HEALTH COMPLAINTS ADVOCACY

Health Complaints Advocacy
What is Leeds Independent Health Complaints Advocacy (LIHCA)?

LIHCA can help if you feel you have not had the service you expect from the NHS and want to complain, using the NHS complaints process.

This might mean providing information so you can pursue a complaint by yourself or giving you the support of an experienced worker who can help you to make your complaint.

LIHCA gives you the opportunity to speak confidentially to someone who is independent of the NHS

Our service covers residents within the Leeds Metropolitan District area, even if the treatment was elsewhere.

LIHCA is free.

LIHCA is independent of the NHS.

LIHCA is confidential.

 

The philosophy of the organisation is to go the extra mile in all aspects of its operation, to treat people with dignity and respect, recognising that “People don’t fit in boxes.”

 

What does an LIHCA Advocate do to help?

LIHCA Advocates work with you so that you feel confident to make a complaint.

LIHCA Advocates provide you with information about how the NHS complaints process works and what you can expect to achieve from the process.

LIHCA Advocates will decide with you the best way to support you.

LIHCA Advocates will help you explore your options at every stage of your complaint and can give you information that can help you to decide what to do.

Throughout the complaints process an advocate might also do some or all of the following:

  • help you to write letters to the right people
  • prepare you for meetings and, if necessary, go to these with you
  • help you to monitor the progress of your complaint with the organisation or individual responsible

Please click here to download our information guide.

First Steps

Things to know before making a complaint

Time Limits

As a general rule, you should make your complaint within 12 months of the incident or within 12 months of realising that you have something to complain about. However, the NHS may use its discretion if particular circumstances prevent you from complaining in good time.

Who can complain?

Anyone can make a complaint about NHS services you have received from an NHS organisation or if you have been affected by any actions made by a NHS organisation.

Can I complain on behalf of someone else?

You can make a complaint on behalf of a friend or relative or someone you care for.  If you are complaining on behalf of someone else it’s a good idea to get their permission in writing, unless you have the patient’s permission any response will be limited by patient confidentiality. If they cannot give consent because of incapacity or illness you can complain without their permission.

Things to think about before making a complaint

Decide what you are unhappy about.

Before you start, it is important to be clear about what it is that you are unhappy about. This can be any aspect of the care and services that you have received, but might include:

  • Treatment or care
  • The attitude of staff
  • Waiting times
  • Lack of information
  • Failure to diagnose a condition
  • Poor communication between services

Decide what you want to achieve

This will determine whether the NHS Complaints procedure is the right process for you.  The usual outcomes from an NHS complaint tend to be an explanation, an apology if appropriate and an improvement to services.

How to raise a concern or make a complaint

What are my options for raising concerns or a making a complaint?

Once you are clear on what you are unhappy about and what you want to achieve you need to decide how best to raise your concern. There are different ways that you can do this and it helps to think about which option you would prefer.  Some issues may be dealt with more quickly and effectively outside of the complaints procedure.

You could:

(1) Speak to a member of staff directly

Many concerns are caused by misunderstandings or miscommunication and can be resolved quickly when you tell someone.

If you feel able to, you can speak to a member of staff who is directly involved in your treatment, or to their manager, to explain what you are unhappy about. This is often the quickest way to put things right and stop them getting worse, especially if your complaint concerns ongoing treatment.

(2) Speak to the Patient Advice and Liaison Service (PALS)

If you feel uncomfortable talking directly to the member of staff involved or you have tried and it has not resolved your issues then a service called PALS may be able to help you.

PALS is part of your local NHS and provides information, advice and support to patients, families and their carers. They can speak to the staff on your behalf and may be able to help you resolve your concerns more quickly.

(3) Make a complaint using the Complaints Procedure

The Complaints Procedure may be the best route to follow if:

  • Your concerns haven’t been resolved fully by staff or PALS
  • There are complex issues you wish to raise relating to standards of care which will require more in depth investigation
  • More than one organisation is involved in the issues you wish to raise
  • You would like a written response to your complaint

It may be helpful to keep a record of any phone calls and letters including details of who you wrote or spoke to, what was agreed and any action that needs to be taken.

There are two stages to the complaints procedure but most complaints are resolved during stage one, Local Resolution.

 

Some things to bear in mind at the start…………

Compensation for Clinical negligence

This is only possible through legal action and you will need to speak to a solicitor who specialises in medical or clinical negligence.

