access to the services we provide. In exercising the duty to address health inequalities, the CCG has made every effort to ensure this policy does not discriminate, directly or indirectly, against patients, employees, contractors or visitors sharing protected characteristics of: age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion and belief; sex (gender); sexual orientation or those protected under Human Rights legislation. All CCG policies can be provided in large print or Braille formats; translations on request; language line interpreter services are available; and website users can use contrast, text sizing and audio tools if required. For any other assistance, please contact the CCG at sdtccg@nhs.net or NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 1 of 20

2 CONTENTS Part Description Page 1 Purpose 3 2 Executive Summary 3 3 Introduction 4 4 Scope 4 5 Definition 5 6 Policy Statement 5 7 Equality and Diversity 6 8 What a person making a complaint can expect from our 6 Complaints Process 9 Rights of Patients 7 10 Responsibilities and Accountabilities 8 11 Policy principles 9 12 Audit Patient and Service user Involvement Complaints not covered by this policy 10 Appendix A NHS South Devon and Torbay CCG Complaints Process 12 Appendix B Procedure for dealing with a Habitual or Vexatious Complainant 14 Appendix C Patient Information 17 Applicable legislation The Local Authority Social Services and National Health Services Complaints (England) (Amendments) Regulations 2009 Health and Social Care Act 2012 Equality Act 2010 Mental Capacity Act 2005 Freedom of Information Act 2000 The Human Rights Act 1998 Data Protection Act 1998 Useful websites Office of the Public Guardian (Power of Attorney) Parliamentary and Health Ombudsman Mental Capacity Act NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 2 of 20

3 1 Purpose The purpose of this policy is to provide guidance and to support NHS South Devon & Torbay Clinical Commissioning Group (CCG) in meeting its obligations to receive, investigate and report on complaints received from service users and other recognised persons. 2 Executive Summary The roles and responsibilities of the CCG are described in the Health and Social Care Act This includes receiving, investigating and replying to complaints received by users of services commissioned by the CCG, usually once the complaints process of the provider of those services has been exhausted. The applicable legislation for all parts of the NHS applies to the CCG The Local Authority Social Services and National Health Service Complaints (England) Regulations The CCG has an in-house Complaints team to handle any complaints received by the CCG. For clarity South Devon and Torbay CCG have branded their complaints team as the Patient Experience Team. The processes described in this policy are also applicable to the ways in which the CCG may process correspondence and general vexatious behaviour directed to the CCG and its officers. The process described at Appendix B (Habitual or Vexatious Complainants) may be invoked upon instruction from a Director of the CCG to enable the CCG to effectively deal with any such person. 1 NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 3 of 20

4 3 Introduction NHS South Devon and Torbay Clinical Commissioning Group recognise that suggestions, concerns, compliments and complaints provide valuable insights into services. Every person's experience counts. Therefore we will use this valuable intelligence on the services we provide as commissioners, and the care pathways and services we commission to ensure that quality, patient focussed care and treatment is at the heart of our work. In order to achieve this there are three steps to our policy: 1. Listening 2. Responding 3. Improving We will place equal emphasis on each of the three. We are aware that unless we listen, our response will not address the key issues raised by complainants and valuable opportunities to improve will be lost. Complaints and the outcomes of the investigation into those complaints will form part of our continuous quality improvement process. We also acknowledge that some complaints involve a number of different organisations or providers of care. We believe that the person making the complaint has one experience and wants to be assured tht all departments and/or organisations involved in that care have worked together to ensure that any changes are made in a consistent and sustainable way and seek to ensure an improved patient experience for others. Therefore, when a compliant is received by the CCG, the complaints team will lead the coordination of a single response. This will include leading investigations into individual complaints made to an independent contractor where the Governing Body of the CCG feels this is appropriate. In response to feedback from people who need to complain, and the changes to NHS structures, we have made arrangements to ensure that our processes are robust and the management of complaints is monitored. We will ensure we operate a cost effective but person centred complaints management process, linked to a customer service process that ensures all complaints, concerns and compliments are managed efficiently, effectively and with sensitivity. 4 Scope This policy has been developed to provide clear guidance on the handling of complaints by the CCG. The policy relates to the NHS South Devon and Torbay Clinical Commissioning Group and is for this CCG s patients and service users. The CCG will only normally accept a complaint made within 12 months of the situation which is the subject of the complaint. This is discretionary and all complaints will be NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 4 of 20

