Greater Glasgow NHS Board Board Meeting Tuesday, 17 December 22 Board Paper No. 2/88 HEAD OF BOARD ADMINISTRATION AND TRUST CHIEF EXECUTIVES QUARTERLY REPORT ON COMPLAINTS : JULY - SEPTEMBER 22 Recommendation The Board is asked to:- note the quarterly report on NHS complaints in Greater Glasgow for the period 1 July to 3 September 22. 1. Greater Glasgow NHS Board One Local Resolution complaint was received in this quarter and related to the alleged failure of GGHNSB to follow procedures set out in the Guidelines on NHS Responsibility for Continuing Care (Section 3 Review Procedures) [NHS MEL(1996)22], particularly in relation to meeting the timescales. The complaint was acknowledged on the day it was received and answered within the target of 2 working days. There were no requests for an Independent Review this quarter. 2. Trust Performance The information contained in the Complaints Report will ultimately form part of the Performance Assessment Framework (PAF) and will be reported under the PAF reporting arrangements once agreed. Until then, the Complaints Report will continue to be submitted to the NHS Board. (a) July - September 22 Shown below are the performances of each Trust against the national target of 7% of written Local Resolution Complaints to be completed within 2 working days of receipt:- No. of Complaints No. Completed Within 2 Working Days As Shown as % North Trust 212 133 63% South Trust 93 59 63% Yorkhill Trust 32 2 62% PCT Trust (excluding FHS) 14 6 43% (b) Further Breakdown of Trust Performance For ease of reference Trust performance against the national target has been summarised to show the last four quarters as indicated overleaf:- 1
Current Quarter 1/4/2-3/6/2 1/1/2-31/3/2 1/1/1-31/12/1 North Trust 63% 62% 63% 66% South Trust 63% 66% 62% 59% Yorkhill Trust 62% 44% 62% 63% PCT Trust (excluding FHS) 43% 75% 79% 86% 3. Themes and Trends Trust Chief Executives may wish to expand, at the meeting, on any themes or trends noticed with regard to complaints handling at their Trust. For the purposes of an NHS Greater Glasgow analysis, the following three areas attracted the most number of complaints:- Communication (including Attitude and Behaviour) Waiting Times Treatment Action taken and lessons learned for patient care as a result of complaints completed this quarter are as follows:- North Trust In Medicine for the Elderly a range of staff are addressing issues of attitude and behaviour, and communication, by attending customer care and interpersonal skills training. Strategies have been introduced to formalise procedures to ensure that relatives receive accurate and timely information. South Trust Yorkhill Trust Reviewed and reconfirmed transport arrangements for transferring patients to other NHS organisations. Addressed specific communication issues with Ward Staff and Senior Nurse Managers Reviewed and reconfirmed communication issues around informing families of imminent death Waiting list review held resulting in some patients being either removed from the list, transferred to Day Surgery Waiting List resulting in a more efficient use of limited in-patient bed resources. Efforts continue to be made to reduce waiting times. PCT Trust (excluding FHS) As a result of an assumption being made with regard to the wishes of a family not to have a relative admitted to a specific hospital, staff have been reminded that all such matters should initially be discussed with families. Additional training has been provided by the Patient Affairs Manager following a complaint about a pension book not being transferred appropriately with the patient from ward to ward. Staff have been reminded about the correct procedures to be followed when medical records are required from outwith the Trust. The approach to assessing physically frail patients prior to transfer to partnership homes will be more flexible and based on individual cases. 2
Following a request from Greater Glasgow Health Council, the outcome of complaints completed at Local Resolution, in terms of number upheld, number upheld in part and number not upheld have been analysed as indicated below:- July to September 22 Complaints Completed Upheld Upheld in Part Not Upheld North Trust 212 67 (32%) 72 (34%) 73 (34%) South Trust 93 14(15%) 27 (29%) 52 (56%) Yorkhill Trust 32 5 (15%) 13 (41%) 14 (44%) PCT Trust (excluding FHS) 14 4 (28%) 5 (36%) 5 (36%) 4. Conciliation Within this quarter, one request was received from the Primary Care Trust for a conciliator. 