Executive Summary

 

As a GOS contractor you are obliged to operate the NHS complaints system in accordance with regulations and with your contract with the NHS England Area Team regarding the provision of GOS and other (but not private) locally commissioned primary eye care services. You must take responsibility for the arrangements in your practice(s) for dealing with complaints and designate a complaints manager. You must inform the public of your arrangements, e.g. by means of a notice or your practice leaflet (if you have one). You must seek to resolve complaints in good faith and treat complainants appropriately. (An oral complaint resolved within 24 hours is not considered to be a complaint.) A complaint may be made up to twelve months after the incident in question. A complaint may be made directly to the practice or via the NHS England Complaints Team.  In either case, you must acknowledge receipt of the complaint within three working days. You must then offer to discuss the complaint with the complainant.  Whether or not the complainant meets you, you must inform the complainant about how you intend to deal with the complaint and how long it will take. You must try to resolve the complaint within six months.  You must keep a record of all the complaints that you have received and report on them annually to the Area Team. You may wish to keep such records separately from patients’ clinical records, although it would be a sensible procedure to note in the clinical record that there has been a complaint.

 

The following model documents are attached:

 

• model practice leaflet/poster

• model letter acknowledging receipt of written complaint

• model form to record receipt of oral complaint

• model action sheet recording investigation and resolution of complaint

 

 

Background

 

The NHS complaints system in England was revised by regulations which came into effect on 1 April 2009, the introduction of NHS England in April 2013 and Nockolds taking over the OCCS complaints service in April 2014 has necessitated further changes to this guidance. GOS contractors will have to adapt their paperwork as a result. However, in practical terms, most of the changes are not major.

 

The few major changes include the following:

 

• a patient can complain directly to the NHS England Complaints Team,  if they wish

• you must record all the complaints that you receive about GOS services, domiciliary sight-testing and locally commissioned community service NHS services which you provide

• you must record the remedial actions taken and the lessons learned

• you must report annually to the Area Team the number and nature of all the complaints received and the important actions taken.

 

Note that, for the purpose of operating the system, a complaint:

 

• must relate to GOS or a locally commissioned service only

• can include the issuing of optical vouchers

• is not a complaint, if it is made orally and is resolved within 24 hours

• is not a complaint, if it concerns dispensing services or spectacles or lenses which are entirely private arrangements.

 

If a complaint specifically states or implies negligence, you are strongly advised simply to acknowledge receipt of the complaint and to consult your representative body or insurance provider, before attempting to resolve the matter or admitting liability.

 

 

Contents of the 2009 Complaints Regulations1

 

1.   As a GOS contractor, you are obliged by law to have arrangements in your practice (or in respect of your domiciliary service) to deal with complaints about your NHS services. Complaints about your private services or dispensing are matters for you to decide. Thus, the rest of this advice refers to NHS matters only, including the issuing of optical vouchers (but not the dispensing connected with vouchers).

 

2.   For the purpose of these arrangements, a complaint is not a complaint, if it is made orally and is resolved to the complainant’s satisfaction within 24 hours. A complaint may not refer to a failure to comply with the Freedom of Information Act (dealt with by a separate procedure). Nor may a complaint relate to a subject which has already been dealt with as a complaint and been resolved. In other words, a complaint cannot be repeated ad nauseam.

 

 

 

 

1 The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 (Statutory Instrument 2009 No. 309)

 

 

3.    Your arrangements for dealing with NHS complaints must ensure that:

 

• complaints are dealt with efficiently and are properly investigated

• complainants are treated courteously, fairly, expeditiously, appropriately and are informed of the outcome of the investigation of their complaint

• action is taken in the light of the outcome of the investigation if any is necessary.

 

4.   Your arrangements must designate a person to be responsible for ensuring compliance with the law and a person as a complaints manager. They may be the same person. The responsible person must be either the chief executive of a corporate body or the sole proprietor of a business or a partner of a partnership.  However, the functions of the responsible person and the complaints manager may be delegated to another person.  In the case of a body corporate it is sensible for a senior manager to be appointed as soon as possible to carry out the functions of the responsible person on the chief executive’s behalf and for designated complaints managers to be appointed in each branch.

 

5.   A complainant may be a patient; or a person acting on behalf, and in the interests, of a patient; or a third party actually or potentially affected by the substance of the complaint against you.

