Complaints, Concerns, Comments and Compliments Policy, May 2020 – May 2022

1.1 Portsmouth Clinical Commissioning Group (CCG) is committed to providing an accessible, equitable and effective means for people and/or their representative to express their views about the services it provides or services it is responsible for commissioning. Commissioned services are those that are paid for by the CCG but provided by other organisations such as acute hospitals, community services and other providers.

1.2 The CCG takes a positive approach to handling complaints, concerns, comments and compliments as a genuine means to improving the experiences of patients and the quality of services it commissions.

1.3 This policy sets out the process for handling complaints, concerns, comments and compliments received by the CCG from patients, carers and the general public. It incorporates the CCG’s obligations in the NHS Constitution and the Health and Social Care Act and addresses best practice in the handling of complaints.

1.4 The aim of this policy is to ensure that complaints are:

• Actively encouraged and that people know how to complain
• Taken seriously and responded to promptly
• Investigated and findings are used as an opportunity to learn and improve.

2.1 The CCG is committed to providing service users, their family members, carers and the general public with the opportunity to seek advice, provide compliments, raise concerns or make a formal complaint about the CCG and its services.

2.2 The CCG aims to provide a complaints process which is easy to access and use; is supportive of those wishing to make a complaint; provides a timely and appropriate response and is used for the purpose of learning and improvement.

2.3 This Policy details the process for complainants and staff working for, with or on behalf of the CCG. This includes temporary, agency, contractors and sub-contractors.

2.4 The CCG acknowledges that the organisations it commissions services from also have policies and procedures for dealing with complaints, concerns and compliments which will be utilised where appropriate.

3.1 The terms “patient” and “service user” are used interchangeably to describe all those people for whom we commission and provide services.

3.2 Compliment: A compliment provides positive feedback regarding the CCG or its services and can highlight improvements and successes, recognition of good practice.

3.3 Comment: Comments may be made either verbally or in writing to any member of staff working for, with or on behalf of the CCG. These may be general observations or opinions regarding the CCG or its services and can be positive or negative

3.4 Concern: A concern is likely to be an issue which can be raised verbally or in writing which may highlight or identify a shortfall in service leading to possible improvements in services or a specific aspect of a service.

3.5 Complaint: A complaint is an expression of dissatisfaction about any aspect of the CCG or its services. It requires formal acknowledgement, investigation and a formal response. A complaint can be either verbal or in writing.

3.6 Some concerns, comments and complaints, dependent on the subject matter, may prompt the use of processes other than that in the management of complaints. For example the Serious Incident Requiring Investigation (SIRI) process may need to be followed in the case of physical or sexual abuse, financial misconduct or criminal offence or safeguarding issue.

3.7 All compliments, comments, concerns and complaints are shared with the relevant services or teams however the focus of this policy is on the management of complaints.

3.8 The Accountable Officer of the CCG has overall responsibility for complaints. Overseeing and managing the process of dealing with complaints has been delegated to the Head of Governance.

5.1 The CCG aims to have a complaints procedure that:

• Is easily accessible – this includes providing appropriate assistance for patients and service users who do not speak, read or write English or who have communication difficulties (including hearing, oral or learning impairments)
• Is simple to understand and use
• Is fair and impartial
• Ensures that all complaints are dealt with honestly, openly, confidentially
• Ensures that complainants and those they are complaining on behalf of, are not discriminated or disadvantaged as a result of making a complaint
• Allows complaints to be dealt with promptly and as close to the point where they arise as possible
• Enable lessons learnt to be used to improve service quality
• Follows best practice and meeting national guidance including; data protection, patient confidentiality, access to medical information (records)
• Meets all of its obligations and statutory duties in respect of the management of complaints, including those under equality, diversity and human rights and duty of candour.

6.1 Anyone who is receiving, or has received NHS services, the complaint needs to be made with 12 months of the incident occurring or becoming aware of the incident.

6.2 A representative* acting on behalf of someone who:

• Has died
• Is a child (under the age of 18 years)
• Is unable to make the complaint themselves due to physical incapacity or lack of capacity within the meaning of the Mental Capacity Act 2005 or
• Has requested that the representative acts on their behalf.

*Complaints made on behalf of someone who has died or who lacks capacity must be a relative or other person who is considered to have had or has “sufficient interest” in their welfare and is a suitable person to act as their representative or/an executor.

In the case of a child, a suitable representative would normally be a parent, guardian or other adult person who has care of the child, or one who is authorised by the Local Authority/voluntary organisation in the case of a Looked After child.