5. NHS Greater Glasgow Procedure for Vexatious and Habitual Complaints Following a request from the North Trust, it was agreed that a short life Working Group be set up to establish a Policy for dealing with Vexatious and Habitual Complaints - NHS Greater Glasgow wide. The membership of this group is as follows:- Representative from Greater Glasgow Health Council. The NHS Board's Head of Board Administration and Secretariat Manager. The Associate Convener, GGNHSB and Associate Convener, South Glasgow University Hospitals NHS Trust. One representative from each Greater Glasgow NHS Trust. The Working Group had its first meeting on 8 August 22 and the Board's Secretariat Manager prepared a first draft of the Policy. This was sent out to all Members of the Working Group and their comments and views further discussed at a meeting held on 6 November 22. Following that, further revisions were made to the Policy and it went out, on 11 November 22, to a wider audience for consultation (all Complaints Officers to share also with Conveners, Greater Glasgow Health Council, Trust Chief Executives and Chairs and Working Group Members). The closing date for this consultation stage is Monday, 9 December 22. Following that, and incorporation of any further comments, it is intended to share the Policy with other agencies such as the Scottish Public Services Ombudsman, the Mental Welfare Commission, Advocacy Projects and Voluntary Sector Organisations within Greater Glasgow. Thereafter, Board approval will be sought and the Policy will be distributed throughout NHS Greater Glasgow for general use. 6. Scottish Public Services Ombudsman Act 22 The Scottish Public Services Ombudsman Act 22 (The 22 Act) commenced on 23 October 22. With effect from that date, the responsibilities of the existing Scottish Parliamentary Commissioner for Administration, the Health Service Commissioner for Scotland, the Commissioner for Local Administration in Scotland and the Housing Association Ombudsman for Scotland transferred to the Scottish Public Services Ombudsman, Professor Alice Brown. The new Ombudsman also took over the Mental Welfare Commission s function on investigating complaints relating to mental health. 3
Guidance was issued on 7 October 22 from the Scottish Executive on the new legislative framework for handling complaints about maladministration and service delivery arising from the activities of public authorities in Scotland. Paragraphs 11 to 18 of the Circular summarised the requirements that the Act placed on all authorities within the jurisdiction of the new Ombudsman. In accordance with that, the Board s Secretariat Manager notified all staff of the new arrangements via a message on GGNHSB s Intranet on 22 October. Furthermore, a new section was inserted into the Board s Complaints Handling Policy leaflet ensuring all complainants were thoroughly advised of the new Ombudsman s responsibilities. For ease of reference, the information provided to members of the public in the Board s leaflet is shown on Annex 1. For completeness, the Scottish Public Services Ombudsman s new leaflet is attached as Annex 2. 7. Consultation on Revised Complaints Procedure The Scottish Executive intended to launch a consultation paper on a new and revised Complaints Procedure during the course of Summer 22. We are advised that it will now be launched in the Autumn. The Head of Board Administration, Mr J C Hamilton, and Secretariat Manager, Ms S Gordon, will be closely involved in presenting the consultation document's findings/recommendations to all key players in the Complaints Procedure with a view to responding to the Scottish Executive with the views/ comments of Greater Glasgow NHS Board. Board Members will be kept advised. 8. NHS Complaints Association Scotland The Head of Board Administration, Mr J C Hamilton and Secretariat Manager, Ms S Gordon, are both members of the NHS Complaints Association Scotland. This continues to provide an opportunity for Complaints Officers in Scotland to discuss various topical issues in relation to complaints. 9. Report Distribution The quarterly Complaints Report continues to be circulated to Conveners, Lay Chairmen and Members, Trust Complaints Officers, as well as Conciliators for their information. Author: Shirley Gordon, Secretariat Manager - 141 21 4477 4
