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

 

DoH

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.

Saturday, July 26, 2014

Who can make an NHS complaint

Section 5 of the Local Authority Social Service and National Health Service (England) Complaint Regulations 2009 sets out who can make a complaint.

Whilst you will find the relevant section below in laymans terms you can make a complaint if you are any of the following;-

a) a person who received the poor treatment

b) a person who might be affected by the poor treatment (for example if you have your partner was the bread winner and they can no longer work as a result of the poor treatment then you can make a complaint)

c) a person who is acting on behalf on someone who has died

d) a person acting on behalf of a child, although in this case the NHS will have to decide if the child should have made the complaint instead.

e) a person who is acting on behalf of someone who cannot make a complaint because they are physically unable to or because they lack the mental capacity to do so (in regards to mental capacity this is quite specific in that it is someone who lacks mental capacity as per the Mental Capacity Act 2005)

f) a person who has been asked to make a complaint by the person affected.

If you are representing someone and the complaints department don't think you are acting in their best interests then they do not have to investigate the complaint and should write to tell you why they think this way.

If you've been told that you can't make a complaint and fit into one of the categories above then you might try the complaints department again. If that doesn't work you can complain to the Health Service Ombudsman about the fact your complaint isn't going to be investigated.


Persons who may make complaints
5.—(1) A complaint may be made by—
(a) a person who receives or has received services from a responsible body; or
(b) a person who is affected, or likely to be affected, by the action, omission or decision of
the responsible body which is the subject of the complaint.
(2) A complaint may be made by a person (in this regulation referred to as a representative)
acting on behalf of a person mentioned in paragraph (1) who—
(a) has died;
(b) is a child;
(c) is unable to make the complaint themselves because of—
(i) physical incapacity; or
(ii) lack of capacity within the meaning of the Mental Capacity Act 2005(a); or
(d) has requested the representative to act on their behalf.
(3) Where a representative makes a complaint on behalf of a child, the responsible body to
which the complaint is made—
(a) must not consider the complaint unless it is satisfied that there are reasonable grounds for
the complaint being made by a representative instead of the child; and
(b) if it is not so satisfied, must notify the representative in writing, and state the reason for
its decision.
(4) This paragraph applies where—
(a) a representative makes a complaint on behalf of—
(i) a child; or
(ii) a person who lacks capacity within the meaning of the Mental Capacity Act 2005;
and
(b) the responsible body to which the complaint is made is satisfied that the representative is
not conducting the complaint in the best interests of the person on whose behalf the
complaint is made.
(5) Where paragraph (4) applies—
(a) the complaint must not be considered or further considered under these Regulations; and

(b) the responsible body must notify the representative in writing, and state the reason for its
decision.
(6) In these Regulations any reference to a complainant includes a reference to a representative.

Wednesday, July 23, 2014

Averil Hart

Just a quick post in regard to a new blog I have added to the list on the right, that of Averil Hart, who passed away in early 2013. Read her fathers blog about how he is getting on with his NHS complaint here.

Monday, July 21, 2014

Don't make a complaint in haste

When something goes wrong it's tempting to make a complaint while everything is fresh in your mind. What's wrong with this you might ask? Well when something has just gone wrong your also likely to be angry or upset, you may well want the NHS service involved to know how you feel immediately, to put things right straight away. Whilst there certainly isn't anything wrong with this in principle making a complaint in haste might mean you rush over certain points that you later regret.

So before you start hammering out your email or putting your pen into overdrive take a deep breath and think about the following questions; -

1. Are you clear about what you want from your complaint, if it's damages for medical negligence then perhaps you should speak to a solicitor first. If you are clear then make sure you tell the NHS service involved what you want from the complaint, don't expect them to read minds or indeed go to that much effort to find out.

2. Would requesting the medical notes notes first help you make your complaint?

3. Would it be worth looking at the NICE guidelines, the NHS Constitution and / or the GMC Code of Practice? If you think they've done wrong then pointing out how you believe the individual or organisation you are complaining about broke the relevant guideline or best practice principle might well help your complaint.

4. Are you sure about all the times and dates that might be relevant to your complaint? Would it be worth just checking them first?

5. Do you have an idea about how to put what you are unhappy with into a easy to read, effectively made complaint?

If having thought about these questions you decide not to make the complaint straight away then it can be an idea to just scribble out any dates, names, incidents that might be relevant whilst they are fresh in your mind. Then after you've done your research, had a think about what you want from your complaint and how to put it in a letter you can come back to your notes and put it all together.

Wednesday, July 16, 2014

Get an advocate to help with your NHS complaint

By law a person who wants to make a complaint about an NHS provided service is entitled to have an advocate to assist them. Such assistance is free and available to everyone regardless of your income.

Since April 2013 Advocacy services have been commissioned on a Local level either by your County Council or City Council (depending on where you live).

Advocates can provide practical support and assistance in making a complaint. If you need help with such things as drafting a letter, need guidance on the complaints procedure, or want someone to attend a Local Resolution meeting then you may wish to contact your local Advocacy service. Please note however that Advocacy services do differ as what they will assist with.