5 reviewed and assessed to decide if an investigation is appropriate and able to take place, complainants will be provided with an explanation where the CCG believes that it is unable to investigate a complaint. The Local Authority Social Services and National Health Services Complaints (England) (Amendments) Regulations 2009 state that a complaint can either be raised with the service provider or the commissioning organisations. Complainants contacting the CCG will be offered the choice of either the service provider or the commissioners investigating their complaint. Where a complaint has been investigated by a service provider and a full written response provided, the CCG will be unable to re-investigate the same complaint. Where a complaint has been investigating by the CCG the service provider will be unable to re-investigate the same complaint. Where complainants remain dissatisfied with the response to their complaint, complainants should take their concerns to the Parliamentary and Health Service Ombudsman for investigation. Complaints can be made by an individual or their representative this can be someone with the legal right to do this or with the individual s explicit consent. This includes the legal rights for a parent of a child under the age of 12, and where a Power of Attorney (Health and Welfare) is in place. Proof of the relevant consent documents may be required where complaints are raised on behalf of someone else. There are a number of exclusions to this policy and these can be found in Section 14. This policy applies to member practices acting as commissioners but not in respect of general practices as providers of primary care. Each member practice will have its own complaints policy and process for the management of complaints made by patients about their own provision of services. 5 Definition A complaint is an expression of dissatisfaction about any aspect of health care commissioned by the CCG or the services the CCG commissions, and requires an investigation and written response. Such expressions of dissatisfaction may be made in a variety of ways: verbal, face-to-face, by telephone, or in writing (letter or ). Sometimes it is difficult to determine if feedback is a complaint. All expressions of dissatisfaction will be discussed with the person raising the complaint. The person making the complaint will decide if they wish for their expression to be handled as a formal complaint. This policy will also apply to any complaint received from a Member of Parliament making/forwarding a compliant on behalf of a constituent. 6 Policy Statement The CCG aims to commission high quality health care services for the residents of South NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 5 of 20

6 Devon and Torbay. Whilst we endeavour to ensure that the care provided is high quality, evidence based and cost effective, we accept that sometimes things do go wrong and that the services commissioned may not meet the specific needs of individuals, or may provide a poor patient experience of care. Where this is the case, we are committed to listening to our patients, their families, their carers or their advocates and to ensure that changes are made wherever possible. We will always seek to use feedback to improve services,quality of care provided and enhance the experience of the patient. When things go wrong or patients feel they have experienced poor service they are able and are encouraged to raise their concerns directly to the service provider, whether that is a hospital, community services, a private provider, general practice, or an independent practitioner. Where possible, patients are encouraged to speak to someone at the time or as soon as they are aware there may be a problem. All our providers will welcome the opportunity to try to resolve patient concerns directly and to learn from that feedback. Sometimes people raising complaints might not want to take their complaint directly to the service provider or would prefer for the commissioning organisation (CCG) to investigate thier complaint. Where the complainant wishes for the CCG to investigate their complaint the complaints team will deal with the concerns and provide advice on the options available to an individual to enable them to reach resolution or progress their complaint. We will work with complainants to ensure that a response is provided in the most appropriate way for them, this can include a face to face meeting if necessary. NHS South Devon and Torbay CCG will ensure that all complaints are viewed positively and will be used to identify any improvement needs. We will treat people making a complaint openly, fairly, courteously and sympathetically. An apology will be given whatever the content of the complaint in recognition of the concern caused to the person making the compliant, as well as for any shortfall in experience of care or services. We will ensure that the person making the complaint receives one response that addresses all the issues raised and clearly sets out changes made, or planned. Where changes are planned we will agree a timeframe by which we will update the complainant on the changes made. We will monitor the complaints management process to ensure that all complaints are dealt with in a timely and appropriate way. We will ensure that regular analysis of information from complaints is reported within the CCG through the Quality Committee and to the Governing Body, to ensure that the CCG s Executive and Non-Executive Directors are made fully aware of patient experience and feedback. We will ensure that regular patient experience reports are provided to the Localitiy Managers, to help them make quality improvement changes in their locality. We will ensure that learning from complaints is used to help identify issues of poor quality care, or where the quality of services or patient experience could be improved. We will act to ensure that plans are put in place to make improvements and we will monitor those plans to completion. We will proactively support Care Pathway Groups and providers of care with whom we have contracts to use learning from complaints to continuously improve their services. We will monitor the complaints that our commissioned services receive to help provide a NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 6 of 20

