NHS complaint procedure & Duty of Candour

Question 1

What is the aim of the complaint procedure?

Answer 1

To provide a simple, responsive way of tackling complaints, w/ goal of improving the level of service provided by NHS

Question 2

What are the 3 tiers of response to complains?

Answer 2

1. Local resolution
   2.Independent review
   3.Ombudsman

Question 3

Explain the first tier of the complaint procedure?

Answer 3

1. Local resolution:

• most complains should be dealt w/ at local level
• involves person whom the complain was made responding either in writing or in person to the complaint
• Hospital Trusts provide lay conciliator to facilitate such meetings

Question 4

Explain the second tier of the complaint procedure?

Answer 4

2. Independent review:

• complaint not satisfied by local resolution can request independent review

-All trusts have a complaints convenor- decided whether to set up independent review panel or return complain to local level

• no automatic right to independent review - complain must state a case for why local resolution was unsatisfactory
• Panel consists of 3 lay members advised by clinical specialists- function of panel is to investigate complaint & make report setting out conclsuions
• Report is sent to Chief Executive of the trust- who writes to complainant informing them of any action that is being taken as result of panel

-Chief executive decides if they want to refer case to professional body e.g. GMC or initiate their own disciplinary procedures.

Question 5

What is the 3rd tier of the complaint procedure?

Answer 5

Ombudsman:

• A civil servant, independent of NHS, who is responsible for reporting to parliament about running of NHS
• Up to ombudsman whether or not to further investigate any complaints
• W/in his power to ask healthcare professionals involved in complain to appear before parliamentary select committee to give their account of subject

-This procedure provides no avenue for complaint to be compensated- patient needs to use civil justice system for that

Question 6

What is duty of candour?

Answer 6

Requires doctor to be open & honest when something goes wrong in the care of a patient or has potential to cause harm or distress.

Question 7

What is required from the doctor as part of duty of candour?

Answer 7

• Honesty- acknowledge incident
• An apology
• An explanation of what happened & why (needs to be truthful & timely)
• A plan to redress any harm that has resulted from the error
• An explanation of what steps are being taken to ensure the same error does not happen again (to the patient or anyone else)
• Empathy- Listen to the patient’s or relative’s concerns & show that you are listening
• Reassurance that their care will be unaffected

Question 8

What do complaints result from? Impact culture has?

Answer 8

Patients from minority cultures get poorer healthcare than others of same socio-economic status, even when they speak same language
- consultations are shorter w/ less engagement of patient by clinical
- cultural issues may affects patients behaviour e.g. willingness to discuss sensitive topics
- if interpreter required, should not be family member.