Effective Handling of Local Investigations for Complaints Resolution
Learn the crucial steps for successful local investigations in complaint handling, ensuring complaints are addressed in line with regulations and principles. Understand what individuals seek when making complaints, emphasizing the importance of clear decision-making, evidence-based processes, and empathetic communication in reaching a resolution.
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Presentation Transcript
Good local investigations Getting it right first time
The local investigation: Getting it right first time Has the complaint been handled in line with: NHS Complaints Regulations Ombudsman s Principles of Good Complaint Handling Ombudsman s Principles for Remedy Local policy and procedures 2
What do you want when you complain? The local investigation: Getting it right first time 3
The local investigation: Getting it right the first time What people want in decision making Where possible, a swift outcome. A real opportunity to be heard and to input into the process before decisions are made. To see how decisions are made via clear, understandable and transparent rules. For complaints handlers to show they re acting sensitively and impartially by basing decisions on objective information and appropriate criteria. 4
Initial contact A real opportunity to be heard and to input into the process before decisions are made. Listen carefully confirm concerns/matters to be investigated Ask what they want to achieve (can it be delivered now?) If appropriate, manage expectations and explain what is possible Explain how long the process is likely to take be open and realistic Agree how to keep them updated/involved and how often Explain what will happen 5
Evidence-based decision making To see how decisions are made via clear, understandable and transparent rules. Explain investigation process at the start What evidence will be considered Who you will speak to Who will give advice/independent opinion How you will decide if the care/service was right or not Who will be involved in decision making 6
Your decision For complaints handlers to show they re acting sensitively and impartially by basing decisions on objective information and appropriate criteria Remember your audience appropriate language and empathy Be impartial Set out all relevant evidence Set out your test (ideally use the Ombudsman s) Make sure your decision/the outcome is clear Explain any action taken 7
Improving the complaints process My Expectations 8
Sharing learning: Good local response Response should set out: The issues raised and what the complainant wants to achieve How you have investigated and the evidence considered including: the complainant s evidence staff/witness statements relevant extracts from clinical records independent clinical opinion 9
Sharing learning: Good local response Explanation of whether or not something went wrong, by setting out: what happened -with reference to the evidence what should have happened - quoting relevant regulations, standards, policies, or published guidance, and if they were met Your view of care/service provided in appropriate, clear, empathetic language If there is a shortfall (between what happened and what should have happened) an explanation of the shortfall and the impact it has had 10
Sharing learning: Good local response If failings have caused injustice or hardship suitable apology and redress If appropriate, explain how it will be put right for other service users Explain how the complainant will be updated/involved in the changes Signpost to the Ombudsman service 11
NHS complaints received 2013/14 2017/18 30000 25000 20000 15000 10000 24616 18870 21371 23159 24237 5000 0 2013/14 2014/15 2015/16 2016/17 2017/18 12
Fully and partly upheld complaints 2016/17 and 2017/18 50% 40% 30% 2016/17 2017/18 20% 43% 36% 25% 43% 33% 36% 40% 25% 10% 0% All NHS Acute Trusts GPs Dentists 13
[INSERT TRUST NAME] data Accepted for investigation (Investigations concluded) Discontinued/ Resolved without finding Complaints Received Upheld Partly upheld Not upheld 2015/16 2016/17 2017/18 2018/19* * 2018/19 data as at [insert report date] 14
National picture 2017/18 Top substance issues acute trusts Top complaint handling issues acute trusts 1. Diagnosis delay, failure to diagnose, misdiagnosis 1. Complaint response is wrong and/or incomplete. 2. Access to services/treatment 2. Response to complaint is delayed 3. Communication and information (including confidentiality) with patients/families 3. Insufficient personal remedy and/or apology 4. Insufficient actions planned to improve services 4. Planning of care, admission, discharge, transfer 5. Conclusions unsound and/or not evidence based/wrong guidelines used 5. Failure to treat 15
Feedback and questions ? Questions? Any thoughts and experiences of PHSO s service? What more could PHSO do to support you? 16
Thank you Website www.ombudsman.org.uk @PHSOmbudsman Helpline 0345 015 4033 8.30am - 5.30pm Monday to Friday Parliamentary and Health Service Ombudsman Email liaisonmanagers@ombudsman.org.uk Radio Ombudsman Podcast 17