7 picture of the overall quality of care and will regularly discuss complaints and patient experience with our providers, to help us understand patient experience. Where a complaint investigation leads us to believe that the quality of care provided is poor or that people are not safe, we will inform the appropriate agencies and instigate the necessary safeguards to ensure that people are kept from harm. 7 Equality and Diversity A key principle of this policy is that all people making a complaint will be treated equally, and will not be discriminated against because of their race, ethnic origin, nationality, gender, culture, religion or belief, sexual orientation, age or disabiltiy. A person making a complaint is entitled to seek external advice and support to ensure that their complaint is handled in line with national best practice, and to refer their complaint to the Parliamentary and Health Service Ombudsman. Persons making a complaint should not experience any negative impact on future health care as a result of their complaint. 8 What a person making a complaint can expect from our Complaints Process This policy has been developed to ensure that a consistent approach is undertaken with all complaints irrelevant of the issues raised. People raising complaints who have chosen for the CCG to investigate their complaint can (in line with the complaint regulations) expect: an acknowledgement that the complaint has been received. This will be sent within 3 working days of receipt of the complaint to be asked to arrange completion of a consent form if they are complaining on behalf of another person or where access to medical records may be required and where sharing of complaints information between organisations is necessary an offer to discuss the complaint or concerns and resolve them straight away, informally, if possible to be listened to with respect, to be responded to sympathetically and effectively and to have all concerns taken seriously that we will be fair and proportionate in investigating your concerns an explanation of the options relevant to the content of the complaint in order to ensure resolution which will take into account the views and wishes of the person making the complaint a plan (including timescales) for dealing with the complaint to be agreed with the person making the complaint that NHS South Devon and Torbay CCG will uphold the rights set out in the NHS Constitution NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 7 of 20

8 to receive information on where support can be accessed such as Independent Complaints Advocacy Service (ICAS) the offer of a face to face (local resolution) meeting where there are difficult issues to be resolved if necessary where the content of the complaint covers both health and social care issues, we will work with social care colleagues to investigate and provide a single response where possible. to receive an apology to receive and open, honest and factually accurate response that we will try our best to put things right to be advised of the details for the Parliamentary and Health Service Ombudsman if the person making the complaint remains dissatisfied after the initial response 9 Rights of Patients to have any complaint made about NHS services dealt with efficiently and to have it properly investigate to know the outcome of any investigation into their complaint to take their complaint to the Parliamentary and Health Service Ombudsman if not satisfied with the way their complaint has been dealt with by the NHS. The Ombudsman will only review those complaints that have completed local resolutioin through a practice or through an NHS complaints process. Helpline: (open 8.30am 5.30pm, Monday to Friday) phso.enquiries@ombudsman.org.uk Fax: The Parliamentary and Health Service Ombudsman Millbank Tower Millbank London SW1P 4QP to make a claim for a judicial review if they think that they have been directly affected by an unlawful act or decision of an NHS body to be compensated where they have been harmed by negligent treatment 10 Responsibilities and Accountabilities NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 8 of 20

