Information updates June 2016 to be revised March 2017 Source of Information: see pages 9, 10, 12, 13, 14 and 15
‘How to make a Complaint’
What we do Page | 1
We are an independent charity and our motto is listening to Patients, Speaking up for Change. We gather thousands of stories each year about people's experiences of using health and social care services. We use this knowledge to campaign for real improvements across the UK. We press health and social care organisations to involve patients in decision-making and to listen and respond to their complaints in a positive way. We believe that patients and service users should be involved as full partners in any decision that affects them. We believe in the power of using people's personal stories to illustrate what is working and what is not working in our health and social care system.
How we help patients and service users We gather your opinions by carrying out surveys, focus groups, and listening events. We also get feedback from our Helpline and from our Ambassador Network of volunteers. We build campaigns from the issues that matter most to you. We target our campaigns where we can make the biggest difference – at politicians, the media, civil servants, other charities, and professional organisations.
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How we help health and social care organisations
You will be charged a local rate. If a phone provider does charge, we are happy to return calls.
We help health and social care organisations to listen to their patients and service users in ways that mean people feel their opinions and concerns are welcomed and valued.
The Helpline will give you information about health and social care services as well as gathering your views about health and social care services.
Patients and service users trust us because of our independence and our experience. If we work with an organisation, they can expect to hear the real truth about how their services are experienced by the people that use them. They will also get lots of positive ideas about what changes are needed. This 'listening' work usually results in the organisation taking positive steps to plan and design better services for the future. Our Project Managers work alongside them in the role of a critical friend, helping them to find ways to involve patients and service users in an honest and open way that puts them at the very centre of the services they use.
You can contact our helpline on: 0845 608 4455/020 8423 8999 See our website for a wide range of advice and information:
Contents Introduction ............................................... 4 Page | 3
Your Rights ................................................ 4 What to expect when you complain .............. 5 Three Steps to a Successful Complaint ......... 5 Step 1 – How Can I Make an Informal Complaint? ............................................... 6 Step 2 – If That Doesn’t Work How Do I Make a Formal Complaint? .................................. 7 What can I do if my complaint is about something serious and I think a healthcare professional has behaved below professional standards? .................................................8 Professional bodies contact details and their powers ...................................................... 9 Can I complain about something that happened months or years ago? ................ 10 Tips for making a healthcare complaint ....... 11
Step 3 What should I do if they are slow to act or I am not happy with what they are telling me? ....................................................... 12 If I want compensation when should I take legal action to get it? ................................ 13 What if I am still not satisfied after I’ve gone through all three steps? .............................13 Help with healthcare complaints ........................ 14
Most patients and their relatives are happy with Page | 4 their healthcare but sometimes things go wrong. When this happens, you need to know how to complain effectively. This guide sets out the options you have to make sure your complaint is treated properly. It focuses on hospital and GP care but also has some advice about other healthcare professionals, such as care homes.
The NHS Constitution guarantees your right to complain. You have the right to have your complaint investigated properly and you can take it to the Parliamentary and Health Service Ombudsman if you’re not satisfied (see the section on ‘What should I do if they are slow to act or if I’m not happy with what they tell me?’ below).
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What to expect when you complain
Three Steps to a Successful Complaint
Don’t be afraid to complain.
Must be dealt with efficiently Must be properly investigated
You should: • • • • •
Be treated with respect and politeness Receive, as far as possible, help to understand the process or advice on where to find help Receive a suitable reply with no unnecessary delay Be told what has been decided about your complaint Be told what has to be done to make sure services is improved as a result of your complaint
You should always complain if you are unhappy with your treatment or care. Never be put off because you don’t want to make a fuss or get someone into trouble. Complaints are important to healthcare providers. They help them find out about their mistakes and improve what they do for you and everyone else.
Your rights are protected by law but you are much more likely to get what you want if you follow a few simple rules. First of all, you need to know the different steps or stages in the complaints process. Step 1 – Try an informal approach first – that may be all you need to put things right. Step 2 ─ Use the healthcare provider’s formal complaints system. Step 3 – If you are still not satisfied, write to the Parliamentary Ombudsman. These steps are described in more detail below. At every stage you should stay calm and be polite. It’s worth saying what’s worked well alongside the things you are complaining about. If, after all this, you think your complaint has been handled badly, you can ask for a Judicial
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Review – a chance for a judge to look at how a decision on your complaint was made and whether it was done fairly). If you have any questions about what’s in this leaflet, please contact The Patients Association Helpline, 0845 608 4455/020 8423 8999. We aim to help you with your complaint. That can include talking about your worries with your care provider, and supporting you through the complaints process.
Step 1 – How Can I Make an Informal Complaint?
