If you have any concerns over the quality of service that you or a relative have been provided with through the NHS, then you can make a complaint to your local Hospital or GP or NHS dentist.
This empowers you, the patient, to voice your concerns about your treatment. If your complaint is upheld, an apology may be offered and systems changed to prevent similar incidents occurring in the future. It affords the hospital an opportunity to provide an explanation about your treatment, in some cases this may help to resolve matters.
However, if you give a firm indication that legal proceedings are contemplated, the complaints procedure will cease. If, however, you are seeking public funding (or legal aid) to investigate your potential medical negligence claim, the Legal Services Commission will require you to go through the NHS Complaints procedure first before granting you public funding.
There are some exceptions to this:
If you have fallen outside the time limits for bringing a complaint (normally 12 months from the date of the event you’re complaining about).
If your claim has a potential high value and is complex, such as a brain damaged baby claim.
If you have a terminal illness (this could be in such circumstances as a delay in diagnosis of cancer claim).
If you have pursued the NHS Complaints procedure but there has been no resolution within six months. You can apply at that stage.
If your treatment was private.
The information that you obtain through the NHS Complaints procedure will be very useful to assess your potential medical negligence claim and will be used in support of any application for public funding, if appropriate.
How to make an NHS Complaint
There are two stages to the Complaints procedure:
local resolution
independent review
If you need any assistance in making your complaint then you could seek help from your local ICAS (Independent Complaints and Advocacy Service).
Local Resolution
Both the hospital trust or health authority and general practitioner/dentist will have a complaints procedure in place. The hospital Chief Executive or GP Practice Manager will have to respond in writing to any complaint made either orally, and subsequently put in writing, or any written complaint.
If the complaint is in respect of hospital care, the complaint should be responded to within 25 working days, although there is no sanction if this target is not met. In some circumstances you may be invited to a meeting to discuss the circumstances of your complaint.
If the complaint relates to care provided by your general practitioner/ dental practitioner or their staff, this should be responded to within 10 working days. The time limit to respond to your complaint can be extended by agreement.
Independent Review Panel
If matters cannot be resolved at a local level, you then have 28 days within which to request that the “convener” sets up an independent review panel to look into your complaint. You have to provide a written statement about your complaint and why you feel that your grievance has not been adequately dealt with at local resolution.
However, you do not have an automatic right to an independent review panel. It is for the convener to decide whether an independent review panel should consider the complaint, or whether further attempts at local resolution should be made. If the convener considers the complaint has been dealt with sufficiently at local level, then you have the right to seek redress through the Health Ombudsman.
The convener must inform you in writing of their decision whether or not to convene a panel. If they refuse to convene a panel, he must set out their reasons in writing and advise you of the right to appeal to the Health Ombudsman. If the convener agrees to convene a panel then they must set out the terms of reference for the panel. If you are referred back to local resolution by the convener and still remain dissatisfied, then you can refer back once again to the convener.
The panel is made up of three people, one of whom is the convener, another the independent lay chairperson (usually a non-executive director of the trust or health authority) and another independent representative from the health authority or trust.
If dealing with a clinical matter, the panel will be advised by at least two independent clinical assessors, who will assist on any clinical issue. They should have no connection with any of the parties involved and so will be from outside the region. The chairman and third panel member chosen, should not be practising or retired clinical professionals to maintain their independence. The panel will have access to all the records relating to the complaint and any relevant health records to assist with their inquiry.
The panel will investigate the complaint and will consider the reports prepared by the independent clinical assessors. They will then prepare a report on its conclusions and make appropriate suggestions. It does not have the power to impose any changes or to suggest any disciplinary action. The panel carry out their investigations in private and must hear both sides of the complaint. It is the chairman’s decision that is final. You can be accompanied by a person of your choosing at any interview.
Copies of the assessors’ reports will be attached to the final report of the panel and provided to all parties concerned in the complaint. The report is confidential,so permission needs to be obtained from the chairman before it is disclosed to an adviser. The first draft of the report should be made available within 50 days of the panel being established or, in the case of a primary care trust complaint, within 30 days.
The chief executive of the trust must write to the complainant advising of any changes that are being recommended as a result of the panel’s findings. Also, to advise the complainant of a right of appeal to the Health Ombudsman if they are still dissatisfied with the outcome of the complaint.
The Health Ombudsman
The Health Ombudsman is completely independent of the NHS and has wide powers including considering clinical complaints and considering complaints in respect of the complaints procedure itself. The Ombudsman can request that the convener reconsider the case or can investigate the matter themselves. Any complaint to the Health Ombudsman should be made within one year of the event complained of.
Heptonstalls are renowned specialists in dealing with medical negligence claims both regionally and nationally. For more information call our medical negligence team on 01405 765661 or free phone 0800 9178267.
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