Shipston Medical Centre takes complaints from patients and their relatives very seriously. The Medical Centre aims to investigate complaints thoroughly and learn from the outcomes of these investigations.
The complaints system aims to be:
- Open and transparent
- A simple and swift process
- A learning opportunity for the organisation
Responsible person for complaints & complaints manager: Rachel Vial, Practice Manager. Where the Practice Manager is absent the Deputy Practice Manager will be delegated to undertake the Practice Manager’s responsibilities with regard to complaints.
Information for patients
Copies of the practice Complaints Procedure Leaflet are freely available to patients from the reception desk and the leaflet rack in the clinical corridor. The complaints leaflet is also available on the practice website.
Definition of a complaint:
Any feedback from a patient where there is dissatisfaction with any aspect of the service or care received, and, if the complaint has been made verbally, resolution of the concerns cannot be resolved within 1 working day. All written feedback will be regarded as a complaint.
Where a third party without authority* makes a complaint, they will be encouraged to ask the patient to complain directly or provide written authority from the patient enabling the practice to communicate about the matter with the third party.
A third party with authority might be a parent of a child aged 15 or younger, a power of attorney etc.
Timescales for making a complaint
Complaints should usually be raised within 12 months of the event, or of the person becoming aware of the event. The practice will endeavour to investigate complaints made outside of this timescale if it is still possible to investigate the complaint effectively and fairly.
Process for handling complaints
- All patient complaints are passed to the Practice Manager (or Deputy Practice Manager when the Practice Manager is absent for a period longer than 1 day).
- The Practice Manager may seek clarification regarding the complaint from the complainant.
- Where the complainant is complaining about incidents that have affected others, confidentiality will be maintained and no specific information given without express consent from the patient whose care has warranted the complaint to arise.
- Where a complaint covers the work of other NHS organisations the complainant will have this explained to them, and they will have their understanding of the need to discuss the complaint with the other organisations checked and permission to share details confirmed
- Verbal complaints will be recorded in writing by the practice, including the name of the complainant, the subject matter and the date on which the complaint was made.
- The Practice Manager will communicate with the complainant acknowledging the complaint within three working days of receipt of the complaint and will provide information on the manner in which the complaint will be handled and the time-frame during which the complainant might expect a full response. The complainant will be given the opportunity to discuss this with the Practice Manager. Information about the practices complaints process and the local advocacy service will be sent.
- Anonymised information about significant clinical complaints complaints will be sent to NHS England in line with NHS England’s request contained in their letter dated 23rd September 2015.
- The Practice Manager will then undertake a risk assessment of the complaint. The risk assessment will inform the speed, priority and detail which is needed for the investigation.
- The Practice Manager will investigate the incident. This will involve discussing the incident with the parties involved. The Practice Manager will make notes of her investigation.
- Where the complaint involves other NHS bodies the Practice Manager will liaise with these bodies as required / pass the complaint onto the relevant organisation if the basis of the complaint is not related to the Medical Centre in any way.
- Once the incident has been investigated a letter will be sent to the complainant, which will:
- detail what happened and what went wrong
- offer an apology if appropriate
- offer an opportunity for the complainant to come into the practice and discuss the incident with the Practice Manager and/or one of the Partners if deemed useful
- detail any remedial action that is taking place to prevent a similar event occurring in the future
- inform the complainant of the next steps in the process (independent review) should they not be satisfied with the local resolution of the complaint.
This letter will be sent to the complainant within a reasonable period. Where there is a delay in the investigation for some reason, the complainant will be informed of this.
- Details of all complaints will be kept on file, separate to the patient medical notes, for 10 years, after which time they will be destroyed in a confidential manner.
- Should the complaint be referred to the ombudsman for independent review the Practice will ensure complete cooperation with the ombudsman, by providing information that is required in a prompt and honest manner. Representation from the Practice will also attend any panel investigation that is convened.
- Any report prepared by the ombudsman will be considered at length by the Partners.
- The practice will consider all complaints annually in an attempt to identify general learning points, such as themes and systemic organisational failures. This will occur at a Primary Health Care Team meeting to ensure the learning points are shared with the team.
- An annual return regarding complaints will be made to NHS England.
Persistent and Unreasonable Contact
Persistent contact may be as a result of complainants raising genuine issues and therefore it is important to ensure this process is fair.
Persistent and unreasonable contact can be difficult to define. NHS England provide a definition of persistent and unreasonable complainants in their Complaints Policy (2015) and the practice has adopted this definition as one that is reasonable and considered.
“Examples of behaviour may include those who:
- Persist in pursuing a complaint when procedures have been fully and properly implemented and exhausted.
- Do not clearly identify the precise issues that they wish to be investigated, despite reasonable efforts by staff, and where appropriate, the relevant independent advocacy services could assist to help them specify their complaint.
- Continually making unreasonable or excessive demands in terms of process and fail to accept that these may be unreasonable e.g. insist on responses to complaints being provided more urgently than is reasonable or is recognised practice.
- Continue to focus on a ‘trivial’ matter to an extent that it is out of proportion to its significance. It is recognised that defining ‘trivial’ is subjective and careful judgement must be applied and recorded.
- Change the substance of their complaint or seek to prolong contact by continually raising further issues in relation to the original complaint. Care must be taken not to discard new issues that are significantly different from the original issue. Each issue of concern may need to be addressed separately.
- Consume a disproportionate amount of time and resources.
- Threaten or use actual physical violence towards staff
- Have been personally abusive of verbally aggressive on more than one occasion (this may include written abuse, e.g. emails)
- Repeatedly focus on conspiracy theories and/or will not accept documented evidence as being factual.
- Make excessive telephone calls or send excessive numbers of emails or letters to staff.”
(NHS England 2015, page 18)
Where there is a suspicion that a complainant is making persistent and unreasonable contact the facts must be reviewed and considered against the above definitions. Consideration must be given to the complaint (s) and whether or not these has been fully considered and responded to. Consideration should be given to the state of the mental and physical health of the complainant as this may be a factor in their behaviour. A quorum of partners (as defined by the practice agreement) will consider this information and decide if the complainant should be considered to be displaying persistent and unreasonable behaviour.
Where a complainant is identified as displaying persistent or unreasonable behaviour an action plan will be developed for managing communication with the patient. This may include such actions as:
- Removal from the practice list (for example where violence against a member of the practice team has occurred)
- The channelling all communications through a named individual
- Limiting what communications take place, by time, subject or communication method
- Informing the complainant that future correspondence will be read and placed on file but not responded to
- Asking the complainant to enter into an agreement about their conduct
- Consideration of reporting matters to the police or taking legal action if warranted.
Where an action plan is put in place the complainant should be informed unless it is deemed unsafe to do so.
MPS (2009) NHS Complaints in England: Regulations and Principles London: MPS
NHS England (2015) NHS England Complaints Policy https://www.england.nhs.uk/wp-content/uploads/2015/01/nhse-complaints-policy.pdf
Department of Health (2015) The NHS Constitution for England http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx