1. Clinical Governance VTS 24.11.10

2. Clinical Governance “a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”. Liam Donaldson

3. Plan for the afternoon 14.15 - Dealing with patient complaints 14.15 - Dealing with patient complaints 15.15 – Tea! 15.15 – Tea! 15.30 – Local clinical governance structures 15.30 – Local clinical governance structures 15.45 – Patient access to records 15.45 – Patient access to records 16.00 – Appraisal and Revalidation 16.00 – Appraisal and Revalidation

4. Patient Complaints VTS Teaching 24.11.10 Tom Lawes

5. Aims and objectives Review our existing knowledge of handling complaints Review our existing knowledge of handling complaints Scenarios on handling complaints: Scenarios on handling complaints: –Face-to-face, and –Written Personal case discussions if time Personal case discussions if time

6. Complaints procedures Both a legal and contractual obligation for NHS organisations (and their contractors) to have systems in place. Both a legal and contractual obligation for NHS organisations (and their contractors) to have systems in place. New Regulations 2009 New Regulations 2009 Care Quality Commission Care Quality Commission

7. NHS Constitution Patients have the right: Patients have the right: –To have complaints dealt with efficiently and have them properly investigated –To know the outcome of any investigation –To take complaints to the Ombudsman if not satisfied with how complaints are dealt with by the NHS

8. ‘Spotlight on complaints’ Healthcare Commission 2008 GPs most common subject of complaint GPs most common subject of complaint 45% of complaints were upheld by HC 45% of complaints were upheld by HC Many complaints could be reconciled before needing secondary level investigation if dealt with appropriately. Many complaints could be reconciled before needing secondary level investigation if dealt with appropriately.

9. Complaints Quiz

10. You receive a complaint that involves your practice and a local nursing home. After investigating the complaint, how should you write your response to the complainant? a)Each organisation should write a separate response b)Each individual involved should write a response c)The organisations involved should write a single response

11. You receive a written complaint from a 20 year old patient. Within what time period should you acknowledge receipt of the complaint? a)Within three working days b)Within five working days c)Within seven working days

12. You receive a phone call from a patient who is unhappy about the care she received from another doctor at the practice. What should you do? a)Listen to the patient and record the details of the complaint b)Ask her to speak to the doctor she wants to make a complaint about c)Ask her to speak to the practice manager

13. You receive a written complaint from a 55 year old man who is a patient at your practice. After reading the complaint you find that it is about social services and not the practice. What should you do first? a)Forward the complaint to the correct organisation b)Contact the patient to explain that the complaint has been made to the wrong organisation c)Return the written complaint to the patient and ask them to contact social services

14. Which one of the following statements about why patients make complaints is correct? a)Patients usually want financial compensation b)Patients usually complain because of a perceived or actual failure to investigate or treat c)Patients often want to prevent other people experiencing the same problems

15. A 40 year old woman makes a complaint and wants to see her records. When she has gone you realise there are many letters from the hospital specialist in her records. You wonder whether you should ask this doctor for permission to copy his letters. What is the best course of action? a)You must get permission from the hospital specialist before releasing copies of his letters b)You don't need the hospital specialist's consent before releasing copies of his letters

16. Your practice recently wrote a response to a patient who made a complaint about waiting times for appointments at your practice. The patient does not feel the response has dealt with her concerns. What should you advise her to do? a)Contact the health service ombudsman b)Contact the primary care trust c)Contact the Department of Health

17. Which one of the following statements about the role of the health service ombudsman is correct? a)Patients can direct their initial complaint to the ombudsman b)The ombudsman will assess whether the patient has a valid case that needs addressing

18. A patient at your practice has made six complaints about access to the car park at your practice. You have responded to the complaint and the patient’s case was not upheld by the health service ombudsman. You feel that the patient is an unreasonable complainant. How should you manage the situation? a)Make sure one person from your practice oversees the situation b)Remove the patient from the practice list c)Contact the health service ombudsman

19. A 55 year old man has had chronic bronchitis for many years and was diagnosed with mesothelioma three months ago. He worked as an electrician for years and has also worked as a docker. He is very unhappy with the care he has received from you and from the local hospital and wants to make a complaint. He also wants to see his records. You say you will sort this out, but he wants to see the records immediately. How quickly must you comply with his request to see the records? a)You must give him a copy of the records immediately b)You must give him a copy of the records within 20 days c)You must give him a copy of the records within 40 days

20. Role-play Scenario

21. Responding to written complaints Initial response: –Should be within 3 days –Acknowledge patient’s complaint –Should offer a discussion to agree on how complaint will be handled and reasonable timescale –Otherwise give timescale in initial letter

