Local resolution: health and social care
Health and Social Care Complaints
The NHS and Social Services do not currently share the same complaints procedure. Complaints relating to NHS bodies are to be dealt with in accordance with the Principal Regulations, as amended by the 2006 Regulations. Complaints relating to local authorities are to be dealt with by them, under the Social Services Complaints Regulations. NHS bodies have no ability to deal with complaints under the Social Services Regulations, likewise, local authorities are unable to deal with complaints under the Principal Regulations.
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The new Local Authority Social Services Complaints (England) Regulations 2006 has a three-stage approach
Stage 1 local resolution
Stage 2 formal investigation
Stage 3 If the complainant is dissatisfied with the local authority’s response and, within 20 days, notifies the authority accordingly in writing, requesting a Panel. The Panel is to comprise three people including at least two independent people one of whom must be the chairperson. |
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Close co-operation between complaints managers when cross-boundary issues are being investigated is essential.
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Get to know the Complaints Manager(s) in your Local Authority(ies) and, if they exist in your area, Care Trusts. Ask for a copy of their complaints protocol and whether they have local joint procedures. |
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Examples of mixed sector complaints
- complaints which from the outset cover several areas, some of which are NHS responsibility while others are the responsibility of the Local Authority, e.g. multi-disciplinary team working
- complaints which start off as being about one organisation but investigations reveal possible failings by another, e.g. hospital discharge arrangements
- complaints which are about one organisation but arise from that organisation’s decision not to accept an assessment/recommendations of the other, e.g. continuing care.
The approach to mixed sector complaints
A complaint involving social care and health services can be made in its entirety to any one of the organisations involved. Under the amended regulations there is now a duty on NHS bodies to cooperate with local authorities when complaints relate in part to a local authority’s functions. A ‘lead body’ should be identified with a single joint reply where possible. This will ensure that patients and service users get a more integrated response when they raise concerns which cover both health and social care.
The duty to cooperate for all parties includes the duty to:
- share relevant information, and
- attend joint meetings reasonably arranged to consider the complaint.
Additionally, the two bodies should seek to agree which organisation should take the lead in co-ordinating the handling of the complaint and dealing with the complainant. The lead body’s Complaints Manager must:
- coordinate the handling of the complaint by working closely with all those involved,
- ensure a comprehensive and appropriate response is sent, and
- ensure that they keep the complainant informed and, where possible, coordinate a single reply.
The CSCI will also have a duty to work closely with the Healthcare Commission (external link) in matters of complaint concerning joint health and social care provision.
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In the March 2005 budget it was announced that the Healthcare Commission and the CSCI will be merged by 2008. The CSCI and the Healthcare Commission will form a new body to regulate all adult health and social care services, whilst responsibility for inspecting children's social services, children's homes and fostering will pass to Ofsted.
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Complaints about NHS and Social Care Partnership Agreements
The introduction of partnership arrangements between the NHS and Social Services has the potential to confuse established arrangements for complaints.
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Partnership arrangements have been developed between PCTs and Social Services, but the national complaints procedure has not kept up to date with these developments yet. PCTs are awaiting Complaints Directions and are working with a system devised in 1996 in pre-PCT days. This means that although they can work jointly at a Local Resolution level they are still restricted by different legislation beyond this. |
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Ideally, complaints should be dealt with by the partnership itself, with the responsible manager taking the complaint through the informal processes, and a joint committee or sub-committee of the partnership’s governance arrangement being able to take on a formal review.
A complaints protocol for a partnership arrangement will have usually have been agreed on the processes to be used. The procedure may be similar to this example of a joint complaints procedure.
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Check if one exists locally in your area |
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There may be circumstances when a referral to one or more of the partners' parent bodies is necessary. In addition, a complainant may wish to use an existing statutory complaints procedure from the outset.
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Partnership Agreements between NHS and Local Authorities
Under the Health Act 1999 (external link), new powers to enable health and local authorities to work together better came into force from 1st April 2000. These are called “Partnership Agreements.” Pooled funds, lead commissioning and integrated provision have been introduced so that the focus of attention is on how responsive organisations can be to the needs of their clients rather than worrying about the boundaries of organisations.
These arrangements can be of any size and can include Primary Care Trusts and Local Authorities services such as social services, housing, transport, etc.
Partnership agreements are especially relevant to services for well-defined client groups with long term needs, where the underlying aim is to support people increasingly in social care settings but with a strong health component. Mental health services in many areas are provided under partnership agreements. |
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If the complainant remains dissatisfied
If the complainant is still dissatisfied, they can write to
- the Healthcare Commission
- the CSCI
- or the Local Government Ombudsman
and ask for a further investigation. Further clarity is still needed on who would take lead responsibility for investigating these cases, and advice should be sought initially from the Healthcare Commission.
Next: Complaints about Social Care Services
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