COMPLAINTS AND CONCERNS POLICY

Policy Statement

Connect Healthcare Rotherham CIC is committed to excellent patient service. We regard complaints as an opportunity to turn a negative experience for a patient or service user into a positive one, as well as an opportunity to learn and to improve. The context for our complaints procedure is effective patient care, with regular dialogue and review with patients of the services provided. The purpose of our complaints handling procedures is to ensure that we: 

  • Listen and are responsive to anyone that raises an issue with us 
  • Respond swiftly and at a level close to the point of service delivery 
  • Are fair and consistent 
  • Offer solutions and/or explanations 
  • Ensure that staff who are mentioned in complaints receive support 
  • Respect confidentiality 
  • Record complaints consistently, and monitor what we record 
  • Use complaints positively as an opportunity for learning and improvement

Scope

This document applies to all employees of the organisation and other individuals performing functions in relation to the organisation such as agency workers, locums and contractors. 

This review undertaken in March 2023 is guided by the NHS complaints procedure and adopts a patient focused approach to complaint handling in accordance with the National Health Service Complaints policy (2022) along with previously referenced guidance.

At Connect healthcare, the responsible person for Complaints is the Lead Development Nurse,  ( Complaints Manager )who is responsible for ensuring compliance with the complaints regulations making sure action is taken as a result of the complaint.

 Complaint versus a concern

There is no difference between a “formal” and an “informal” complaint. Both are expressions of dissatisfaction. 

It is the responsibility of the complaints manager to consider whether the complaint is informal and therefore early resolution of an issue may be possible. If the complaints manager believes an issue can be resolved quickly then this organisation will aim to do this in around 10 working days and, with the agreement of the enquirer, importantly we will categorise this as a concern and not a complaint. 

However, if the enquirer is clear that they wish to make a formal complaint then the organisation will follow this complaints policy in full.

Complainant options

The complainant, or their representative, can complain about any aspect of care or treatment they have received at Connect Healthcare to:

  • This organisation via the Lead Development Nurse or Member of the Senior Management Team
  • NHS England: Telephone 03003 112233, email england.contactus@nhs.net

Who can make a complaint?

A complaint may be made by the person who is affected by the action, or it may be made by a person acting on behalf of a patient in any case where that person: 

  • Is a child (an individual who has not attained the age of 18)

    In the case of a child, this organisation must be satisfied that there are reasonable grounds for the complaint being made by a representative of the child and furthermore that the representative is making the complaint in the best interests of the child.

  • Has died

    In the case of a person who has died, the complainant must be the personal representative of the deceased. This organisation will require to be satisfied that the complainant is the personal representative.

    Where appropriate we may request evidence to substantiate the complainant’s claim to have a right to the information. 

  • Has physical or mental incapacity

    In the case of a person who is unable by reason of physical capacity or lacks capacity within the meaning of the Mental Capacity Act 2005 to make the complaint themselves, this organisation needs to be satisfied that the complaint is being made in the best interests of the person on whose behalf the complaint is made.

  • Has given consent to a third party acting on their behalf

    In the case of a third party pursuing a complaint on behalf of the person affected we will request the following information:

    • Name and address of the person making the complaint
    • Name and either date of birth or address of the affected person
    • Contact details of the affected person so that we can contact them for confirmation that they consent to the third party acting on their behalf 

The above information will be documented in the file pertaining to this complaint and confirmation will be issued to both the person making the complaint and the person affected. 

  • Has delegated authority to act on their behalf, for example in the form of a registered Power of Attorney which must cover health affairs

  • Is an MP, acting on behalf of and by instruction from a constituent

Should the complaints manager believe a representative does or did not have sufficient interest in the person’s welfare, or is not acting in their best interests, they will discuss the matter with either the defence union or NHS England area complaints team to confirm prior to notifying the complainant in writing of any decision

Timescale

The time constraint for bringing a complaint is 12 months from the occurrence giving rise to the complaint or 12 months from the time that the complainant becomes aware of the matter about which they wish to complain.