 

6.   A complaint about your NHS service may be made directly to you or via the NHS England Complaints Team.  If the complaint about you is made to NHS England, NHS England is obliged to consider the complaint and can decide to handle the complaint itself. Alternatively, NHS England may, with the complainant’s consent, refer the complaint to you for resolution. This is the course of action recommended in most circumstances by Department of Health guidance. You are obliged to deal with the complaint in accordance with the law and to cooperate with the NHS England Complaints Team.  Whether the complaint is made directly to you or via the Complaints Team,  you must acknowledge receipt of the complaint within three working days, either orally or in writing.

 

7.    A complaint must be made within 12 months of the date, on which the matter which is the subject of the complaint occurred or came to the complainant’s notice.

 

8.   A complaint may be made orally, in writing or electronically. If it is made orally, you are obliged to make a written record of the complaint – but only if 24 hours have elapsed since the complaint was made and if the complaint has not been resolved (see above). A copy of the written record must be given to the complainant.

 

9.  If you choose to reply to the complainant electronically, you may only do so with the complainant’s agreement, for example if they have provided you with their email address.

 

 

10.  When acknowledging receipt of a complaint, you must offer to discuss with the complainant how and when you intend to investigate and resolve the complaint. If the complainant refuses your offer, you must tell the complainant in writing how long it is likely to take you to respond concerning the substance of the complaint (the ‘response period’).

 

11. If your investigation of the complaint takes a long time, you must endeavour to keep the complainant informed of the progress of the investigation. As soon as possible after completing your investigation, you must tell the complainant in writing how you have considered the complaint and what you propose to do to resolve the complaint and any consequent action. You must also inform the complainant of their right to pursue the complaint with the Health Service Commissioner (the ‘health ombudsman’).

 

12.  You must endeavour to resolve the complaint within six months after receiving the complaint or, if you cannot, tell the complainant why you have not managed to do so.

 

13.  You must make information available to the general public about your arrangements for dealing with complaints about NHS services and how further information may be obtained. This can be in the form of a poster.

 

14.  You must keep a record of each complaint received, the subject matter and outcome of each complaint, each response period where applicable (see above), and, in the cases of a response period being applicable, whether the complainant was informed of the outcome of the investigation.

 

15.   On the date agreed with your Area Team in your contract, you must report annually to the NHSBSA  the number of complaints you received in the year in question, the number of complaints which were justified (‘well founded’) and the number referred to the ombudsman.2 You must also summarise the nature of the complaints received, any matters of general importance arising out those complaints, or the way in which they were handled, and any action taken to improve NHS services as a result of those complaints. Finally, your report must be made available to anybody on request.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 The optical bodies recommend reporting by 30 June on the period of the preceding financial year.

 

NHS Complaints Procedure

 

Do You Have a Complaint?

 

If you wish to complain about our services or products, please let us know as soon as possible. Whether you are a patient receiving General Ophthalmic Services under the NHS or you are a private patient, we hope that most problems can be sorted out quickly and easily. The sooner you tell us about the problem, the quicker it can usually be resolved.

 

If your complaint is about a NHS sight test or other NHS service, you should tell us - verbally, electronically or in writing - within 12 months of the incident itself or 12 months of you becoming aware of the problem.

 

Please raise your concern with any of our staff or please contact:

Alternatively you can complain to NHS England. They will tell you how they intend to deal with your complaint. https://www.england.nhs.uk/contact-us/complaint/

 

Complaints should be sent to:

NHS England

PO Box 16738

Redditch

B97 9PT

Email:  england.contactus@nhs.net

Please state:  ‘For the attention of the complaints manager’ in the subject heading

Tel:  0300 311 22 33

(Monday to Friday 8am to 6pm, excluding English Bank Holidays)

 

They will acknowledge receipt of your complaint within three working days; and, if you wish, they will explain to you in person how and when they will investigate and resolve the complaint. If the investigation takes longer than expected, they will keep you informed. Although they undertake to resolve complaints within six months, most complaints are dealt with much more quickly than that.

 

You can be sure that they will treat your complaint in strict confidence. If you are complaining on behalf somebody else, they will need that person’s permission to respond to you.

 

If your complaint is not about NHS sight testing or other NHS services but about spectacles or contact lenses only and we are not able to resolve it to your satisfaction, further help is available from: http://www.opticalcomplaints.co.uk/

 

Optical Consumer Complaints Service

6 Market Square, Bishop's Stortford, Hertfordshire, CM23 3UZ

 

Telephone: 0344 800 5071

 

 

[MODEL LETTER OF ACKNOWLEDGEMENT]

 

 

 

 

(DATE)

 

Dear ………..

 

 

 

Thank you for your letter dated …. about [brief description of alleged problem and date].

