What are the issues and elements of the complaint? (“personal grievance” or “clinical governance” complaint?)

ICAS has a broad remit, to provide assistance with not just the NHS complaints procedure, but in fact any type of grievance put forward under any form of procedure that falls under the jurisdiction of the Health Ombudsman.

Local resolution seeks to provide prompt investigation and resolution of the complaint at local level, aiming to satisfy the complainant whilst being fair to staff, and is likely to be the first aim of supporting a complainant.

At the heart of the NHS complaints reform is changing attitudes to complaints so they are integral to

• clinical governance
• service improvement.

It is important to differentiate at the outset between complaints which are relatively minor in nature and relate to purely “personal grievance” matters and those which have a relevance to “clinical governance”, i.e. those that might indicate that a health professional has placed a patient at risk or has delivered a poor standard of care.

“Personal grievance” complaints are usually addressed by way of conciliation and mediation. This is offered by Trusts to restore, if possible, the relationship of trust between the health professional and the complainant.

“Clinical governance” complaints are likely to be viewed more formally by Trusts, so that the Trust concerned can address the issues raised as part of its clinical governance responsibilities.

The 5th Report of the Shipman Inquiry (external link)(published December 2004) identified the provision of arrangements for the prompt and thorough investigation of “clinical governance” complaints as the single most important issue to be tackled in the reform of the complaints procedures. The Government’s response to the recommendations of the Shipman Inquiry’s 5th   report and to the recommendations of the Ayling, Neale and Kerr/Haslam Inquiries, “Safeguarding Patients” (external link) has just been published (February 2007) This has specific recommendations in relation to complaints procedures.

When ICAS advocates consider that there is a serious risk to patient safety or there is clear evidence of malpractice, the ICAS advocate, with the advice of their line manager, needs to consider how the complaint can be dealt with as promptly and thoroughly as possible.

Next: Is patient safety at risk?