There are time limits for making legal claims and a claim must be made within 3 years of the incident happening or when you became aware of the incident.

Private medical treatment

Private healthcare services have their own complaints procedure that you can follow, you should contact them directly and ask what their procedure is.

However if your care and treatment was carried out by a private organisation but was funded by the NHS then the NHS complaints procedure applies. We can only support you if your complaint is about NHS funded healthcare.

Disciplinary action against an NHS staff member

The NHS procedure cannot be used to instigate disciplinary action against a member of NHS staff. This could however happen under a separate procedure as result of your complaint

Removal of Licence to practice (Struck off)

The General Medical Council, The Nursing and Midwifery Council, The General Dental Council and other professional bodies deal with whether a clinician is fit to practice and complaints can be made directly to them. This isn’t part of the NHS Complaints procedure and we can’t help with this, although you can complain to these bodies at the same time as making an NHS Complaint

Diagnosis or Treatment

The NHS complaints procedure cannot guarantee medical treatment or a diagnosis. If you are looking for immediate medical treatment you should see your GP or speak with the Patient Advice and Liaison Service (PALS) at the hospital.

Please see our Useful Contacts for details of how to contact other organisations

NHS Complaints procedure

Local Resolution

The first part of the Complaints Procedure is called Local Resolution, the aim is to sort out your problem directly with the NHS organisation involved. This is your opportunity to explain what you are unhappy about and what you would like to happen. It gives the NHS organisation the opportunity to investigate, explain what happened and resolve your concerns. Where appropriate they will use your experience to improve services.

How to make a complaint

NHS Trusts prefer receiving complaints in writing, this can be by letter or email. If you would rather telephone, the complaints manager should make a written record of your complaint and you should be given a copy. It is important to raise everything that concerns you at this stage, as new issues cannot later be introduced as part of the same complaint. If you would like advice on writing a complaint letter, please take a look at our Complaint Letter Guide.

Who do I complain to?

If you want to complain about your hospital, ambulance service or most community healthcare contact the Chief Executive of the NHS Trust. (See our Useful Contacts sheet) For complaints about primary care and independent providers such as your GP, dentist, optician, pharmacist or other independent NHS contractor you have two options: (a) You can complain directly to the NHS organisation by contacting the person in charge of complaints. In most GP and dental practices, this will be the practice manager. OR (b) You can complain to the Commissioner. (The commissioner is the organisation that asks the organisation to provide these services) If you choose Option (a) and you are not satisfied with the response you cannot then raise the issue with the commissioner. The next stage of the complaints procedure will be to contact the Health Service Ombudsman. NHS England commissions Primary Care Services such as GPs, Dentists, pharmacies and some other community care however the local Clinical Commissioning Groups also commission some services. If your complaint concerns more than one NHS organisation you only need to complain to one of the organisations. They should then contact the other services involved and work together to investigate the complaint and provide one co-ordinated response. If you are not clear where to send your complaint, ask for advice from:

  • the Patient Advice and Liaison Services (PALS) or the Patient Relations Team in larger organisations such as hospitals.
  • NHS England on 0300 311 2233 for Primary Care Services
  • The Leeds Clinical Commissioning Groups (CCGs) can be contacted on 0800 052 5270 for some services

Please see our Useful Contacts for details of local NHS organisations

What happens when the NHS Organisation receives your complaint?

Acknowledgement

The NHS organisation you have complained to should acknowledge your complaint within 3 working days. An acknowledgement letter should include a suggested timescale for resolving the issues and may offer you the opportunity to contact them to discuss this. Someone from the NHS organisation may contact you to discuss your complaint and arrange a plan to resolve your concerns with you.

Timescales

The suggested timescales can be influenced by issues such as how many staff they need to speak to, how easy it is for them to access your medical records and if other NHS organisations are involved in your complaint. If there is a problem in keeping to the agreed timescale they should contact you before it expires to agree an amended timescale.

How should the NHS investigate your complaint?

The Trust should try to resolve your issues in the most appropriate way. This may include:

  • Talking to people who were involved in your care
  • Looking at medical and nursing records
  • Asking other professionals to review what happened
  • A meeting with you, this gives you the chance to speak to staff directly about what has happened. You can take a friend, relative and /or an Advocate with you.