Phoning our Helpline 0845 608 4455/020 8423 8999, could be a useful first step. Making a complaint can seem complicated. We can help you understand how the system works. We can help you decide what you want to happen as a result of your complaint. It’s always best to try to sort out your complaint by speaking to the people involved first. Healthcare professionals on the spot might be able to deal with the problem straight away. To start with, you should speak to the Practice, Ward or Care Home Manager or the lead doctor or nurse in charge of your care. If your complaint is about a GP surgery, you should always talk to your GP or the Practice Manager first. If you are not sure where or how to start, the Patients Association can help you contact the healthcare provider.
Step 2 – If That Doesn’t Work How Do I Make a Formal Complaint? Page | 7 All healthcare providers have a policy and a
system for dealing with complaints. It should cover your rights, listed in Box 1 above. Ask to see a copy of the healthcare provider’s Complaints policy and details of how to complain.
Although you should always try an informal approach first, you can make a formal complaint at any time. (But some organisations have time limits so it’s best to act fast). You should use the formal complaints system for your provider and also copy your complaint to senior managers – see our list of suggested contacts below. GP Surgery: The Practice Manager. If you want to complain about the Practice Manager, talk to your GP first so that someone else knows you are complaining. Practice Reception (or the surgery website) can give you information about how to complain.
NHS Hospitals: The Chief Executive or Medical Director. They will probably pass your complaint to their Complaints Manager but it is useful if senior staff know about your complaint. Private Hospitals: Private Hospitals have their own complaints systems. We think the best way to start is the same as for NHS hospitals – make sure that senior managers, such as the Chief Executive or Medical Director, know you are complaining. Care homes: You should complain to the Director of the Care home. (If any of the care home fees are paid by the Local Authority, you can also contact them). Social Services: Complaints about adult or children’s care services should be handled by the Local Authority. You should follow their complaints procedure and copy the complaint to the Authority’s Chief Executive. You can get a name and contact details from their switchboard or website. Or, if you call our Helpline we will be happy to help find the details you need.
If you think your complaint about NHS services hasn’t been dealt with fairly or quickly enough, you can complain directly to the Clinical Page | 8 Commissioning Group (CCG) in your area. They organise and fund healthcare services in England. The provider should be able to tell you which CCG they work with and give you contact details. The Care Quality Commission (CQC), which inspects hospitals and care homes, is also keen to hear from patients and their families about what is not working well – see the contact details listed under Help with healthcare complaints below
What can I do if my complaint is about something serious and I think a healthcare professional has behaved below professional standards?
You should contact the professional body for that healthcare person (see Box 2 for contact details of major healthcare bodies). Each one has its own rules about complaints and you need to contact them directly to find out if they can deal with your complaint. Or you can speak to our Helpline and we will do our best to help you.
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Professional body contact details:
someone from the professional register.
The GMC can:
(The NMC has no time limit for complaints, but you should complain as soon as possible.)
Most other health professionals:
The HCPC can investigate complaints about a wide range of professionals, for example chiropodists, hearing aid dispensers, radiographers and social workers in England.
General Medical Council Regent’s Place 350 Euston Road London
NW1 3JN Telephone: 01619236602 http://www.gmcuk.org/concerns/23339 .asp
Nurses and Midwives Nursing and midwifery council 23 Portland place London W1B 1PZ
Stop of limit a doctor’s permission to work in medicine in the UK Post a warning on the doctors record for up to 5 years
It cannot Pay compensation to make a doctor pay a fine • Force a doctor to apologise or give you the treatment you want. (Normally, you have up to 5 years to make a complaint to the GMC) •
The council can use several penalties, from a 1 year caution (which future employers can see) to suspensions and removing
Health and care professionals Council Park House 184 Kensington Park Road London SE11 4BU Telephone: 0800 328 4218 Email: hpcuk.org/complaints
For a complete list see: Http://www.hpcuk.org/aboutregisteration/pr otectedtitles/
(Like the NMC, the HPC has no time limit, but you should complain as soon as possible)
Can I complain about something happened months or years ago? Page | 10
That depends on the type of complaint. NHS: Normally, you should complain within 12 months of the events concerned (or 12 months from the date on which you found out about them). Healthcare providers should deal with any complaint they receive inside that 12 month time limit. If your complaint is older than 12 months they can choose not to deal with it, but they should be flexible ─ for example, if you had a major injury and it took you a long time to be well enough to complain.
Private care: The system is different for different providers. You will need to check with your provider how their complaints system works. Some private care providers are registered with the Independent Healthcare Advisory Service (IHAS). If the provider you want to complain about is a member and you are unhappy about how they’ve dealt with your complaint, you can contact IHAS. They use a range of penalties, including removal of membership. They can be contacted on 020 3713 1740. Ideally you should complain as soon as possible, while events are still fresh in everyone’s minds.
Tips for making a healthcare complaint Keep detailed notes. Page | 11 Healthcare complaints can become confused and complicated very quickly. Keep detailed notes so that you are always sure of the facts and dates. Make the notes and letters you send to others short and to the point (but always polite). Your complaint may be part of a much longer story of unhappiness with a provider. You can help the investigator focus on what really matters by cutting out anything that isn’t relevant to the incident / events at the centre of your complaint. But don’t forget to include essential details: • • • • •
Patient’s name Date of birth NHS number Place where the events you are complaining about took place. When they happened ─ the date and time of day, if you know them, or a date range (for example sometime between 10th and 17th November) if you’re not certain
Who was involved in the events. Who saw / knew what happened.