9 The CCG commits to the following as part of its overall responsibliites: If a patient or their relative or representative has cause to complain about services commissioned by the CCG and the complainant remains dissatisfied after receiving the service provider s final response, the emphasis will be on seeking to resolve the complaint to the satisfaction of the person making the complaint. A person making a complaint will be given a named case manager as a point of contact to discuss the complaint Individuals making a complaint will be involved in decisions about how their complaint will be handled. This will include agreeing a realistic outcome for their complaint, agreeing points for investigation and a timescale for a response to be provided. In order to fulfil our responsiblities, the CCG s Governing Body have nominated the following agencies and personnel to deliver the policy: Chief Clinical Officer Responsible for reviewing and signing complaints letters/responses. Clinical Lead for Patient Safety and Quality Responsible to the Governing Body for overall complaints handling and ensuring Learning from Experience. Director of Quality Governance Responsible for ensuring the implementation and delivery of the complaints process. Head of Quality and Patient Experience Responsible for analysis of complaints and concerns, reporting to Governing Body through the Quality Committee; reporting to the Localities, ensuring that the Director of Quality Governance is aware of any major or complex complaints or issues of poor or inadequate service quality. Patient Experience Lead Responsible for the day to day management of complaints and investigations. Nominated complaints manager. All Staff All members of the CCG staff will respond to a complaint in a positive manner and comply with this policy and the procedures on complaint handling. Complaints about commissioning matters received by member practices in localities will be passed to the CCG for management. Responses and outcomes will be copied to NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 9 of 20

10 appropriate Locality Manager until resolution. 11 Policy principles publicise the complaints policy and procedure implement a process to deliver the six principles of good complaints handing: getting it right being customer focussed being open and accountable acting fairly and proportionately putting things right seeking continuous improvement ensure complaints are dealt with efficiently and that investigatons are appropriate to enable a response to the complainant and to identify areas for improvement ensure all complaints that have been made within 12 months of an incident or experience are dealt with under the complaints procedure ensure a robust procedure is followed when complaints relate to services we purchase from contracted services. We will do this by requiring them to provide us with information on the complaints they have received on a quarterly basis. We will jointly investigate any complaint where there is significant concern relating to patient safety or patient experience ensure a robust procedure is in place for any organisations that they CCG commission services from. This will be monitored via our Quality Scrutiny Groups or Quality Review Meetings. We will require the organisation to keep us informed at all stages of the investigation if there is a significant concern identified which relates to patient safety. Implement procedures to ensure clarity of roles and responsbilities, including between organisations implement a system for grading complaints implement a reporting process which enables the Governing Body to understand the issues raised and the improvements made from learning from complaints produce an annual report on complaints in line with current legislation ensure training is provided on complaints handling for teams or localities as appropriate ensure collection and collation of Equality and Diversity data in line with local and national requirements ensure a record is maintained of each complaint in line with current legislation NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 10 of 20

11 ensure the annual KO41 return is completed as required. 12 Audit The CCG will undertake an annual audit of complainants satisfaction with the handling of complaints and ensure that lessons learned from this are used to review this policy, associated procedures. 13 Patient and Service User Involvement We will provide a summary of findings from investigations and lessons learned at patient and user groups (to be determined) and identify wider learning from the complaints process by publc and user scrutiny and involvement. 14 Complaints not covered by this Policy The Complaints Policy applies to complaints made by or on behalf of patients. This policy does not apply to: complaints made by patients relating to funding /commissioning arrangements unless their case has been considered via the NHS South Devon and Torbay CCG Commissioning Appeals Process complaints about decisions made about NHS Continuing Health Care (CHC). Such complaints will be dealt with by Torbay and Southern Devon Health and Care NHS Trust, who commission CHC on behalf of the CCG complaints and grievances by members of staff relating to their contract of employment. Employees should raise such issues with their Line Manager or with the Managing Director in the first instance. The CCG s HR policies for grievances and disputes will be followed. Complaints by primary care practitioners that relate either to the exercise of the NHS South Devon and Torbay CCG functions or to the contract or arrangement under which the practitioner or practice provides primary care services complaints made by any other organisation which are not made on behalf of a patient complaints made by an independent provider about contracts arranged by NHS South Devon and Torbay CCG under its commissioning arrangements complaints about the non-disclosure of information requested under the Freedom of Information Act 2000 or the failure to comply with a data subject access request made under the Data Protection Act Applicants have the right to appeal directly to the Information Commissioner's Office. NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 11 of 20

