Single Complaints System- Unit 4 &5

The new Single Complaints System

There is now a single complaints system for all health and adult social care services. This came into effect on 1 April 2009. The new procedure is set out in the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009.

The new system covers complaints against Local Authorities, NHS hospitals, Primary Care Trusts and independent providers. GP practices are incorporated into Primary Care Trusts. These are known as “responsible bodies”.

Under the new procedure, each responsible body must make arrangements for dealing with complaints. These arrangements must ensure that:

• Complaints are dealt with efficiently;
• Complaints are properly investigated;
• Complainants are treated with respect and courtesy;
• Complainants receive, as far as possible, assistance to help them understand the procedure and advice on where to obtain such assistance;
• Complainants receive a timely and appropriate response;
• Complainants are told the outcome of the investigation of their complaint; and
• Action is taken if necessary.

Each responsible body must designate a person to be responsible for ensuring compliance with the complaints procedure. In the case of a Local Authority or NHS body this will be the Chief Executive. The responsible body must also designate a person to be a complaints manager to be responsible for managing the complaints procedure.

A complaint can be made by a person who receives or has received services from a responsible body or by a person who is affected or is likely to be affected by the action, omission or decision of the responsible body which is the subject of the complaint. A person can make a complaint on behalf of a person who has died, is a child, is unable to act because of physical or mental incapacity or if they have been asked to do so by that person.

If a complaint relates to services provided by more than one responsible body, the different organisations must co-operate with each other in handling the complaint and ensuring that the complainant receives a co-ordinated response. Each body must provide the other with relevant information and attend at any meetings which are reasonably required. Where a Local Authority considers that a complaint relates to care home standards, it must obtain the consent of the complainant before it contacts the relevant care home. If the complaint relates to social care, consent is required before details can be sent to the social care provider.

The time limit for making a complaint is 12 months from the date on which the relevant matters occurred or the date on which the matter came to the notice of the complainant. This time limit does not apply if the responsible body is satisfied that there were good reasons for not making the complaint earlier and it is still possible to investigate the complaint properly.

In many cases a problem can be dealt with quickly by speaking directly to the person involved in providing the medical treatment or care services, without the need to make a formal complaint. However, if the matter cannot be dealt with in this way then it will need to be investigated as a complaint.

A complaint can be made orally, in writing or electronically. Where the complaint is made orally, the responsible body must make a written record of the complaint and provide a copy to the complainant. The responsible body must acknowledge the complaint within 3 working days after the date of receipt. The responsible body must offer to discuss with the complainant the way in which the complaint is to be handled and the period within which the investigation is likely to be completed and a response sent. If the complainant does not wish to discuss this, the responsible body must decide itself.

The responsible body must investigate the complaint as quickly and efficiently as possible and keep the complainant informed of progress. As soon as reasonably practicable after the end of the investigation, the responsible body must send the complainant a written response which must include an explanation of how the complaint has been considered and the conclusions reached. The responsible body must also confirm that it is satisfied that action needed has been taken or will be taken. In addition, the complainant must be informed of their right to take their complaint to the Health Service Ombudsman and/or the Local Government Ombudsman if they are not satisfied with the outcome. If the responsible body fails to send the complainant the response within 6 months of the date the complaint was made, it must explain why and send a response as soon as reasonably practicable thereafter.

3. The role of the Health Service Ombudsman

In England, if the above procedures fail to resolve a complaint about health care, a complainant may appeal to the Health Service Ombudsman (officially called the Parliamentary and Health Service Commissioner). If the complaint also concerns social care then the Local Government Ombudsman will jointly review the case (see below). The Ombudsman is entirely independent of the NHS and of the Government. The Ombudsman is not obliged to investigate every complaint referred to him or her and will not generally take on a case which has not been through the single complaints procedure. He or she will not investigate a complaint which is the subject of legal proceedings. Strict time limits apply. In particular a complaint must be made within 12 months of the date of the relevant events unless there are special reasons for the delay.

The Ombudsman can investigate complaints about poor treatment or service provided through the NHS.

If the Ombudsman does find a fault has occurred with your case then they can get the organisation to:

• provide an explanation and acknowledgement of what went wrong; and
• take action to put the matter right, including giving you an apology.

Where the Ombudsman finds serious faults with the organisation they can also recommend that:

• changes are made in the way the organisation works so that similar things don't happen again;
• lessons are learnt from things that have gone wrong; and
• compensation should be made for a financial loss or for the inconvenience or worry you have been caused.

Please note that the Ombudsman does not have any formal power to enforce their recommendations but they are almost always followed.

The Ombudsman can be contacted at:
Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London
SW1P 4QP

T: 0345 015 4033
e: phso.enquiries@ombudsman.org.uk
w: www.ombudsman.org.uk.