Say what you want to happen Modern hospitals want to learn from what isn’t working. They want to know if their care falls below what people expect. If this is all you want them to do, they may be able to agree with your complaint quite quickly. If you want more than that (for example, you would like them to improve staff training in a particular area), you should say so. They can then look at your request in detail. Help them to help you Healthcare complaints can be extremely emotional, and many people find it hard to make them. However, if the provider contacts you with questions and needs a speedy reply, you should do your best to help them. If you don’t there may be delays in getting a final answer to your complaint. Get a copy of your medical records Get a copy of your medical records as soon as you can. This is very important. You want to be sure that
you have all the evidence you need to back up your complaint (we have callers who say that parts of their medical records have gone missing after they Page | 12 complain). You are legally entitled to apply for a full copy of your records – look at our advice on Seeing your Medical Records or call our Helpline on 0845 608 4455/020 8423 8999. Get the help and support of friends and family It is always a good idea to discuss complaints with a professional or expert, but your friends and family can give you the emotional support that you really need at stressful times. Talking about it with loved ones can help you decide what you want to get out of a complaint and help you cope with any distress.
Step 3 – What Should I Do if they are Slow to Act or if I’m Not Happy with what they Tell Me? The Parliamentary and Health Service Ombudsman (PHSO) can investigate your case if you meet their very strict rules. Your complaint must be about NHS care or other services from government departments. They won’t investigate unless the care provider has had the chance to put things right first. So you need to show that you have tried complaining to the provider and that you gave them a reasonable time to reply before contacting the PHSO. You can find out more about the PHSO process by visiting their website http://www.ombudsman.org.uk/ or by contacting their Helpline on 0345 015 4033.
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If I want compensation, when should I take legal action to get it?
What if I Am Still Not Satisfied After I’ve gone Through All 3 Steps?
You can make an NHS complaint at the same time as taking legal action. But if you take legal action at the same time as the complaint goes to the PHSO, the Ombudsman can’t investigate. The Ombudsman’s investigation can restart when the lawsuit is over.
If you are still not happy once a decision has been taken by the PHSO or a professional body you can ask for a Judicial Review (see the advice on finding a specialist lawyer above). This will look at the decision of the NHS body or the Secretary of State for Health and whether it was made unlawfully.
You can get a list of lawyers near you who specialise in medical matters from The Law Society on 020 7242 1222 or at http://solicitors.lawsociety.org.uk/.
Help with healthcare complaints
The Care Quality Commission (CQC)
The Patients Association
The Care Quality Commission inspects many healthcare providers and is interested in improving standards over a wide range of healthcare provision. They can be contacted at 03000 616161 and there is a lot of useful information on their website http://www.cqc.org.uk/content/complainabout-service-or-provider
Page | 14 The Patients Association Helpline may be able to help you talk to your hospital, GP, Dentist or Social Care Provider. As a small independent charity we can’t get involved in detail for everyone who comes to us but we can often talk to care providers on their behalf. Please call 0845 608 4455/020 8423 8999 if you think this would help you. Independent Complaints Advocacy Service (ICAS) ICAS was set up to help patients through the complaints process. ICAS can offer you support, talk you through the complaints process and attend meetings with you and the hospital administrator. This service is only for NHS complaints. Contact ICAS at 01273 229 002 or visit their website at http://www.bh-impetus.org/projects/independentcomplaints-advocacy-service-icas/
Citizens Advice Bureau The Citizens Advice Bureau has information and advice for those with complaints about healthcare. For advice, or to find your local branch please call 03444 111 444 or visit their website at https://www.citizensadvice.org.uk/
Healthwatch Healthwatch is a consumer champion for healthcare. Contact them at 03000 68 3000 or see http://www.healthwatch.co.uk/find-localhealthwatch
NHS Complaints Advocacy Services NHS Advocacy services can support you and talk Page | 15 you through the complaints process, helping with correspondence and attending meetings. Services are based in each local council area. To find your local service, you can call them on 0300 330 5440 or see http://nhscomplaintsadvocacy.org/ Patient Advice and Liaison (PALs) The PALs service varies a lot from hospital to hospital. However, PALS can be a useful source of information and support. They should be able to help you find out about their own hospital complaints service. Check the contact details on the hospital website or use the service finder at http://www.nhs.uk/ServiceSearch/Patient%20advice%20and%20liaison%20se rvices%20(PALS)/LocationSearch/363
The Patients Association PO Box 935 Page | 16 Harrow Middlesex HA1 3YJ
020 8423 9111 Helpline: 0845 6084455/020 8423 8999 [email protected]
www.patients-association.com We welcome your feedback on this leaflet Registered charity no. 1006733 Published by The Patients Association, Harrow.