Everyone has the right to expect a positive experience and a good treatment outcome. In the event of concern or complaint, patients have a right to be listened to and to be treated with respect.
Service providers should properly manage complaints, so customers’ concerns are handled appropriately.
Good complaint policy handling matters because it is an important way of ensuring customers receive the service they are entitled to expect.
Complaints are a valuable source of feedback; they provide an audit trail and can be an early warning of failures in service delivery. When handled well, complaints provide an opportunity to improve service and reputation.
We aim to provide a service that meets the needs of our patients and we strive for a high standard of care;
We welcome suggestions from patients and from our clinicians and staff about the safety and quality of service, treatment and care we provide;
We are committed to an effective and fair complaints system; and we support a culture of openness and willingness to learn from incidents, including complaints.
Patients are encouraged to provide suggestions, compliments, concerns and complaints and we offer a range of ways to do it.
Patients are encouraged to discuss any concerns about treatment and service with their treating clinician [or alternate], or they can complete our customer feedback form.
Clinicians and staff can also use the feedback form to record any concerns and complaints about the quality of service or care to customers.
All complainants are treated with respect, sensitivity and confidentiality.
All complaints are handled without prejudice or assumptions about how minor or serious they are. The emphasis is on resolving the problem.
Patients and staff can make complaints on a confidential basis or anonymously if they wish, and be assured that their identity will be protected.
Patients, clinicians and staff will not be discriminated against or suffer any unjust adverse consequences as a result of making a complaint about standards of care and service.
The process of resolving the problem will include:
an expression of regret to the consumer for any harm or distress suffered;
an explanation or information about what is known, without speculating or blaming others; considering the problem and the outcome the consumer is seeking and proposing a solution; and confirming that the patient is satisfied with the proposed solution.
If the problem is resolved, clinicians and staff are expected to complete the Suggestion for Improvement form to record feedback from patients.
Our clinicians and staff will consult with their manager if addressing the problem is beyond their responsibilities.
Complaints that are not resolved at the point of service, or that are received in writing and require follow up, are regarded as formal complaints.
Our clinicians and staff refer complaints to [complaints manager/clinical director] if:
If the complaint is not resolved at the point of service, clinicians and staff are expected to provide the complainant with the formal complaints policy.
Clinicians and staff then complete the first two sections of the Complaint Follow-up form and forward it to Robert Munroe.
The complaints manager coordinates the resolution of formal complaints in close liaison with the treating clinician and other staff who are directly involved.
Robert Munroe and Privè General Counsel are responsible for coordinating investigation and resolution of formal complaints, conducting risk assessments (in consultation with clinicians), liaising with complainants, maintaining a register of complaints and other feedback, providing regular reports on informal and formal complaints, and monitoring the performance of those complaints.
Matthew Fellowes is responsible for a proactive approach to receiving feedback from patients and staff, risk management in consultation with Robert Munroe and General Counsel.
Investigation and review of complaints and follow up action for serious complaints, or where complaints result in recommendations for change in policy of procedures.
Ensuring appropriate action is taken to resolve individual complaints;
Acting on recommendations for improvement arising from complaints;
Ensuring there is meaningful reporting on trends in complaints;
Ensuring compliance and review of the complaints management policy;
Notifications to insurers; and
Consultation with professional registration boards, and others where necessary.
All clinicians and staff need to have been appropriately trained to manage complaints competently.
The service provides training in dispute management, customer service and our complaints management procedures as part of induction and through regular updates.
Regular reviews are conducted by the Robert Munroe to check understanding of the complaints process among clinicians and staff.
Information is provided about the complaints policy and external complaints bodies that patients can go to with a complaint, such as [Save Face ltd] in a variety of ways, including;
Formal complaints are normally resolved by direct negotiation with the complainant, but some complaints are better resolved with the assistance of an alternative dispute resolution provider.
Robert Munroe will signpost the complainant to an appropriate external body if;
After receiving a formal complaint, Robert Munroe reviews the issues in consultation with relevant clinicians to decide what action should be taken, consistent with the risk management procedure.
Formal complaints are acknowledged in writing or in person within 48 hours.
The acknowledgement provides contact details for the person who is handling the complaint, how the complaint will be dealt with and how long it is expected to take.
If a complaint raises issues that require notification or consultation with an external body, the notification or consultation will occur within three days of those issues being identified.
Formal complaints are investigated and resolved within 30 days.
If the complaint is not resolved within 20 days, the complainant, clinicians and staff who are directly involved in the complaint will be provided with an update.
The complaints manager maintains a complaints and patient feedback register ( e.g. Save Face portfolio), with records of informal feedback (Suggestions for improvement and patient feedback forms) and formal complaints.
Personal information in individual complaints is kept confidential and is only made available to those who need it to deal with the complaint.
Complainants are given notice about how their personal information is likely to be used during the investigation of a complaint.
Individual complaints files are kept in a secure filing cabinet in the [complaints manager]’s office and in a restricted access section of the computer system’s file server.
Patients are provided with access to their medical records [in accordance with the confidentiality policy]. Others requesting access to a patient’s medical records as part of resolving a complaint are provided with access only if the patient has provided authorisation [in accordance with the confidentiality policy].
Robert Munroe carries out investigations of complaints to identify what happened, the underlying causes of the complaint and preventative strategies. Information is gathered from:
Talking to clinicians and staff directly involved;
Listening to the complainant’s views;
Reviewing medical records and other records; and
Reviewing relevant policies, standards or Guidelines.
Where an individual clinician or staff member has been nominated by a complainant, the matter will be investigated by the relevant manager or supervisor, who will:
The clinicians and staff members will be asked to provide a factual report of the incident, identify systems issues that may have contributed to the incident and suggest possible preventive measures.
Where the investigation of a complaint results in findings and recommendations about individual clinicians and staff members, the issues are addressed through the service’s staff performance and review process.
Robert Munroe and Privè General Counsel prepare Monthy reports on the number and type of complaints, the outcomes of complaints, recommendations for change and any subsequent action that has been taken.
The reports are provided to staff, clinicians, senior management and if appropriate, uploaded into a personal portfolio for audit and appraisal.
Robert Munroe and Privè General Counsel periodically prepare case studies using anonymised individual complaints to demonstrate how complaints are resolved and followed up, for the information of staff, and for use in audit and appraisal.
Information about trends in complaints and how individual complaints are resolved is routinely discussed at staff meetings and clinical review meetings as part of reflecting on the performance of the service and opportunities for improvement.
Complaints reports are considered and discussed at monthly clinical review meetings and directors’ meetings.
An annual quality improvement report is published that includes information on:
The number and main types of complaints received, common outcomes and how complaints have resulted in changes;
How complaints were managed—how the complaints system was promoted, how long it took to resolve complaints (and whether this is consistent with the policy) and whether complainants and staff were satisfied with the process and outcomes; and
The results of the annual patient satisfaction survey.
The service promotes changes it has made as a result of patient complaints and suggestions in its general publicity.
Robert Munroe and Privè General Counsel continuously monitor the amount of time taken to resolve complaints, whether recommended changes have been acted on and whether satisfactory outcomes have been achieved.
Robert Munroe and Privè General Counsel annually review the complaints management system to evaluate if the complaints policy is being complied with and how it measures up against best practice guidelines. As part of the evaluation, consumers, clinicians and staff are asked to comment on their awareness of the policy and how well it works in practice.
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