Tuesday, August 26, 2014

Complaints, Parking and NHS Parking Guidance

On 23rd August 2014 the Department of Health published guidance on parking charges for all NHS organisations to follow.

The guidance can be found HERE and on the right under 'Information to Help your complaint'

One small tip in that if you are attending a meeting at an NHS organisation in regard to your complaint then ask the organisation if you can have your parking fee waived. You may have to push for this but given that you may well have to be attending a meeting because of an NHS error then you shouldn't really have to pay to attend.

Thursday, August 21, 2014

Revised Serious Incident Framework

Further to my previous post in regard to when an independent investigation might be appropriate I have received an answer as below from the DoH


Dear Mr X,

Thank you for your correspondence of 4 August about the Serious Incident Framework. I have been asked to reply.

I note your concerns about updating the Serious Incident Framework to reflect Recommendation 115 of Robert Francis’ report on the Mid Staffordshire NHS Foundation Trust public inquiry.
Recommendation 115 states that ‘Arms-length independent investigation of a complaint should be initiated by the provider trust where any one of the following applies:
- A complaint amounts to an allegation of a serious untoward incident;

- subject matter involving clinically related issues is not capable of resolution without an expert clinical opinion;

- complaint raises substantive issues of professional misconduct or the performance of senior managers; or

- a complaint involves issues about the nature and extent of the services commissioned.’

The Serious Incident Framework, which was published by NHS England in March 2013, makes clear that the level of investigation required following a serious incident will vary according to the severity of the incident, and that the need for an independent investigation must be determined in conjunction with the relevant commissioner.

As you correctly point out, the current Framework is a working draft. However, a revised draft is currently being developed by NHS England in partnership with providers, commissioners, regulators, and other experts. The final version of the Framework will be published in the autumn.

This review has been undertaken in order to ensure that the Framework is fit for purpose as an authoritative reference document that describes a nationally consistent set of principles that can be applied to the management of serious incidents within different healthcare settings, and is relevant to all NHS-funded care in the primary, secondary and tertiary sectors.
Once approved, the revised draft will replace both the National Framework for Reporting and Learning from Serious Incidents Requiring Investigation, which was issued by the National Patient Safety Agency in March 2010, and the current version of the Framework.

I hope this reply is helpful.

Monday, August 11, 2014

Unhappy with your first response? The next stage

So you've made a complaint and got your response.

You aren't happy with it.

What do you do next?

Well as per THIS post you are unlikely to be able to go the Parliamentary and Health Service Ombudsman and as such you will need to put why you are still unhappy back to the NHS body involved. The NHS body may well offer you a Local Resolution meeting or if you prefer a further written response. You can usually request a meeting without the need for a formal letter, but see below regarding an agenda.

In order to try and make the best of this next step try to be as prepared as possible by considering the following.

1. Could you benefit from your free local NHS complaints advocacy organisation? They might be able to attend a local resolution meeting with you or a follow up letter. They could also support you in going to the PHSO if you need it.

If you don't want to get help from an advocate ask if you can take a friend with you for support.

2. If you haven't got your medical notes now might be the time to get them as they might help you compose your response to the Trust or help you at your Local Resolution meeting

3. If you have been offered a local resolution meeting then make it clear what you want to discuss. This could be done by setting a clear agenda with questions sent to the NHS body in plenty of time.

4. As hard as it might be don't get angry at a local resolution meeting, it rarely helps and you might well regret it afterwards.

5. If you want a local resolution meeting then find out if they will record it and if you can have a copy of it. Some Trusts do this, some don't but will if you ask them. Some will just refuse and send you the written minutes of the meeting.

6. Don't wait too long before doing any of the above. The PHSO may take this into account if you don't complain to them within 12 months of when the incident you are complaining about happened or when you became aware of it. Remember the 12 months the PHSO gives you is NOT from when you finish the local resolution process.

Thursday, August 7, 2014

NHS Whistleblowing

If you don't know about it then 'The freedom to speak up review', lead by Sir Robert Francis QC, has just been set up to look into creating an open and honest reporting culture in the NHS.

Many whistleblowers have websites and twitter accounts but it can be quite hard to find them so I've tried to put together a few links so you can read more about their experiences of whilstblowing, which really are quite terrible. The links can be found below and in a new column on the left.

Clinical Concerns

David Drew

Kay Sheldon

Dr Kim Holt (Patients First)

Sharmila Chowdhury

Friday, August 1, 2014

Independent NHS complaint investigation and the curious case of recommendation 115

One quest is to get the NHS to offer an independent investigation into a complaint where appropriate.

Recommendation 115 of the Francis report and the Government response discusses when an independent investigation might be appropriate.

As part of the response it states that the Serious Incident Framework (last published March 2013) would be updated to reflect the Francis recommendations. It doesn't seem to have been. I may be missing something so I've written to the DoH as below.

                                                                                      1st August 2008



By Email attachment


Dear Sir / Madam


In the government’s response to the Francis Report delivered on 26th March 2014   recommendation 115, regarding complaint handling, stated that the working draft of the Serious Incident Framework published in March 2013 would be updated to reflect the recommendation as below


‘Depending on the nature of a complaint, fully independent investigation of the serious incident by an external team may be appropriate. However in some cases, particularly where it is not clear that a serious incident has occurred, it is appropriate, particularly in the initial phase, for an organisation to undertake its own investigation using staff sufficiently removed from the incident with no conflict of interest, until such a time as the facts require an independent investigation to be commissioned. The current NHS England Serious Incident Framework is a working draft and will therefore be updated and clarified in relation to this recommendation.


The Serious Incident framework itself states that


‘This is a working draft. As the system learns and matures, changes will be made where appropriate, including in relation to any relevant actions that result from the recent report of the Mid-Staffordshire Public Inquiry’


Many complainants are still frustrated at the fact that no independent investigation is ever offered into their complaint and as such I would be grateful if you could answer the following.


1.      Has the Serious Incident Framework been updated as per recommendation 115?


2.      If not then what is the reason for this and when do you propose to update it to reflect recommendation 115?


Thursday, July 31, 2014

Beware of going to the Health Service Ombudsman too quickly

So you've made a complaint and received a response which you are not happy with.

The response letter that you have received should, by virtue of section 14 of the NHS Complaints (England) Regulations will have to mention your right to go the Parliamentary and Health Service Ombudsman (PHSO) if you are unhappy with the response.

Unfortunately what some response letters don't mention is that in most cases* the PHSO will not investigate your case if you have not put your concerns about the complaint response back to the NHS organisation involved who should then try and resolve these further concerns by either a written response or an offer of a Local Resolution meeting.

Sadly the poor wording of complaint responses can mean that people go to the PHSO to early only to get told to complete the local resolution process.

*I say most cases in that sometimes the PHSO will not expect you to get a further response. There are no specific set of circumstances where this applies but an example may be where there could be serious detrimental consequences to waiting for a further response. If you are unsure about whether you could go straight to the PHSO then give them a bell.

Monday, July 28, 2014

Make NHS Complaints Count petition

PHSOthefacts linked to a petition in regards to 'Making Complaints Count'. If you're interested in signing up you do HERE.