North Glasgow University Hospitals NHS Trust Local Resolution (a) Number of complaints completed at Local Resolution (all complainants) 212 (b) Number of complaints completed at Local Resolution within 2 working days 133 (c) (b) shown as a percentage of (a) [The Board's target is to complete 7% of Local Resolution Complaints within 2 working days] 63% Outcome of complaints completed at Local Resolution: Number upheld 67 Number upheld in part 72 Number not upheld 73 Independent Review (a) Number of requests for Independent Review received 8 (b) Outcome of requests for Independent Review received: Number referred back to Local Resolution 1 Number refused 4 Number proceeding Decision Awaited 5 (c) Number of requests for Independent Review completed Outcome of Independent Review Panel Hearings completed: Number upheld Number upheld in part Number not upheld Ombudsman Notification from the Ombudsman this quarter that he is investigating any Trust complaint. If so: (a) Number: 1 (b) Of these: Number from Independent Review refusal 1 Number gone through Independent Review Action Taken and Lessons Learned for Patient Care as a Result of Complaints Completed this Quarter In Medicine for the Elderly a range of staff are addressing issues of attitude and behaviour, and communication, by attending customer care and interpersonal skills training. Strategies have been introduced to formalise procedures to ensure that relatives receive accurate and timely information. Breakdown of the Three Issues Attracting Most Complaints this Quarter and the Reasons for this 1. Communication 2. Treatment 3. Waiting Times for Appointment Trends of Complaints Noticed this Quarter No trend found. Specific Service Improvements Made as a Result of Complaints Completed No information provided.
COMPLAINT CATEGORIES ISSUES RAISED NUMBER ISSUES RAISED NUMBER Staff Attitude/behaviour Procedural issues Medical/Dental 9 Failure to follow agreed procedure Nursing 22 Policy and commercial decisions (of trusts) PAMS NHS Board commissioning Ambulance (& paramedics) Mortuary/post mortem arrangements Administration Code of Openness complaints Other 6 Complaint handling 1 Treatment Communication (written/oral) 46 Clinical treatment (all aspects) 52 Shortage/availability 6 Medical/Dental 34 Nursing 16 Other Staff 2 Waiting times for Date for admission/attendance 19 Date for appointment 51 Consent Result of tests 7 Delays in/at Transport Arrangements (including ambulances) Admission/transfer/discharge 4 procedures 3 Outpatient and other clinics 8 A & E 3 Environment/domestic Other (where no definition applies) 2 Aids & appliances, equipment, premises (including access) Catering Cleanliness/laundry Patient privacy/dignity 5 Patient property/expenses 3 Patient status/discrimination (e.g. race, gender, age) Personal records (including medical, complaints) Shortage of beds
South Glasgow University Hospitals NHS Trust Local Resolution (a) Number of complaints completed at Local Resolution (all complainants) 93 (b) Number of complaints completed at Local Resolution within 2 working days 59 (c) (b) shown as a percentage of (a) [The Board's target is to complete 7% of Local Resolution Complaints within 2 working days] 63% Outcome of complaints completed at Local Resolution: Number upheld 14 Number upheld in part 27 Number not upheld 52 Independent Review (a) Number of requests for Independent Review received (b) Outcome of requests for Independent Review received: Number referred back to Local Resolution Number refused 1 Number proceeding Decision Awaited (c) Number of requests for Independent Review completed 1 Outcome of Independent Review Panel Hearings completed: Number upheld Number upheld in part Number not upheld Ombudsman Notification from the Ombudsman this quarter that he is investigating any Trust complaint. If so: (a) Number: (b) Of these: Number from Independent Review refusal Number gone through Independent Review Action Taken and Lessons Learned for Patient Care as a Result of Complaints Completed this Quarter 1. Reviewed and reconfirmed transport arrangements for transferring patients to other NHS organisations. 2. Addressed specific communication issues with Ward Staff and Senior Nurse Managers 3. Reviewed and reconfirmed communication issues around informing families of imminent death 4. Waiting list review held resulting in some patients being either removed from the list, transferred to Day Surgery Waiting List resulting in a more efficient use of limited in-patient bed resources Breakdown of the Three Issues Attracting Most Complaints this Quarter and the Reasons for this 1. Clinical Treatment 2. Date for Out-Patient Appointment 3. Communication. Trends of Complaints Noticed this Quarter There has been an increase in the number of patients awaiting dates for surgical procedure. This is due to a Consultant retiring and the new postholder not taking up post until October 22. Following appointment additional clinics have been programmed to take reduce the pressure on waiting times. Specific Service Improvements Made as a Result of Complaints Completed The Trust is in the process of appointing a new Breast Nurse and running nurse-led clinics to reduce the waiting times at the Breast Clinic.