Also it is worth remembering that Advocates do not offer medical or legal advice, this is not their role. Rather they are there to explore what options you might have with regard to your complaint and offer you practical assistance and support in making it.

If you do not know who your local advocacy service is then you might wish to contact your local Healthwatch or Hospital complaints department and they should be able to point you in the right direction.  

Monday, July 14, 2014

Tip for the day - Keep your receipts

If the NHS do something wrong and you incur out of pocket expenses, like getting a taxi to an appointment that you later find out was given to you on the wrong day, then you can make a complaint to ask for compensation. You should not have to take legal action for compensation (as opposed to damages for medical negligence) as the compensation is merely putting you back into the financial situation had the NHS error not happened in the first place.

One of the reasons for not paying compensation is that you haven't got the receipts. Whilst you shouldn't need receipts and the PHSO may not think it appropriate for the NHS to ask for them if it gets that far it's easier if when you think that you are incurring any out of pocket expenses as a result of an NHS error to keep all of your receipts.

Tuesday, July 8, 2014

BBC article on NHS complaint satisfaction

An interesting if not somewhat depressing article on the BBC website today regarding people's satisfaction with the NHS complaint's process. The first part of the article from Nick Triggle is quoted below. 

The NHS still has a long way to go to improve the way it handles complaints, although there are signs of improvement, a survey suggests.

The NHS has been heavily criticised over its complaints system in the wake of the Stafford Hospital scandal.

The poll of 4,000 people in the UK by Populus for consumer group Which? found just a quarter were happy with the way their complaint had been handled.

But this was a rise from 16% two years ago.

The survey showed more than half felt their complaint had been ignored - more than in other parts of the public sector - and 43% were "dissatisfied" with the outcome.

But four in 10 who have had a problem reported not even complaining - although this was again a slight improvement on the picture two years ago.

The comments are quite interesting but mostly about whether people should make a complaint or not rather than the actual process of making a complaint. 

What many NHS complaints departments don't seem to realise is that by poorly handling complaints ie by not acknowledging the complaint, by not keeping the complainant informed of any delays etc then the less likely it is that the complainant will be satisfied with the response. 

Poor complaint handling in my experience increases the chance that a complainant who started off just wanting an apology and an assurance that it wouldn't happen again will decide they want compensation as well. 

The handling of a complaint isn't rocket science, it just requires some decent administration and staff who value the complaints being made.

Regardless of what the NHS actually put in the response if they could just handle how they take and then deal with the complaint they could save themselves a lot of trouble.

Friday, July 4, 2014

NHS Complaint Timescales

When making an NHS complaint in England it is important to note that there are timescales involved. If you take to long to make your complaint it may not be dealt with.

The Local Authority Social Services and NHS Complaints Regulations (England) 2009 at 12. states the following; -

Time limit for making a complaint

12. (1) Except as mentioned in paragraph (2), a complaint must be made not later than 12 months after-

(a) the date on which the matter which is the subject of the complaint occurred; or

(b) if later, the date on which the matter which is the subject of the complaint came to the notice of the complainant.

(2) The time limit in paragraph (1) shall not apply if the responsible body is satisfied that-

(a) the complainant had good reasons for not making the complaint within that time limit; and

(b) notwithstanding the delay, it is still possible to investigate the complaint effectively and fairly.

Therefore this means that if you make an NHS complaint within 12 months of either when the incident happened or when you knew you had a cause for a complaint the NHS should investigate it.

But what does 'when you knew you had a cause for a complaint mean' I hear some of you ask. Well let's say you have an operation and a surgeon leaves something inside your stomach. You wake up and for the next two years everything is fine. Then one day you start suffering from stomach pains. You go to the doctor and eventually find out that a swab from your operation was the cause of all the problems. Although two years have elapsed you can still complain as the 12 month time limit starts from when you found out that a swab had been left in you.

As per (2) (a) and (b) of the Complaint regulations you can still make a complaint outside of the 12 month time limit. In these cases you will should explain why you have made the complaint outside of the limits ie you may have been recovering from a mental or physical health problem that prevented you from complaining. You should note however that if because of the delay in making a complaint it is not possible to effectively and fairly investigate your complaint, say because the staff member has left, your complaint might not be investigated.

 


Thursday, July 3, 2014

Welcome

Welcome to the NHS Complaints blog. Making a complaint about an NHS provided service can be a daunting task. From the time it takes, to the barriers you may face, to the lies you might be told, to the stress that it creates making a complaint can be like running a marathon, backwards, blindfolded, on one leg, whilst carrying a fridge.

The aim of this blog is to try and remove some of the obstacles in making a complaint. The aim is to have links to organisations that can provide help and support in making your complaint. Furthermore I will endeavour to give hints and tips that might make making a complaint more effective.

I would also like to hear about your experiences in making a complaint and what help you might like to share with others.

Thanks for reading and good luck with your complaint.