If, however, there are good reasons for complaints not being made within the timescale detailed above, consideration may be afforded to investigating the complaint if it is still feasible to investigate the complaint effectively and fairly.

Complaints Verbal / In Writing

Patients can opt to complain either verbally or in writing. No matter what the cause of the complaint, all staff are to offer empathy when entering discussions with the complainant.

Patients should be made aware of the two-stage process of investigation.

Stage 1- The complainant may make a complaint to either the organisation or to NHS England.

Stage 2- If not content with either response following a full investigation, the complainant may then escalate this to the Parliamentary Health Service Ombudsman (PHSO).

Verbal complaints

If a patient wishes to complain verbally and if the patient is content for the person dealing with the complaint to deal with this matter and if appropriate to do so, then complaints should be managed at this level. After this conversation, the patient may suggest that no further action is needed. If this should be the case, then the matter can be deemed to be closed, although the complaints manager should still be informed as this needs to be added to the complaints log.

This local resolution is the quickest method of resolving a complaint and will negate the requirement for the complaint to proceed through the formal complaint process.

An acknowledgement of the verbal complaint will suffice and therefore the complaints manager does not need to subsequently respond in writing, although the verbal complaint must be recorded in the complaints log. This will enable any trends to be identified and improvements to services made if applicable. 

If the matter demands immediate attention, the complaints manager should be contacted who may then offer the patient an appointment or may offer to see the complainant at this stage. 

Staff are reminded that when internally escalating any complaint to the complaint’s manager then a full explanation of the events leading to the complaint is to be given to allow any appropriate response.

Note a verbal complaint, may simply be a concern. Should this be a less formal concern and in agreement with the enquirer the concern can be dealt with as above and recorded o the concerns log

Written complaints

Whilst this is not the preferred option due to the timescales involved in compiling a letter of complaint and any subsequent response for both the patient and the complaints manager, an alternative option can be offered for any complaint to be forwarded by letter or email to the complaints manager.

Responding to a concern

Should the complaints manager become aware that a patient, or the patient’s representative, wishes to discuss a concern, then these are deemed to be less formal and should be responded to as quickly as possible and documented on the complaints and concerns form and log 

Ensure that as much information is available at the time of the response and many of the concerns raised are not a true complaint, simply a point to note or a concern and this will still be investigated, and an answer ordinarily given within 10 working days. In doing this and with agreement with the enquirer, this would not need to be logged as a complaint as this can be dealt with as a concern.

Responding to a complaint and meeting with the complainant

The complainant has a right to be regularly updated regarding the progress of their complaint. The Lead Development Nurse will provide an initial response to acknowledge any complaint within three working days after the complaint is received. 

All complaints will be added to the complaints log 

NHS England Complaints Guidance (October 2021) advises that a meeting should be provided between the complainant and the complaints lead. However, it should be noted that whilst this is a useful guide to complaints management this is not mandatory, however probably is best practice and a better outcome can often result from a meeting.

There are no timescales when considering a complaint, simply that it must be investigated thoroughly, and that the complainant should be kept up to date with the progress of their complaint. Best practice recommendations suggest completion within 6 months  Connect Healthcare however will aim to complete any investigation within 28 working days and will communicate with the complainant giving regular agreed updates .

Investigating complaints

Connect Healthcare will ensure that complaints are investigated effectively in accordance with extant legislation and guidance.

The organisation will adhere to the following standards when addressing complaints:

  • The complainant has a single point of contact in the organisation and is placed at the centre of the process. The nature of their complaint and the outcome they are seeking are established at the outset.

  • The complaint undergoes initial assessment and any necessary immediate action is taken. A lead investigator is identified.

  • Investigations are thorough, where appropriate obtain independent evidence and opinion, and are carried out in accordance with local procedures, national guidance and within legal frameworks. 

  • The investigator reviews, organises and evaluates the investigative findings.

  • The judgement reached by the decision maker is transparent, reasonable and based on the evidence available. 

