NHS complaints procedure - Local Resolution

Summary

MPS understands that handling complaints can be complex and stressful. It requires time and commitment during a period when individuals are feeling at their most vulnerable. Getting it right can pay huge dividends and this factsheet aims to provide you with what you need to know about NHS complaints.

The NHS complaints procedure has two stages

The first stage is Local Resolution, where the practice or PCT tries to resolve the complaint.

The second stage is where the complaint is not resolved in the practice and the complainant asks for an Independent Review by the Healthcare Commission (HCC).

The complaints procedure forms part of the GP contract and any failure to comply could be considered a potential breach of contract.

Responsibility for complaints

One person should be nominated to manage complaints. Depending on the nature of the complaint, the complaints manager will attempt to resolve the matter to the satisfaction of the complainant.

Publicising the procedure

The practice’s complaints procedure should be publicised to your patients so they know how the procedure works, including details of the conciliation service, ICAS, the HCC and the Health Service Ombudsman.

Who can complain?

A complaint can be made by a patient or person affected, or likely to be affected, by the action or decision of an NHS organisation or primary care practitioner. A complaint can also be made by someone acting on behalf of the patient or person with their written consent.

Possible claims for compensation

If you are aware through a complaint that a patient intends to pursue a claim for compensation, please contact MPS as soon as possible – as this is excluded from the NHS complaints procedure. 

Confidentiality issues

You must ensure that the patient has given their written consent before you can disclose clinical information to a third party. It can be a complex matter, particularly if the patient has died, was a child or an adult without capacity: in which case we advise you to contact MPS for further advice.

Receiving and acknowledging complaints

All complainants should be contacted within three working days to acknowledge that their complaint has been received, explain the procedure and, where necessary, clarify any issues arising from the complaint. A full response should be provided within ten working days in primary care and within 25 working days if you practise in a hospital setting. If a complaint is made verbally and documented by the practice, the complainant should be asked to confirm in writing that they agree with what has been recorded.

Replying to the complainant

The way a response is written, or the way a meeting is conducted, can often be the deciding factor as to whether or not a complaint proceeds further. Sometimes acknowledging that the person’s feelings of frustration, anger or emotion at what happened are real and understandable, regardless of whether the complaint is justified or not, and is often enough to defuse the situation.

The complaints manager should inform the complainant of the results of the investigation in writing. This should include a detailed account of what happened. It should also include an apology, full explanation of events, lessons learned and reassurance of any changes which might be implemented in the future.

Time limits for making a complaint

Normally a complaint should be made within six months of the incident that caused the problem, or within six months of the complainant discovering the problem – as long as this is not more than one year after the event. However, you can extend the time limits, where it would be unreasonable to expect the complaint to have been made earlier.

Deputising and out-of-hours services

Where there is a complaint against a deputising doctor, it can be made directly to the deputising service, or the practice may make the complaint on behalf of the complainant. The registered GP would not necessarily be involved in the investigation at all, though he/she should be told of the complaint out of courtesy.

If the practice had opted out of providing out of hours service, the trust is responsible for ensuring that the complaint is investigated.

Locums or doctors in training

Complaints against locums or doctors in training should be investigated by the practice and, if they have left the practice, the doctors concerned contacted if possible for their comments.

Keeping records

A separate file must be kept for complaints records; these should not be included in the patient’s medical records. Clear and accurate documentation is essential for complaints handling. In cases where a complaint has been resolved by the practice procedures, the practice should keep records of complaints for ten years – the same length of time as for litigation. This should include copies of all correspondence between the complainant and the practice, but not draft documentation unless you are prepared for the possibility that this might be disclosed in the future.

Conciliation

You may wish to consider using the PCT’s free conciliation service, whereby they appoint an independent person to facilitate a discussion or meeting. Please contact your local PCT for further information.