22. Responding to written complaints Full response: Avoid being defensive Avoid being defensive Address every issue raised Address every issue raised Fully explain all findings of an investigation Fully explain all findings of an investigation Apologise where appropriate Apologise where appropriate Detail any changes being made as a result Detail any changes being made as a result Advise the patient of their right to complain to the Ombudsman if not satisfied Advise the patient of their right to complain to the Ombudsman if not satisfied

23. Investigating complaints Assess seriousness and likelihood of recurrence (low-extreme) Assess seriousness and likelihood of recurrence (low-extreme) Consider SEA or RCA Consider SEA or RCA Remember to seek consent if forwarding information to other bodies or discussing with patient’s relatives. Remember to seek consent if forwarding information to other bodies or discussing with patient’s relatives.

24. Practice arrangements Make complaints procedures freely available to patients (e.g. posters, leaflets) Make complaints procedures freely available to patients (e.g. posters, leaflets) Should have a ‘Responsible Person’ (partner) and Complaints Manager (can be same person) Should have a ‘Responsible Person’ (partner) and Complaints Manager (can be same person) Annual reports to PCT Annual reports to PCT

25. Quiz Answers

26. You receive a complaint that involves your practice and a local nursing home. After investigating the complaint, how should you write your response to the complainant? a)Each organisation should write a separate response b)Each individual involved should write a response c)The organisations involved should write a single response

27. You receive a complaint that involves your practice and a local nursing home. After investigating the complaint, how should you write your response to the complainant? a)Each organisation should write a separate response b)Each individual involved should write a response c)The organisations involved should write a single response

28. You receive a written complaint from a 20 year old patient. Within what time period should you acknowledge receipt of the complaint? You receive a written complaint from a 20 year old patient. Within what time period should you acknowledge receipt of the complaint? a)Within three working days b)Within five working days c)Within seven working days

29. You receive a written complaint from a 20 year old patient. Within what time period should you acknowledge receipt of the complaint? You receive a written complaint from a 20 year old patient. Within what time period should you acknowledge receipt of the complaint? a)Within three working days b)Within five working days c)Within seven working days

30. You receive a phone call from a patient who is unhappy about the care she received from another doctor at the practice. What should you do? You receive a phone call from a patient who is unhappy about the care she received from another doctor at the practice. What should you do? a)Listen to the patient and record the details of the complaint b)Ask her to speak to the doctor she wants to make a complaint about c)Ask her to speak to the practice manager

31. You receive a phone call from a patient who is unhappy about the care she received from another doctor at the practice. What should you do? You receive a phone call from a patient who is unhappy about the care she received from another doctor at the practice. What should you do? a)Listen to the patient and record the details of the complaint b)Ask her to speak to the doctor she wants to make a complaint about c)Ask her to speak to the practice manager

32. You receive a written complaint from a 55 year old man who is a patient at your practice. After reading the complaint you find that it is about social services and not the practice. What should you do first? You receive a written complaint from a 55 year old man who is a patient at your practice. After reading the complaint you find that it is about social services and not the practice. What should you do first? a)Forward the complaint to the correct organisation b)Contact the patient to explain that the complaint has been made to the wrong organisation c)Return the written complaint to the patient and ask them to contact social services

33. You receive a written complaint from a 55 year old man who is a patient at your practice. After reading the complaint you find that it is about social services and not the practice. What should you do first? You receive a written complaint from a 55 year old man who is a patient at your practice. After reading the complaint you find that it is about social services and not the practice. What should you do first? a)Forward the complaint to the correct organisation b)Contact the patient to explain that the complaint has been made to the wrong organisation c)Return the written complaint to the patient and ask them to contact social services

34. Which one of the following statements about why patients make complaints is correct? Which one of the following statements about why patients make complaints is correct? a)Patients usually want financial compensation b)Patients usually complain because of a perceived or actual failure to investigate or treat c)Patients often want to prevent other people experiencing the same problems

35. Which one of the following statements about why patients make complaints is correct? Which one of the following statements about why patients make complaints is correct? a)Patients usually want financial compensation b)Patients usually complain because of a perceived or actual failure to investigate or treat c)Patients often want to prevent other people experiencing the same problems

36. A 40 year old woman makes a complaint and wants to see her records. When she has gone you realise there are many letters from the hospital specialist in her records. You wonder whether you should ask this doctor for permission to copy his letters. What is the best course of action? A 40 year old woman makes a complaint and wants to see her records. When she has gone you realise there are many letters from the hospital specialist in her records. You wonder whether you should ask this doctor for permission to copy his letters. What is the best course of action? a)You must get permission from the hospital specialist before releasing copies of his letters b)You don't need the hospital specialist's consent before releasing copies of his letters

