Background
The system for resolving complaints made by patients changed on 1st April 1996. The key element of the new NHS Complaints Procedure was that it changed the emphasis on investigation from the Health Board to the individual practice, and placed a requirement on practitioners to institute a speedy and effective investigation designed to address the complaint as close as possible to the point it occurred. This revised complaints procedure is known as Local Resolution and required the setting up of an approved in-house complaints procedure in every practice. Only if the Local Resolution system has been exhausted does the complaint progress to an Independent Review.
The Criteria
The procedure must be practice-based. Everyone working within the practice should understand how the system works.
One named person should be nominated to administer the procedure. A deputy should also be nominated. The names of the Complaints Officer and deputy should be clearly displayed in the surgery so that both staff and patients are aware of contact points.
The procedure should be given publicity and written information given to any enquiries. It should be clear how to lodge a complaint and with whom.
Complaints should normally be acknowledged within 2 working days. An explanation should normally be provided within 10 working days. Acknowledgement should include a statement of the grounds of the complaint as the practice understands it.
The Procedure
A patient, or representative of a patient, may register a complaint by letter, by telephone, or in person. In the first instance the recipient of the complaint should:
If it is by letter, pass it immediately to the Complaints Administrator (usually the Practice Manager).
If it is by any other means, advise the Complainer of the procedure and refer him/her immediately to the Complaints Administrator, not attempting to resolve the matter further, unless it is a very simple matter which can easily be resolved.
A suitable time and place should be arranged with the Complainer for a meeting with the Complaints Administrator to discuss the complaint.
If the complaint is not by letter detailed notes should be made of what the Complainer has to say and the Complaints Administrator's response.
Detailed notes of any meeting with the Complainer should be kept. If it is appropriate, do not be afraid to express regret for the circumstances which prompted the complaint. This does not mean liability has been admitted or that you agree with the patient's perception of events, but may be all that is necessary to resolve the problem.
Information should be given to the Complainer about the procedure. This should include:
How the complaint will be dealt with.
The purpose of the procedure.
The anticipated timescale.
Time limits for making complaints.
Possible outcomes.
Availability of help from the Local Health Council or Health Board.
How to pursue the complaint with the Health Board if the Complainer remains dissatisfied with the in-house procedure.
Rules of confidentiality.
These details should be covered in a Complaints Leaflet, which should be given to the Complainer at the earliest possible opportunity.
Every complaint must be acknowledged within two working days.
The practice or the Complainer may ask the Health Board for Independent Conciliation or help, if this is considered useful.
Complainers should receive a written response, normally within 10 working days of the original contact with the practice.
The response to the complaint should clearly advise of the Complainer's rights to pursue the matter further with the Health Board and where to write to, to do so.
Records
It is important that records are kept of all complaints, investigations and outcomes. The Health Board will require this information if it is asked to investigate a complaint further.
Confidentiality
Where the person complaining is not the patient, you should obtain written consent from the patient for the complaint to be dealt with on his/her behalf, unless they are incapable (because of illness) of providing this. In the case of deceased patients, an appropriate family member or friend may act, provided the next of kin are happy with this arrangement.
Notification to Registered GP
Where the complaint concerns administrative matters, or treatment provided by another doctor who is not a Registered Principal (e.g., a locum working for the practice), it is advisable to inform the patient's registered general practitioner of the complaint. Any further proceedings by the Health Board, in these circumstances, will be taken up with the registered general practitioners, and they may wish to handle the initial complaint themselves.
Further Advice
Further advice on complaints handling can be obtained from Mrs P McCamley at Greater Glasgow Primary Care NHS Trust.