The main changes in relation to local resolution as a result of the 2006 amendments are:

Timescales

• the time limit for trusts to respond to a complaint at the local level has been extended from 20 working days to 25 working days from the date the complaint is made and received

• time-limits for requesting independent review by the Healthcare Commission extended from 2 to 6 months after the end of local resolution. This will give individual patients more time to reach a decision about whether to take their complaint to the Healthcare Commission if they are dissatisfied with the local response.

Complaints involving more than one body and complaints made to an NHS body relating only to a local authority

There is now a duty on NHS bodies to cooperate with local authorities when complaints relate in part to a local authority’s functions. 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 protocols for determining the lead agency are best worked out locally. However, regulation 13(2) of the Principal Regulations provides that the Chief Executive of the NHS body should sign the response, except where there are good reasons for them not being able to do so. Irrespective of ‘lead’ responsibility, each body retains its duty of care to the complainant and must handle its part of the complaint in accordance with its own regulated procedures. The Social Services Regulations have a provision that mirrors the new regulation 3A to ensure that this can occur

The Complaints Manager

The complaints manager does not have to be an employee of the NHS body and may act as Complaints Manager for more than one NHS body. This will give NHS bodies more flexibility and allow them to pool resources

Two new types of complaints that cannot be considered under the regulated complaints process:

• a complaint the subject matter of which has already been investigated under these Regulations
• a complaint which relates to any scheme established under section 10 (superannuation of persons engaged in health services, etc) or section 24 (compensation for loss of office, etc) of the Superannuation Act 1972(a), or the administration of those schemes.

Foundation trusts

The amended Regulation broadens the remit of the Healthcare Commission in respect of complaints relating to NHS foundation trusts to bring it into line with complaints about NHS bodies. It enables the Healthcare Commission to investigate both patient and non-patient complaints arising from NHS Foundation Trusts. This gives consistency in the type of complaints the Healthcare Commission can investigate across NHS trusts and NHS foundation trusts.

Healthcare Commission

The amended Regulation

• removes most of the prescription which sets out how the Commission must use independent panels to consider complaints ( e.g. to have a lay panel), if it exercises its choice to use such panels.
• removes the obligation on the Healthcare Commission to forward a copy of all complaints relating to NHS foundation trusts to Monitor within two working days and replace it with a requirement to provide reports that provide a breakdown of aggregate data and complaint trends. The regulations will enable Monitor to require the Healthcare Commission to send it any particular types of complaints it is interested in. This will remove an unnecessary administrative burden and replace it with a more focussed and useful set of information being shared with the Monitor.

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-

(a) the complaints procedure;
(b) the role of the Primary Care Trust and other bodies in relation to complaints about services under the contract; and
(c) 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)

Next: Key changes now in place