Current position

The NHS (Complaints) Regulations 2004 (SI 2004/1768) (“the Principal Regulations”) came into force on 30 July 2004. They make provision for handling complaints in the National Health Service.
NB The Healthcare Commission is referred to as CHAI in the 2004 regulations.

These regulations were amended in September 2006:

The Amended Regulations apply to Primary Care Trusts, Strategic Health Authorities, NHS Trusts and Special Health Authorities. They also apply to Foundation Trusts with regard to the Healthcare Commission’s role in dealing with complaints about them in certain situations (Regulation 9).

The amendments are intended to make the system more responsive and give better links with the arrangements for responding to social care complaints. Complaints raised before 1 September 2006 will be dealt with under the National Health Service (Complaints) Regulations 2004, which came into force on 30 July 2004.

Latest developments in the reform programme

The amended regulations were introduced after the Department of Health had been able to give proper consideration to recommendations made by the Shipman Inquiry (as well as other inquiries due to report – Ayling, Neale, Kerr & Haslam). The Government’s response to the recommendations of the Shipman Inquiry’s fifth report and to the recommendations of the Ayling, Neale and Kerr/Haslam Inquiries, “Safeguarding Patients”  has just been published (February 2007) This has specific recommendations in relation to complaints procedures.

During 2006, following a commitment in the White Paper Our health, our care, our say, the Department launched a project to carry out a fundamental review of the complaints systems in both health and social care. The aim will be to complete the process begun with the 2004 and 2006 regulations and to develop by 2009 a comprehensive single complaints system across health and social care. The review has been carried out under the oversight of a policy forum with representation from the Healthcare Commission, the Commission for Social Care Inspection, the PALS, complaints staff, and the office of the health and local government Ombudsmen.

The Department will shortly (2007) be issuing a consultation paper with proposals for a new complaints system. The intention is to create a system which delivers a stronger voice for patients, in line with the overall objectives of the Government’s public sector reform programme, and which is

• demonstrably independent
• simple, integrated and consistent across organisations and agencies
• focused on the needs of patients and based on an understanding of the needs of patients, carers and staff
• staffed by well-trained people with sufficient seniority in their organisations to effect improvement
• supported by managers who are committed to learning from mistakes and to delivering specific and systematic changes to the organisations against which complaints are made.

Changes to local resolution as a result of the amendments relate to timescales, the duty to co-operate with local authorities, the role of the complaints manager, Foundation Trusts, the role of the Healthcare Commission. For details go to:
http://www.icasresources.com/regulations_quickNHSguide1.htm

Local resolution for primary care practitioners

The arrangements for local resolution set out in the Complaints Regulations do not apply to primary care practitioners at the moment. The separate Directions and Regulations relating to complaints made about primary care services continue to apply. These are laid out in detail in the 2004 guidance. The practice based procedure booklets issued to primary care practitioners in 1996 continue to apply.

At present PCTs are not able to intervene in the handling of complaints about Primary Care, other than to offer to act as “honest broker” between the complainant and the practice and, where appropriate, to arrange a conciliation meeting if both parties agree.  “Safeguarding Patients” indicates that this may soon change and patients will be able to complain directly to the PCT if they so choose.

The new GP contract requires active cooperation between the GP and the PCT on complaints:

“The contractor shall take reasonable steps to ensure that patients are aware of-

1. the complaints procedure;
2. the role of the Primary Care Trust and other bodies in relation to complaints about services under the contract; and
3. their right to assistance with any complaint from independent advocacy services provided under section 19A of the Act (independent advocacy services)”

The National Health Service (General Medical Services Contracts) Regulations 2004 (external link)

Independent review by the Healthcare Commission

The Healthcare Commission took over the second stage, independent review, of the NHS complaints procedure in England from July 30th 2004. Individuals can ask the Healthcare Commission to review their complaint if they remain dissatisfied with the outcome from local resolution. Where local resolution has

• been refused
• has taken more than six months

or the complainant has grounds for believing that it is not being carried out properly, the Healthcare Commission may decide to review the complaint before the end of local resolution. The Healthcare Commission has discretion to accept late complaints where the reasons for the delay are considered to be reasonable.

The new arrangements for independent review as set out in the Complaints Regulations apply to primary care practitioners from 30 July 2004.

Every complainant will be made aware of the right to independent review by the Healthcare Commission. Regulations require that the letter from the NHS organisation to the complainant, advising that the local resolution is at an end, must include this option.

See: Independent review in journey

Resources on complaints policy

The Department of Health has a complaints policy page with detailed guidance and links to all the relevant regulations.

Next: Background to reform process