6.3 If a Member of Parliament (MP) makes a complaint on behalf of a constituent, it should be demonstrated that the MP has obtained consent from the patient prior to contacting the CCG. Constituents raising concerns regarding a third party will require the consent of the third party.

• A complaint made by a local authority, NHS body, Primary care provider or
  independent provider.
• A complaint made by an employee of a local authority or NHS body about any matter relating to employment.
• A complaint which has previously been made and resolved to the same complainant and where local resolution has been exhausted.
• A complaint which is, or has been investigated by another organisation.
• A complaint whereby the complainant indicates that they intend to take legal action.

8.1 When a complaint is received, either verbally or in writing, the Complaints Manager will acknowledge the complaint within 2 working days and confirm with the complainant:

• The detail of the complaint include what outcome the complainant wishes to achieve
• The process including how the complaint will be investigated. The CCG reserves the right to appoint an independent investigator where and when necessary.
• Timescales (these can be subject to change)
• Consent to discuss the complaint with the relevant parties (services) in the course of the investigation (in keeping with the General Data Protection Regulations).

8.2 In order to ensure that complaints are dealt with quickly and efficiently, the CCG Complaints Manager may suggest that the complaint it made directly to the organisation or service involved. This may also help if the service or organisation requires clarification or further information from the complainant. In such cases the Complaints Manager will record that signposting has taken place and this information will be included in complaints reports.

8.3 The Complaints Manager will provide updates to the complainant where the complaint investigation may exceed the original agreed timescales.

8.4 A response will be provided to the complainant in the format they request. This includes letter, e-mail, telephone, mobile telephone text and will include all aspects of the investigation and findings.

8.5 The Head of Governance and Complaints Manager may wish to meet with the complainant if this is requested. Other individuals may be invited to attend such a meeting to assist in the discussions and resolution of the complaint, where required. This may also include members of staff of partner organisations.

8.6 If a complainant is dissatisfied with the response then they will be signposted to the Health & Parliamentary Services Ombudsman who may choose to either close the complaint or undertake an investigation about the management of the complaint.

8.7 The Complaints Manager will work with the Health & Parliamentary Services Ombudsman in the provision of the requested documentation etc.

9.1 The CCG is keen to learn from complaints in order to improve its services. A quarterly report will be provided to the Quality & Safeguarding Committee which will include:

• Number of complaints received
• Subject of complaint (service) and reason for complaint
• Numbers of signposted complaints
• Learning from complaints
• Information about any response and action taken where the complainant may not be satisfied with the original response including Health & Parliamentary Services Ombudsman investigations and conclusions.

9.2 In addition to quarterly reports, an annual report will be provided for review by the CCG’s Governing Board.

9.3 Members of staff cited in a complaint will be offered support through their line manager and will be informed of the response to the complainant prior to this being sent out. This will include a check for factual accuracy and to ensure all information has been provided in an honest and transparent way.

9.4 The CCG subscribes to a ‘fair and just’ culture. Where staff misconduct is determined through the course of an investigation of a complaint or concern then HR processes and policies will be applied and will be dealt with separately from the complaint.

9.5 The CCG may seek legal Advice on particular aspects of a complaint where there is a possibility of litigation ensuing. If, during an investigation, the complainant explicitly indicates in writing an intention to take legal action, the Complaints Manager will negotiate with the complainant how this can be taken forward. The Complaints Manager may then refer the matter to NHS Resolution and seek advice on next steps.

9.6 There may be occasions when the investigating officer or complaints officer believes that there are grounds for making an ex-gratia payment. This is without accepting liability. An apology and gesture of goodwill may avoid subsequent litigation and offers the opportunity to deal with certain circumstances in a fair and responsible manner.

9.7 Financial compensation may be considered where there has been:

• Direct or indirect financial loss.
• Loss of opportunity.
• Inconvenience.
• Distress.
• Any combination of the above.

9.8 It is recommended that before any compensation is offered in respect of a complaint involving a member of staff, that member of staff should be involved in the discussions when the subject of compensation is raised. This is to ensure that s/he does not feel compromised by the decision to award compensation.

9.9 Any ex-gratia payment should be made having regard to the CCG’s Standing Orders and prime financial policies and current guidance from the Parliamentary and Health Service Ombudsman.

