 |
 |
 |
|
|||
|
|
Every patient has the right to complain about treatment received. The NHS Trust or health authority which provided the treatment is obliged to investigate promptly and respond. Nevertheless a major subject of concern considered in the Chief Medical Officer’s reform proposals was the current NHS-wide complaints procedure which has been in operation since 1996 and the key feature of which is a strong emphasis on local resolution of complaints.
If you are not happy with your treatment, or, indeed, any matter connected with the provision of services at your GP’s surgery or a hospital, but you are looking for a full explanation, perhaps an apology, you must use the present system. This is criticised as lacking independence, frequently failing to yield an apology or explanation, being biased and unfair. It has even been said that many complainants, frustrated at the complaints system, resort to making legal claims which means, under the NHS rules, that the complaints procedure will be immediately halted!
The whole area is scheduled for reform – in fact, the Legal Services Commission, which oversees the provision of public funding – formerly “legal aid”, has stated that this is so urgent that it should be done before any other reforms are considered.
Minor complaints: If you have no serious injury, or you feel that you have been treated rudely or ignored, the quickest and most economical option is to write informally to the doctor, surgeon or other health carer for an explanation, remembering to keep a copy. You would probably be invited to an informal meeting which, with today's expressed aim on speedy resolution of disputes in the NHS, may well resolve matters. You need to be aware however that an apology from a doctor or NHS Trust does not mean that you have a valid claim for clinical negligence.
If you are still not satisfied, or your complaint and injury are serious, then you could contact the Patient Advisory Liaison Services (PALS) www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/PatientAndPublicInvolvement/PatientAdviceAndLiaisonServices/fs/en at the hospital concerned. PALS, which replaced the Community Health Councils (CHCs), were heralded by the Department of Health as a “new era in patient and public involvement in the NHS” but it is early days to assess their service. If you wish to pass on your own experience, whether positive or negative, of this service, we would like to hear from you. Email editor@medneg.com and have your comments posted on our Forum.
The CHC's duty was to recommend improvements to NHS services in its area and consider the individual patient's case. The CHC could refer the patient to the appropriate channel for his or her complaint and probably to a specialist solicitor in the area. Whether this will be available from the PALS remains to be seen. One useful feature is the facility of posting comments on the hospital’s website.
Confused? That’s not all: the government has established a new Commission for Healthcare Audit and Inspection (CHAI) www.healthcarecommission.org.uk/Homepage/fs/en, known as the Healthcare Commission, independent of the NHS and Department of Health, which has independent scrutiny of complaints as one of its functions.
NHS Trusts, hospitals, health authorities and general practitioners have a duty to set up, and publicise to patients, a complaints procedure, usually under a Complaints Manager, who should be readily available. Complaints should be made within six months of the date of the medical accident complained of, or within 6 months of the date when you knew of your injury provided that is within 12 months of the accident. Those dates can be extended at the discretion of the Complaints Manager.
If you complain under the NHS complaints procedure this should be done as soon as possible while memories are fresh. But beware: at present NHS complaint investigation procedures are not available if disciplinary procedures are being taken or if you have stated, in a letter or orally, that you intend to take legal action. If you decide to ask a solicitor to act for you in making your complaint – work, by the way, which cannot be funded through legal aid - this may be taken as evidence of such an intention.
The unfairness of this rule was recognised by the Chief Medical Officer in his report Making Amends published on June 30, 2003. It is scheduled to be abolished.
Step 1: Local resolution: Make your complaint, orally or in writing, to the person responsible locally (usually the Complaints Manager) at your GP, NHS Trust (hospital), or dentist. If you do not want to go to directly to the GP's practice you can ask the Complaints Manager at the local health authority (his details will be with the GP) to mediate.
You should receive acknowledgement of a written complaint within three working days and may be invited to a meeting with the health care provider within 10 working days. The complaints team will investigate - obtain the medical records and notes, interview staff and provide an explanation. If you are dissatisfied ask for a written explanation. Your complaint should be answered within three weeks.
Step 2: Independent Review: If you are not satisfied with the local resolution you may now seek an Independent Review from the Healthcare Commission above.