12 Complaints that are being or have been investigated by the Parliamentary and Health Service Ombudsman (PHSO) NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 12 of 20

13 Appendix A NHS South Devon and Torbay CCG Complaints Procedure The CCG will follow these principles: Basis of Complaint A complaint about a service provider has first been received by and fully responded to by that provider A complaint may be received from an individual or on their behalf by their representative e.g. the parent of a child aged under 12 or someone appointed under a Power of Attorney (Health and Welfare) Listening Complaint received verbally, written, face to face in Localilties or at the CCG s office, or via the Complaints direct line, or contact address Complaint recorded and file opened (electronic data base) Contact made with most complainants to gain more detail from them Complaint Graded Timescale for investigation and response to complainant determined and agreed Acknowledgement letter sent to person making the complaint (within 3 days) Consent is requested to proceed with investigation (as necessary) Responding Each case will be investigated and managed by the Complaints Manager within the Quality Directorate. Once all the required information has been made available, the complaints issues have been clarified and consent returned where appropriate, the investigation process begins. Contact and request information and answers from the specific providers/commissioners as necessary to answer the complainant s concerns and questions This stage may go on for a while and may include phone calls/interviews/note reviews/ expert review or whatever is required to provide answers to the complaint questions or concerns. If an expert review is considered appropriate, the complaints manager will seek prior agreement to this from the Director of Quality Governance. If the complaint is risk rated as very serious, the complaint will be discussed with the relevant senior member of CCG staff where there are concerns about patient safety or Safeguarding of vulnerable adults or children; the Director of Quality NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 13 of 20

14 Governance will determine who will lead any resulting investigation. As required, steps will be taken to protect people from harm and to inform the appropriate agencies When all the information has been collated and the investigation completed, the response letter can be prepared. This should be within the timeframe agreed at the beginning of the process. If the timescale is likely to be breached, then the complainant must be informed. Any anticipated or actual breach will be reported to the Director of Quality Governance. The response letter, having been checked by the Director of Quality Governance will be signed by the Chief Clinical Officer. In their absense, the Clinical Lead for Patient Safety and Quality can sign response letters on behalf of the CCG. Improving The CCG will support providers to learn from complaints and patient feedback Complaints that define specific actions that need to be taken to prevent a certain incident or event happening again will be identified and the action plan monitored The findings and outcomes of complaints will be monitored by the Quality Team and by the appropriate Commissioning leads and Locality leads Learning from complaints will be used to influence care pathway design and commissioning decisions where possible Learning from complaints will be shared widely where useful to promote continuous quality improvement Insights that emerge from the investigation of complaints will be fed back to providers of care to support their drive for continuous improvement where appropriate Closure of complaints Each response letter will identify a date by which the complainant should get in touch with the CCG to notify them if they are not satisfied that their complaint has been addressed fully, otherwise the case will be closed. Each response letter will provide information about how to contact the Parliamentary and Health Service Ombudsman if the person making the complaint is unhappy with the outcome of the investigation and handling by the CCG. On closure of the case, the case review documentation will be completed and databases will be updated to ensure accurate and full records are maintained. Resolution Meetings NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 14 of 20

15 These should be considered when investigations and response letters have failed to resolve the questions and concerns raised by the person making the complaint. NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 15 of 20