The Response

When the investigation is complete and any meetings have been held the Chief Executive or Practice manager should send you a letter on behalf of the NHS organisation. This letter should contain:

  • a summary of your complaint
  • how it was investigated
  • what the investigation found
  • any actions that are going to be taken as a result
  • what to do if you are still unhappy with the answers given.

The letter should be clear and easy to understand, medical jargon should be avoided or explained. If you haven’t received this letter within the timescale agreed you may want to check when you can expect to receive it. If you haven’t received a response letter within six months of your original complaint and the Trust hasn’t agreed an extension they should write to you explaining the reason for the delay. The final response must then be sent as soon as reasonably practicable.

What if I am not happy with the response?

If you are not satisfied with the reply it is useful to look carefully through the response and see what has been answered and what you feel is still outstanding. It may help to review:

  • any letters and meetings
  • whether parts of your complaint have not been answered
  • whether the complaint was handled properly
  • whether anything more could have been done 

What are my options?

The first thing to do is to tell the NHS organisation that you aren’t satisfied with the response you have received.

  • you can write another letter explaining what you feel is still outstanding
  • you can call the person handling your complaint and discuss the response with them
  • you can request a meeting to discuss your outstanding concerns

Further investigation into your complaint may be carried out, you may be invited to a meeting to discuss things and then you should receive a final written response. The NHS organisation you are complaining about may feel that everything has been done to answer your complaint and if so, they should inform you in writing.   If Local resolution has been completed and you are still not satisfied with the response you can ask the Health Service Ombudsman to look at your complaint and how it was handled. This is stage two of the NHS Complaints procedure. For more information on the role of the Health service Ombudsman please go to our Health Service Ombudsman Guide.

Parliamentary and Health Service Ombudsman

The Health Service Ombudsman

If Local resolution has been completed and you are still not satisfied with the response you can ask the Parliamentary and Health Service Ombudsman to look at your complaint and how it was handled. The Ombudsman’s services are confidential and free. The Ombudsman is independent of the NHS.

Time Limits

A complaint should be sent to Ombudsman within 12 months of the incident happening or within 12 months of you realising you have something to complain about.  The Ombudsman may extend this time limit if the local resolution process took longer than a year. The Ombudsman will look at every complaint but is not required to investigate them all.

Will the Ombudsman Investigate?

A member of the Ombudsman’s staff will consider whether your case meets the criteria for investigation. To make this assessment they may need to see clinical records and other documentation. A member of the Ombudsman’s staff will contact you to ask for any papers they need.

The Ombudsman will not usually investigate a complaint if:

  • You have not tried or completed Local Resolution
  • They think that the NHS organisation could do more to resolve your complaint – they will refer your complaint back to the NHS Organisation
  • you don’t agree with the response from the NHS organisation but can’t provide any evidence to show why their decision is wrong or unsatisfactory
  • they decide that there is no evidence that the NHS organisation did anything they shouldn’t have done
  • they decide that the NHS organisation has done all that they reasonably could to put things right and nothing further can be done
  • they decide that there would not be a worthwhile outcome from an investigation (for example, if the solution sought by the complainant is not obtainable).

The Ombudsman has three choices:

  • Intervention

The Ombudsman may decide not to investigate the case but ask the NHS provider or practitioner to take action which they think would resolve your complaint.

  • Investigation

The Ombudsman may decide to carry out a thorough investigation which can take some time resulting in a detailed report. If your complaint is upheld the Ombudsman can make recommendations to the NHS provider or practitioner to put things right.

  • No Investigation

The Ombudsman may decide not to investigate the case and take no further action.

All the Ombudsman’s decisions are final

This includes the decision about whether or not to investigate your complaint and the decision about whether or not your complaint should be upheld.

Whatever the decision the Ombudsman will write to you to let you know the outcome. 

Please click here to download a PDF version of this information

Self help information

Please click on the appropriate link below to download information about the NHS Complaints procedure, writing a complaint letter, the Health Service Ombudsman and  obtaining medical records.

LIHCA Information Guide

Complaint Letter Guide

The Health Service Ombudsman

Obtaining Medical Records

Local Resolution Meeting Guide

If you require any further information or support please do not hesitate to contact us on 0113 244 0606

Useful contacts

Please click here to download contact details for other organisations :

  • Professional bodies, such as  the General Medical Council (GMC)
  • The NHS Regulator
  • The Health Service Ombudsman
  • Legal enquiries
  • Local Leeds NHS Organisations

If you require any further information or support please do not hesitate to contact us on 0113 244 0606 .