Speaking Up Project NHS Complaints – resolution and no recurrence Alex Robinson – Project Manager Presentation to Health Scrutiny Committee 1 st August 2011
Background � National charity nearly 50 years old � Concerned for many years ref. complaints handling via national Helpline � Successful bid for funding from the Health Foundation (charity) to run a 2 year project � Lead organisation – Patients Association Key partners: � Mid Staffordshire NHS Foundation Trust � Pilgrim Projects � National Confidential Enquiry into Patient Outcomes and Death (NCEPOD)
Why NHS Complaints? Why Mid Staffs? � Inequitable relationship between Trust and complainant � Trusts review their own performance – limited external scrutiny � Shipman Review identified lack of uniform standards and guidance for complaints investigation – 6 years on this weakness remains � At Mid Staffs there is a particular need to rebuild trust and confidence with the local community
The Project Itself 4 specific work streams: � Expert Panel Reviews � Complaints Support Service � Digital Story Telling � Complaints Survey
Expert Panel Reviews Proposed methodology � Panel of experts will meet every quarter over the 2 years to review a sample of complaints � Retrospective activity – NCEPOD methodology � Selection criteria – all extremes + mixture of low, medium and high cases � Panels will consist of clinicians [nurses and hospital consultants], complaints managers from other organisations, magistrates, community members � They will use guidance and a scorecard specifically developed for this activity � They will allocate a score to each complaint reviewed. They will look for trends
Expert Panel Reviews Guidance and scorecard � Lots of documents on complaints handling but very little detailed guidance � With the support of the judiciary and complaints managers we have set about bridging that gap � Have drafted a document containing 12 standards, which will be made available to the Trust � Secured expert advice [Dame Janet Smith]
� Standard 1: The investigation of the complaint is impartial and fair. � Standard 2: Individuals assigned to play a part in a complaint investigation have the necessary competencies. � Standard 3: The roles and responsibilities of the complaints handling team are clearly defined. � Standard 4: The governance arrangements regarding complaint handling are robust. � Standard 5: The Complainant has a single point of contact in the organisation and is placed at the centre of the process. � Standard 6: Investigations are carried out in accordance with local procedures, national guidance and within any legal frameworks. � Standard 7: The investigator reviews, organises and evaluates the investigative findings. � Standard 8: The judgement reached by the decision maker is transparent, reasonable and based on the evidence available. � Standard 9: The complaint documentation is accurate and complete. The investigation is formally recorded, the level of detail appropriate to the nature and seriousness of the complaint. � Standard 10: Responding adequately to the complainant and those complained about. � Standard 11: Learning lessons from complaints occurs throughout the Organisation. � Standard 12: Recording, analysing and reporting complaints information throughout the organisation and to external audiences
OVERALL RATING AND ASSESSMENT � HOW DOES THE PANEL Score of 4 – Good practice: a standard � RATE THE of complaints handling you would expect from yourself and your ORGANISATION institution AGAINST EACH Score of 3 – Room for improvement: � aspects of complaints handling that STANDARD? could have been better Score of 2 – Less than satisfactory: � several aspects of complaints handling � Level 1 – Poor Practice that were below standard Score of 1 – Poor: several aspects of � Level 2 – Less than � complaints handling that were Satisfactory substantially below standard � Level 3 – Satisfactory Please provide your reasons for � � Level 4 - Good practice assigning this grade: If you have rated this case as a Level � � Please provide your 1 are there any issues that you would like feeding back to the Chief reasons for assigning Executive at the Trust with immediate this grade effect?
Expert Panel Reviews Progress to date � Recruitment finalised for Phase 1 � From 200 registers of interest, 40 people shortlisted and invited to a training day 2 nd August � Dates for 2 year programme published � First panel [pilot] due 21 st / 22 nd September 2011 � Data protection issues discussed with Trust’s Cauldicott Guardian
Complaints Support Service Proposed methodology � Access to service same as that used for ICAS – patient choice � Introduce trained ‘Patient Champions’ recruited from outside the Trust, but from the local community, to support complainants � Service will offer clinical screening by senior nurse � Prospective activity – Patient Champions will provide a scored judgement on the Trust’s response / handling of the complaint using the aforementioned guidance and scorecard
Complaints Support Service Progress to date � Recruited to the role of Patient Champion Team Manager – senior nurse � 2 volunteer Patient Champions recruited from the local community � Looking to launch service 1 st September 2011 � Eligibility criteria being developed - discussions underway with ICAS ref cross referrals � Starting small but with scope to expand capacity if required
Branding and marketing very important The options that were on the table The decision: � Complaint Support Service � is meaningful - it “does what it says on the tin” � Patient Champion Service � is a name that is acceptable to � Complaints Review Service the local community � Speaking Up: The Patients' � evokes the idea of a strong Association Support Service voice for patients � The Patients Association's � is not too wordy - something NHS Evaluation that rolls off the tongue Support Service
What will the service offer? We will: Ask clinical specialists to review your � medical records if your complaint is about care and treatment � Make sure your complaint has been properly investigated � Tell you what we find and give a view on whether the response from the hospital is reasonable
Digital Story Telling � Pilgrim Projects have been commissioned to run 3 workshops over the life of the project – 2 with patients / complainants and 1 with staff if possible. � Workshops will help complainants translate their experiences into Patient Voices – Digital Stories � 250 word story in their own voice supported by music and images � They will be used as teaching resources for staff at the Trust � Lunch Event 2 nd September 2011 � 1 st workshop scheduled for 8 th – 10 th November 2011
Digital Story Telling � “Jimmy’s story” [told from the viewpoint of his sister, a nurse] � “Yeah, I’ll go” [told from the viewpoint of a junior doctor]
Complaints survey � Every complainant will be asked to complete a survey asking about the quality of the complaints process � Developed from scratch with Trust’s Complaints Focus Group � Reviewed by the Picker Institute � To date, have 7 other trusts interested in running survey / establishing a benchmarking group � Piloted with 48 recently closed cases at the trust
Complaints survey 23 questions in total including: � Were you worried that the quality of your care [or that of a friend or relative if you are complaining on their behalf] would be reduced if you complained? � Do you feel the response to your complaint explains how the Trust will take appropriate action to prevent the same thing happening again ? � Do you feel you have been told the truth in the response to your complaint? � If your complaint involved the behaviour of an individual member of staff , were you given a clear explanation as to how the hospital has dealt with this?
What do we want the project to achieve? � Equality � Transparency � Independence � Organisational Learning
Challenges ahead � Getting buy in and support from the local community, which is a key component of the project. � Getting buy in from staff at the Trust against a backdrop of a Public Inquiry. � Developing professional working relationships with the Trust whilst maintaining independence � Minimising duplication with similar projects – Engaging Communities
Thank You Any Questions?
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