16 Appendix B Procedure for dealing with Habitual or Vexatious Complainants 1. Introduction 1.1 Habitual and/or vexatious complainants can place a strain on time and resources and cause unacceptable stress for staff who may need support in difficult situations. NHS South Devon and Torbay CCG staff are trained to respond with patience and understanding to the needs of all complainants, but there are times when there is nothing further that can reasonably be done to assist them, or to rectify a real or perceived problem. 1.2 The following procedure identifies situations where the complainant could be considered habitual or vexatious and outlines ways of responding to such situations. This procedure should only be used as a last resort and after all reasonable measures have been taken to try to resolve complaints by following the CCG Complaints Procedure. 1.3 Careful judgment and discretion must be used in applying the criteria to identify habitual or vexatious complainants and in deciding what action to take in specific cases. This procedure should only be implemented following careful consideration by, and with the authorisation of, a Director or the Chief Clinical Officer of the CCG. 2. Criteria of a Habitual or Vexatious Complainant Complainants (and/or anyone acting on their behalf) may be deemed to be habitual or vexatious where current or previous contact with them shows that they have met two or more (or are in serious breach of one) of the following criteria: 2.1 Persisting in pursuing a complaint where the CCG complaints procedure has been fully and properly implemented and exhausted. For example, where investigation is deemed to be out of time ; 2.2 The substance of a complaint is changed or new issues are raised persistently or complainants seek to prolong contact by unreasonably raising further concerns or questions upon receipt of a response whilst the complaint is being dealt with. Care must be taken not to disregard new issues which differ significantly from the original complaint these may need to be addressed as separate complaints; 2.3 Complainants are unwilling to accept documented evidence as being factual or deny receipt of an adequate response despite correspondence specifically answering their questions/concerns. This could also extend to complainants who do not accept that facts can sometimes be difficult to verify after a long period of time has elapsed; 2.4 Complainants do not identify clearly the precise issues they wish to be investigated despite reasonable efforts to help them do so by CCG staff and, where appropriate, their advocates; NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 16 of 20

17 2.5 Where the concerns identified are not within the jurisdiction of CCG to investigate; 2.6 Complainants focus on a peripheral matter to an extent that is out of proportion to its significance and continue to focus on this point. It should be recognised that determining what is peripheral can be subjective and careful judgement must be used in applying the criterion; 2.7 Physical violence has been used or threatened towards staff or their families/associates at any time. This will in itself cause personal contact with the complainant and/or their representatives to be discontinued and the complaint will, thereafter, only be pursued through written communication. All such incidents should be documented and reported, as appropriate, to the Local Security Management Specialist (LSMS) or police; 2.8 Complainants have, in the course of pursuing a registered complaint, had an excessive number of contacts (or unreasonably made multiple complaints) with CCG placing unreasonable demands on staff. Such contacts may be in person, by telephone, letter, fax or electronically. Discretion must be exercised in deciding how many contacts are required to qualify as excessive, using judgment based on the instances of each individual case; 2.9 Complainants have harassed or been abusive (including racist, sexist or homophobic abuse) or verbally aggressive on more than one occasion towards staff dealing with their complaint directly or indirectly or their families and/or associates. If the nature of the harassment or aggressive behaviour is sufficiently serious, this could, in itself, be sufficient reason for classifying the complainant as vexatious. It must be recognised that complainants may sometimes act out of character at times of stress, anxiety or distress and reasonable allowances should be made for this. All incidents of harassment or aggression must be documented, dated and reported to the LSMS; 2.10 Complainants are known to have electronically recorded meetings or conversations without the prior knowledge and consent of the other parties involved. It may be necessary to explain to a complainant at the outset of any investigation into their complaint(s) that such behaviour is unacceptable and can, in some circumstances, be illegal; 2.11 Complainants display unreasonable demands or expectations and fail to accept that these may be unreasonable after a clear explanation has been provided as to what constitutes an unreasonable demand (for example insisting on responses to complaints or enquiries being provided more urgently than is reasonable or recognised practice). 3. Options for dealing with Habitual or Vexatious Complainants 3.1 When complainants have been identified as habitual or vexatious, in accordance with the above criteria, a Director or the Chief Clinical Officer will convene a panel to review and decide what action to take. The panel should include the Director or the NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 17 of 20