37. A 40 year old woman makes a complaint and wants to see her records. When she has gone you realise there are many letters from the hospital specialist in her records. You wonder whether you should ask this doctor for permission to copy his letters. What is the best course of action? A 40 year old woman makes a complaint and wants to see her records. When she has gone you realise there are many letters from the hospital specialist in her records. You wonder whether you should ask this doctor for permission to copy his letters. What is the best course of action? a)You must get permission from the hospital specialist before releasing copies of his letters b)You don't need the hospital specialist's consent before releasing copies of his letters

38. Your practice recently wrote a response to a patient who made a complaint about waiting times for appointments at your practice. The patient does not feel the response has dealt with her concerns. What should you advise her to do? Your practice recently wrote a response to a patient who made a complaint about waiting times for appointments at your practice. The patient does not feel the response has dealt with her concerns. What should you advise her to do? a)Contact the health service ombudsman b)Contact the primary care trust c)Contact the Department of Health

39. Your practice recently wrote a response to a patient who made a complaint about waiting times for appointments at your practice. The patient does not feel the response has dealt with her concerns. What should you advise her to do? Your practice recently wrote a response to a patient who made a complaint about waiting times for appointments at your practice. The patient does not feel the response has dealt with her concerns. What should you advise her to do? a)Contact the health service ombudsman b)Contact the primary care trust c)Contact the Department of Health

40. Which one of the following statements about the role of the health service ombudsman is correct? Which one of the following statements about the role of the health service ombudsman is correct? a)Patients can direct their initial complaint to the ombudsman b)The ombudsman will assess whether the patient has a valid case that needs addressing

41. Which one of the following statements about the role of the health service ombudsman is correct? Which one of the following statements about the role of the health service ombudsman is correct? a)Patients can direct their initial complaint to the ombudsman b)The ombudsman will assess whether the patient has a valid case that needs addressing

42. A patient at your practice has made six complaints about access to the car park at your practice. You have responded to the complaint and the patient’s case was not upheld by the health service ombudsman. You feel that the patient is an unreasonable complainant. How should you manage the situation? A patient at your practice has made six complaints about access to the car park at your practice. You have responded to the complaint and the patient’s case was not upheld by the health service ombudsman. You feel that the patient is an unreasonable complainant. How should you manage the situation? a)Make sure one person from your practice oversees the situation b)Remove the patient from the practice list c)Contact the health service ombudsman

43. A patient at your practice has made six complaints about access to the car park at your practice. You have responded to the complaint and the patient’s case was not upheld by the health service ombudsman. You feel that the patient is an unreasonable complainant. How should you manage the situation? A patient at your practice has made six complaints about access to the car park at your practice. You have responded to the complaint and the patient’s case was not upheld by the health service ombudsman. You feel that the patient is an unreasonable complainant. How should you manage the situation? a)Make sure one person from your practice oversees the situation b)Remove the patient from the practice list c)Contact the health service ombudsman

44. A 55 year old man has had chronic bronchitis for many years and was diagnosed with mesothelioma three months ago. He worked as an electrician for years and has also worked as a docker. He is very unhappy with the care he has received from you and from the local hospital and wants to make a complaint. He also wants to see his records. You say you will sort this out, but he wants to see the records immediately. How quickly must you comply with his request to see the records? A 55 year old man has had chronic bronchitis for many years and was diagnosed with mesothelioma three months ago. He worked as an electrician for years and has also worked as a docker. He is very unhappy with the care he has received from you and from the local hospital and wants to make a complaint. He also wants to see his records. You say you will sort this out, but he wants to see the records immediately. How quickly must you comply with his request to see the records? a)You must give him a copy of the records immediately b)You must give him a copy of the records within 20 days c)You must give him a copy of the records within 40 days

45. A 55 year old man has had chronic bronchitis for many years and was diagnosed with mesothelioma three months ago. He worked as an electrician for years and has also worked as a docker. He is very unhappy with the care he has received from you and from the local hospital and wants to make a complaint. He also wants to see his records. You say you will sort this out, but he wants to see the records immediately. How quickly must you comply with his request to see the records? A 55 year old man has had chronic bronchitis for many years and was diagnosed with mesothelioma three months ago. He worked as an electrician for years and has also worked as a docker. He is very unhappy with the care he has received from you and from the local hospital and wants to make a complaint. He also wants to see his records. You say you will sort this out, but he wants to see the records immediately. How quickly must you comply with his request to see the records? a)You must give him a copy of the records immediately b)You must give him a copy of the records within 20 days c)You must give him a copy of the records within 40 days