Complaints in Health and Social Care

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COMPLAINTS
IN
HEALTH AND SOCIAL CARE
Standards & Guidelines for Resolution & Learning

1 April 2009

SUMMARY
Complaints in Health and Social Care: Standards and Guidelines for Resolution and Learning replaces the existing HPSS Complaints Procedure 1996 and provides a streamlined process that applies equally to all health and social care (HSC) organisations. As such it provides a simple, consistent approach for staff who handle complaints and for people raising complaints across all health and social care services.

The standards and guidelines have been developed in conjunction with HSC organisations, following public consultation. They reflect the changing culture across health and social care with an increasing emphasis on the promotion of safety and quality and the need to be open, to learn and take action in order to reduce the risk of recurrence.

The changes to the new HSC complaints procedure include:
• the removal of Independent Review;
• the introduction of Standards for Complaints Handling;
• the introduction of an “Unacceptable Actions” policy for handling unreasonable, vexatious or abusive complainants; and
• clarity on the application of the Children Order Representations and Complaints Procedure.

This new single tier process also aims to provide:
• a strengthened, more robust, local resolution stage;
• an enhanced role for commissioners in monitoring, performance management and learning; and
• improved arrangements for driving forward quality improvements across the HSC.

The new process recognises that there will be times when local resolution will fail. Where this happens the complainant will be advised of their right to refer their complaint to the NI Commissioner of Complaints (the Ombudsman).

The guidelines for resolution and learning provide HSC organisations with detailed, yet flexible, complaints handling arrangements designed to: • provide effective local resolution;
• improve accessibility;
• clarify the options for pursuing a complaint;
• promote the use and availability of support services, including advocacy; • provide a well defined process of investigation;
• promote the use of a range of investigative techniques;
• promote the use of a range of options for successful resolution, such as the use of independent experts, lay persons and conciliation; • resolve complaints more quickly;
• provide flexibility in relation to target response times; • provide an appropriate and proportionate response;
• provide clear lines of responsibility and accountability; • improve record keeping, reporting and monitoring; and
• increase opportunities for shared learning.

The standards for complaints handling are designed to assist HSC organisations in monitoring the effectiveness of their complaints handling arrangements locally and build public confidence in the process.

These new arrangements are effective from 1 April 2009.

SECTION 1 - INTRODUCTION .............................................................. 4

What the guidance covers ........................................................ 7 What the guidance does not cover .......................................... 8 SECTION 2 - MAKING A COMPLAINT ................................................ 14

What is a complaint? .............................................................. 14 Promoting access ................................................................... 14 Who can complain? ................................................................ 14 How can complaints be made? .............................................. 18 Supporting complainants and staff ....................................... 22 What are the timescales for making a complaint? ............... 22 SECTION 3 - HANDLING COMPLAINTS ............................................ 24

Accountability.......................................................................... 24 Actions on receipt of a complaint...
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