If your request is refused, or if you are dissatisfied with the panel report, you can complain to the Health Service Commissioner for England (Health Service Ombudsman) www.ombudsman.org.uk. Her function is to investigate and report clinical and family health service complaints; complaints about health authorities and health carers, and make recommendations. But she will not usually investigate your complaint unless you have first made your complaint through the NHS complaints procedure. She will not investigate if you have a remedy in the courts unless she is satisfied that it was unreasonable to expect you to resort to litigation.
One objective of the complaints procedures outlined above was to avoid litigation. Nevertheless the procedure may provide evidence on which a decision can be taken whether or not to bring a legal claim. In fact funding from the Community Legal Service fund may be refused to a clinical negligence claimant unless it has been established that the NHS complaints procedure has been used – a Catch 22 situation which explains why some solicitors may be rather coy in letting the NHS Trust know they have been consulted.
If you were a private patient you cannot make use of the NHS complaints procedures. You should make your complaint directly to the doctor, surgeon, private clinic or hospital concerned. Normally the situation is that the patient has a contract with the doctor or surgeon who uses the clinic's facilities. All the parties should be insured for liability risks and if you make a claim for damages that will be passed on to the insurers.
www.nhsla.com/Claims/Schemes/CNST
Since 1995 NHS trusts should have an effective procedure for reporting and investigating any serious clinical incident. The purpose of the inquiry is to establish the facts and consider whether action is required to avoid a similar incident. Yet another quango, the National Patient Safety Agency www.npsa.nhs.uk, is supposed to collate these incidents, yet this organisation, as with every other NHS quango, has recently been listed as subject to being axed!
Once preliminary findings are made by an inquiry team an internal inquiry may be held. The patient should be kept informed of the problem and the result of the inquiry. A solicitor acting for the patient would be entitled to a copy of the inquiry proceedings and decision.
Other helpful organisations include:
Charitable organisation: A number of charities have been set up as action groups for certain interests and medical conditions. Many of these are listed in the Health and Social Services Year Book published annually by the Institute for Health Service Management website: www.ihm.org.uk. This book will probably be in your local reference library. The encyclopaedia of charities on the internet website: www.charitychoice.co.uk has thousands of UK charities with contact information and direct links to those with their own websites.
Citizen's Advice Bureaux (CABs) www.citizensadvice.org.uk/macnn/. Once you have told your story, your local CAB worker should provide, without charge, general guidance on the law and direct you to other local organisations. You can find the address and telephone number of your local CAB on the website or in the local telephone directory, library or town hall.
The Patients' Association. Can be contacted at PO Box Box 935, Harrow, Middlesex, HA1 3YG tel: 020 8423 9111 fax: 020 8423 9119 helpline: 08456 084455 website: www.patients-association.com. Its aim is to further the interest of patients.
General Medical Council (GMC). The GMC, which has a range of disciplinary powers from warning a doctor to striking off from the Medical Register, is concerned with a doctor's standards of professional conduct, his fitness to practice and the protection of patients. If you believe that a doctor has committed serious professional misconduct - Has he behaved so badly that he should not even be practising? - or that his performance appears to be seriously deficient you can address your complaint to the Fitness to Practice Department (FPD), General Medical Council, 178 Great Portland Street, London W1N 6JE. Tel 020 7580 7642 fax: 020 7915 3641 website: http://www.gmc-uk.org.
Complaints about dentists should be addressed to the General Dental Council at 37 Wimpole Street, London, W1M 8DQ Tel: 020 7887 3800; fax: 020 7487 2643; website: www.gdc-uk.org.
Complaints can be made to the General Medical Council and General Dental Council when it is not appropriate to sue, for example, where you have been injured by substandard medical treatment but your injury is minor, or you feel that you have been ignored.
Your Member of Parliament: If you feel that you are getting nowhere with your case or that you have suffered an injustice you could ask your MP, by writing or attending one of his or her clinics, to consider taking up your case.
The media: Following a number of recent medical scandals and the political aspects of the NHS, media interest in clinical negligence is high. NHS Trusts are anxious that their services are not perceived as substandard. If you want attention drawn to your case it could be worthwhile contacting your local or national newspaper, radio and TV stations.
- What is clinical negligence?
- Where can you find an experienced clinical negligence solicitor?
- How do you finance your claim?
- How is your claim investigated?
- What happens if your claim is litigated?
- Could you bring your claim yourself?
 |
|
| < Previous | Next > |