9.10 Whilst we strive to ensure that complaints are addressed and resolved where possible, a complainant may raise the same issue or complaint a number of times. Where this is considered vexatious the Complaints Manager will follow the Management of Vexatious Complaints Policy

For information about the CCG and its services:
pccg.enquiries@nhs.net

CCG website:
www.portsmouthccg.nhs.uk

Clinical Commissioning Group Head of Governance (nominated representative of the Accountable Officer):
Head of Governance
NHS Portsmouth Clinical Commissioning Group
CCG Headquarters
1 Guildhall Square
PORTSMOUTH
PO1 2GJ

Complaints Manager:
Portsmouth City Council
CCG Complaints Team
5th Floor Civic offices
Guildhall Square
PORTSMOUTH
P01 2BG

Telephone: 023 9283 4456
Email: portsmouthccgcomplaints@portsmouthcc.gcsx.gov.uk

Parliamentary and Health Service Ombudsman for England:
Millbank Tower
Millbank
LONDON
SW1P 4QP

Telephone: 0345 0154033
Website: https://www.ombudsman.org.uk/making-complaint

1. What is the aim of your policy, service, function, project or strategy?

• To provide a procedure for handling complaints, concerns, comments and compliments received by Portsmouth Clinical Commissioning Group from patients, carers and the general public.
• To ensure that when a patient, carer, member of the public and/or their representatives:
  • Expresses dissatisfaction with a service that it is considered, they receive a response, and, where appropriate, organisational lessons are learnt.
  • Expresses a concern about a service, that this is acknowledged and resolved appropriately.
  • Makes a comment or compliment that this is recorded and the appropriate people are informed.

2. Who is this policy, service, function, project or strategy going to benefit or have a detrimental effect on and how?

Patients, service users, carers and members of the public will benefit from having a clear and uniform process put in place by the organisation. The policy’s list of aims includes: easy to access, simple, fair and impartial, rights of confidentiality. The policy includes a section on equality and diversity in which it is stated that complainants will be dealt with fairly and with dignity and respect. In addition, they will not be discriminated against, regardless of difference and information will be made available in accessible formats, including different languages on request, to inform them of the complaints’ process and assist them through the process as required. An equality monitoring form for anonymous feedback via a pre-paid envelope will be provided with every complaint response.

In addition, the policy includes a section on duty of candour, being open and honest, and the requirement for a complaint to be handled, promptly, fully and compassionately. The policy sets out how the CCG will make every effort to reach a resolution to a complaint made by a patient, service user, their carer(s)s and members of the public, including conciliation meetings, signposting to independent complaints advocacy and the Health Ombudsman’s Department.

For staff, the policy is clear that they should be consulted, involved and supported where a complaint has either named them or their role. In addition, managers are given the responsibility to ensure lessons learnt are embedded into practice and ensure appropriate staff training is put in place. Finally, staff will be trained as investigating officers to ensure to provide a standard of investigation and investigation report for complaint responses.

3. Thinking about each group below does, or could the policy, service, function, project or strategy have a negative impact on members of the equality groups below?

4. Does, or could the policy, service, function, project or strategy help to promote equality for members of the equality groups?

5. Do you have any feedback data from the equality groups that influences, affects or shapes this policy, service, function, project or strategy?

6. Using the assessments in questions 3, 4 and 5 should a full assessment be carried out on this policy, service, function or strategy?

No

7. How have you come to this decision?

The policy follows national guidance from the Equality and Human Rights Commission (Equality analysis and the equality duty 2011 and Meeting the equality duty in policy and decision-making,
2012) and the Department of Health (NHS Contract, recommendations from the Francis Report) on ensuring equality and diversity in the NHS to include alternative formats and languages and Duty of Candour. It also follows Department of Health complaints guidelines for the provison of verbal complaints to be facilitated and taken forward. This policy will be reviewed by staff side groups.

The policy sets out clearly how the procedures will be conducted farily, with impartiality and in an open and honest way. The benefits of candour with the complainant are listed. Reference is made to ensuring alternative formats, including different languages, are used where requested for copy complaints procedure and to support the complainant through the complaints process. In addition, how to make a complaint verbally is set out together with information in respect of 3rd parties acting on behalf of a patient or service user as their representatives.

Requesting completion of an anonymous equality monitoring form by complainants seeks to inform trend analysis by protected characteristics and so organisational learning. Provision of a pre-paid envelope for return of forms facilitates equality of this process. Overall, patient and public feedback will be facilitated by an Easy Read guide on how to complain. This will be available on the CCG’s website and on request.

8. Who was involved in the EIA?

Claire Pond, Equality and Diversity Manager

6 May 2020

Version Number: 2.0
Review Date: May 2022