 

I am so sorry that you are not happy. I am looking into the points you raise as a matter of urgency and will let you have a full response as quickly as possible.

 

[FIRST ALTERNATIVE]

[We would be very happy to discuss the points you raise in your letter with you in person, if you would like to come to the practice. In that way, we can go into more detail and explain to you how we plan to investigate and resolve the matter.]

 

[SECOND ALTERNATIVE]

[We understand that your preference is not to discuss the matter in person, but the offer to do so at any time always remains open. Our estimate is that it will take us … [day/weeks/months] to fully investigate and report to you on the matter.

 

Yours sincerely,

 

 

 

 Steven Harvey

 

Optometrist/Director

 

Yarrow & Harvey  Optometrists

 

 

ORAL COMPLAINT RECEIPT FORM

 

Complainant’s Details

Name:…………………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………..……………..

………………………………………………………………………………………………………………………………….…………….. 

Telephone: ………………………………………………………………………………………………………………….……………..

Email: …………………………………….…………………………………………………………………………………..………………  

 

Patient’s Details (if different from complainant)

Name: ………………………………………………………………………………………………………………………..……………..

Address: …………………………………………………………………………………………………………………….……………..

………………………………………………………………………………………………………………………………………………..

Date of birth: ……………………………………………………………………………………………………………..……………..

NHS number (if known): …………………………………………………………………………………………….……………..

 

Details of complaint

(including date of complaint, date of incident, nature of incident and persons involved)

 

 

 

 

 

 

 

 

 

If the complainant is not the patient: I…………………………………………………authorise the person named above to make this complaint on my behalf. I agree that the practice may disclose to him/her any necessary confidential information about me or my care in order to resolve the complaint.

 

Patient’s name and signature…………………………………………………………………………………..……………..

Date…………………………………………………………………………………………………………………………..……………..

 

 

ACTION SHEET ON HANDLING OF COMPLAINT

Complainant’s name…………………………………………………………………………………………………..……………..

Patient’s name (if different)……………………………………………………………………………………….…………….. Address……………………………………………………………………………………………………………………………………..

………………………………………………………………………………………………………………………………..……………..

Date of birth: …………………………………………………………………………………………………………….…………….. 

NHS number (if known): …………………………………………………………………………………………………………..

Practitioner’s name………………………………………………………………………….. ……………………….…………….

Was the complaint received from the Area Team? Yes / No

Date complaint received…………………………………………………………………….……………………………………..

Date of incident……………………………………………………………………………….………………………..……………..

Method of making complaint: in person/telephone/email/letter [delete as appropriate]

Date complaint acknowledged  a) orally ………………….……… b) in writing …………………………………

Details of complaint

 

 

 

 

Date of meeting with complainant (if any) ……………………………………………………………….……………..

Date of letter of explanation sent……………………………………………………………………………..……………..

Details of explanation

 

 

 

 

Details of further action to be taken (if any)

 

 

 

Date of resolution……………………………………………………………………………………………………..…………….

Name and signature of complaints manager……………………………………………………………..……………..

 

 

 

ANNUAL REPORT SUBMISSION TO NHSBSA

 

 

 

Under GOS 9General Ophthalmic Services) Regulations 2008, contractors are required to complete and submit an annual form to NHSBSA providing the number of written complaints received in their practice. 

 

The completion of the form will be online via the NHSBSA website.  The link to the webpage to complete the form can be found on their website:

http:www.nhsbsa.nhs.uk.what-we-do/ophthalmic-provider-assurance.

 

You will access the SNAP survey using your ODS code.  If you are unsure or do not know your ODS code the Provider Assurance Ophthalmic team will be able to assist you; they will require the Contractors Name, first line of address and post code to locate your ODS code.  The ODS code is the code used to order stationery.

 

Alternatively, to locate your ODS code from the NHS Digital ODS Portal, you can use the following link:

http://odsportal.hscic.gov.uk/Organisation/Search

 

Once the form has been submitted the information cannot be changed.  There will be a review page to check your answers before submitting the form. 

 

On the form you will be asked to supply the name of the person submitting the data in case of any queries and an e-mail address. 

 

If there are no complaints contractors are required to submit a zero return.

 

The collated information from the completed forms will then be shared with the relevant NHS England Regional Teams.

 

If you have any queries, please contact the Provider Assurance Ophthalmic team via e-mail nhsbsa.ophthalmicproviderassurance@nhs.net or telephone 0300 330 9403, lines are open 08:00 till 16:30 Monday to Friday.