  • The complaint documentation is accurate and complete. The investigation is formally recorded with the level of detail appropriate to the nature and seriousness of the complaint.

  • Both the complainant and those complained about are responded to adequately. 

  • The investigation of the complaint is complete, impartial and fair.

  • The complainant should receive a full response or decision within six months following the initial complaint being made. If the complaint is still being investigated, then this would be deemed to be a reasonable explanation for a delay.

Conflicts of interest

The complaints manager and/or investigating clinician must consider and declare whether there are any circumstances by which a reasonable person would consider that their ability to apply judgement or act as a clinical reviewer could be impaired or influenced by another interest that they may hold.

This includes, but is not limited to, having a close association with the complained about, having trained or appraised the complained about and/or being in a financial arrangement with them previously or currently.

Should such circumstances arise, the organisation should seek to appoint another member of the organisation as the responsible person with appropriate complaint management experience.

Final formal response to a complaint

Following a full investigation, a formal written response will be sent to the complainant and will include the following ;

  • Be professional, well thought out and sympathetic
  • Deal fully with all the complainant’s complaints
  • Include a factual chronology of events which sets out and describes every relevant consultation or telephone contact, referring to the clinical notes as required
  • Set out what details are based on memory, contemporaneous notes or normal practice
  • Explain any medical terminology in a way in which the complainant will understand
  • Contain an apology, offer of treatment or other redress if something has gone wrong
  • The response should also highlight what the organisation has done, or intends to do, to remedy the concerns identified to ensure that the problem does not happen again.
  • The response should inform the complainant that they may complain to the

Parliamentary and Health Service Ombudsman (PHSO) if they remain dissatisfied.

A full explanation and apology may assist in avoiding a claim. However, if a

patient subsequently brings a claim for compensation, the complaint file is likely to

be used in those proceedings so it is important that any response to a complaint is

clear and well explained and can be supported by evidence.

The full and final response should ordinarily be completed within six months, signed by the responsible person , although should it be likely that this will go beyond this timescale, the complaints manager will contact the complainant to update and give a projected completion timescale.

Complaints involving External and Locum staff

Should a complaint be received about a member of another organisation’s staff, then this is to be brought to the attention of the complaints manager at the earliest opportunity. The complaints manager will then liaise with the other organisation’s manager.

Connect Healthcare will ensure that all locum staff, be it GPs, nurses, or administrative staff, are aware of both the complaints process and that they will be expected to partake in any subsequent investigation, even if they have left the organisation (keeping in mind the 12-month time frame to complain).

Significant Incidents

When a complaint is raised, it may prompt other considerations, such as a significant incident. SIs are an excellent way to determine the root cause of an event and benefits from the learning outcomes because of the SE.

It is advised that the complainant, their carers and/or family are involved in the SI process. This helps to demonstrate to the complainant that the issue is being taken seriously and investigated.

Fitness to practise

When a complaint is raised, consideration may need to be given to whether the complaint merits a fitness to practise referral. Advice may need to be sought from the relevant governing body such as the GMC, NMC, HCPC etc

Logging and retaining complaints and Concerns.

All complaint and concern information will be recorded by Connect healthcare in a secure IG format with limited access

A separate Complaints and Concerns log will be kept

Evidence required includes:

  • Logging, updating and tracking for trends and considerations
  • Details of all dates of acknowledgement, holding and final response letters and the timely completion of all correspondence relating to the complaint
  • Compliance with the complaints in the categories that are required to complete the annual data tool kit

Governance Monitoring

  • A copy of this procedure will be available for staff on the organisations website.
  • A display sign for patients on ‘how to raise a concern’ will be available at all clinical sites.
  • Information of raising a concern detail will be available on the patient access section of the organisations website.
  • As part of Connect Healthcare governance processes all complaints will be discussed with the Medical Director before a final response is made
  • All complaints will be monitored and reported at Connect Healthcare governance group / Board meetings.
  • Learning from complaints will be shared with colleagues as appropriate and changes made to procedures and processes to improve clinical ca