18 Chief Clinical Officer, the relevant Commissioning lead, with support from other CCG officers such as the Corporate Affairs team. It is recommended, although not essential, that a Non-Executive Director also attends, particularly at a first review. 3.2 The Director or the Chief Clinical Officer will implement such action and notify complainants promptly and in writing, of the reasons why they have been classified as habitual or vexatious and the action to be taken. 3.3 This notification must be copied promptly for the information of others already involved in the complaint such as practitioners, conciliators, advocates and members of parliament. A record must be kept, for future reference, of the reasons why a complainant has been classified as habitual or vexatious and the action taken. 3.4 The Director or the Chief Clinical Officer may decide to deal with habitual or vexatious complainants in one or more of the following ways: a) Once it is clear that complainants meet any one of the criteria in section 2 above, it may be appropriate to inform them in writing that they are at risk of being classified as habitual or vexatious. A copy of this procedure should be sent to them and they should be advised to take account of the criteria in any future dealings with the CCG and its staff. In some cases it may be appropriate at this point to copy this notification to others involved in the complaint and suggest that complainants seek advice in taking their complaint further; b) Try to resolve matters before invoking this procedure, and/or the sanctions detailed within it. If the CCG is to continue dealing with the complaint, it may be appropriate to draw up a signed agreement which establishes a code of behaviour for the parties involved. If this agreement is breached consideration should then be given to implementing other actions as outlined below; c) Decline further contact with the complainant either in person, by telephone, fax, letter or electronically or any combination of these whilst ensuring that one form of contact is maintained. Alternatively, further contact could be restricted to liaison through a third party. d) Notify complainants in writing that the CCG has responded fully to the points raised and has tried to resolve the complaint but there is nothing more to add and continuing contact on the matter will serve no useful purpose. Complainants should be notified that correspondence is at an end and that further communications will be acknowledged but not answered; e) Inform complainants that in extreme circumstances the CCG reserves the right to refer unreasonable or vexatious complaints to solicitors and, if appropriate, the LSMS or the police; f) Temporarily suspend all contact with the complainant(s), or investigation of a complaint, whilst seeking legal advice or guidance from the Security Manager (LSMS), Department of Health or other relevant agencies; NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 18 of 20

19 g) In exceptional circumstances, consideration can be given to the possibility of referring the matter to the relevant department of the Parliamentary and Health Service Ombudsman s Office. 3.5 If this policy is to be implemented, it should be explained to the complainant(s) that any course of action taken as a result only relates to contact with the CCG over their specific complaint(s). It does not, and is not intended to, have any impact on any other dealings between the CCG and the complainant(s) on other, unrelated issues. 4. Withdrawing Habitual or Vexatious Status 4.1 Once complainants have been classified as habitual or vexatious, the Corporate Affairs team will arrange for such status to be reviewed after a period of 12 months, the review to again be carried out by the Director or the Chief Clinical Officer, as before. If it is decided that habitual or vexatious status will be re-imposed for a further period of 6 or 12 months, all relevant parties involved will be informed of this decision. However, there also needs to be a mechanism for withdrawing this status earlier if, for example, complainants subsequently demonstrate a more reasonable approach. If they submit a further complaint, relating to a new matter(s), the normal complaints procedures would apply. 4.2 Staff should have already used careful judgement and discretion in recommending or confirming habitual or vexatious status and similar judgement/discretion will be necessary when recommending that such status should be withdrawn. Where this appears to be the case, discussions will be held with the Director or the Chief Clinical Officer and, subject to their approval, normal contact with complainants and application of the CCG Complaints Procedures will be resumed. 5. Review 5.1 This procedure will be reviewed by the CCG as part of general Complaints Policy and Procedure review and any proposed amendments submitted to the CCG Quality Committee for approval. 5.2 The existence and operation of this procedure, which is part of the Complaints Policy and Procedure, will be shared with and explained to all relevant CCG staff. NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 19 of 20

20 Appendix C Patient Information IHCA - The Independent Health Complaints Advocacy Service provides free help and support for people bringing formal complaints to the NHS. This is an independent and confidential service available in this area through Support, Empower, Advocate and Promote (SEAP) SEAP Torbay can be contacted using the following contact details: Telephone: torbay@seap.org.uk For more information on the background and rationale behind the new NHS complaints process please refer to the information below: NHS Complaints Regulations (England) April 2009 The Department of Health s guidance: Listening Responding Improving The Ombudsman s Principles of Good Complaint Handling NHS South Devon and Torbay CCG Complaints Policy v1.4 March 2014 Page 20 of 20