COMPLAINT CATEGORIES ISSUES RAISED NUMBER ISSUES RAISED NUMBER Staff Attitude/behaviour Procedural issues Medical/Dental 6 Failure to follow agreed procedure Nursing 7 Policy and commercial decisions (of trusts) 1 PAMS NHS Board commissioning Ambulance (& paramedics) Mortuary/post mortem arrangements Administration 1 Code of Openness complaints Other 5 Complaint handling Treatment Communication (written/oral) 15 Clinical treatment (all aspects) 3 Shortage/availability 2 Medical/Dental 19 Nursing 6 Other Staff 5 Waiting times for Date for admission/attendance 14 Date for appointment 17 Consent Result of tests 4 Delays in/at Transport Arrangements (including ambulances) Admission/transfer/discharge 2 procedures Outpatient and other clinics A & E Environment/domestic Other (where no definition applies) 2 Aids & appliances, equipment, premises (including access) 5 Catering Cleanliness/laundry Patient privacy/dignity 2 Patient property/expenses 2 Patient status/discrimination (e.g. race, gender, age) Personal records (including medical, complaints) 3 Shortage of beds 1
Yorkhill NHS Trust Local Resolution (a) Number of complaints completed at Local Resolution (all complainants) 32 (b) Number of complaints completed at Local Resolution within 2 working days 2 (c) (b) shown as a percentage of (a) [The Board's target is to complete 7% of Local Resolution Complaints within 2 working days] 62% Outcome of complaints completed at Local Resolution: Number upheld 5 Number upheld in part 13 Number not upheld 14 Independent Review (a) Number of requests for Independent Review received (b) Outcome of requests for Independent Review received: Number referred back to Local Resolution Number refused Number proceeding Decision Awaited (c) Number of requests for Independent Review completed Outcome of Independent Review Panel Hearings completed: Number upheld Number upheld in part Number not upheld Ombudsman Notification from the Ombudsman this quarter that he is investigating any Trust complaint. If so: (a) Number: (b) Of these: Number from Independent Review refusal Number gone through Independent Review Action Taken and Lessons Learned for Patient Care as a Result of Complaints Completed this Quarter Efforts continue to be made to reduce waiting times. Breakdown of the Three Issues Attracting Most Complaints this Quarter and the Reasons for this 1. Attitude and Behaviour of Staff 2. Communication 3. Waiting Times Trends of Complaints Noticed this Quarter No particular trend identified. Specific Service Improvements Made as a Result of Complaints Completed Efforts continue to be made to reduce waiting times.
COMPLAINT CATEGORIES ISSUES RAISED NUMBER ISSUES RAISED NUMBER Staff Attitude/behaviour Procedural issues Medical/Dental 3 Failure to follow agreed procedure 2 Nursing 5 Policy and commercial decisions (of trusts) PAMS NHS Board commissioning Ambulance (& paramedics) Mortuary/post mortem arrangements Administration 2 Code of Openness complaints Other 2 Complaint handling Treatment Communication (written/oral) 13 Clinical treatment (all aspects) 5 Shortage/availability 2 Medical/Dental 2 Nursing 1 Other Staff 2 Waiting times for Date for admission/attendance 3 Date for appointment 6 Consent Result of tests 2 Delays in/at Transport Arrangements (including ambulances) Admission/transfer/discharge 1 procedures Outpatient and other clinics 1 A & E Environment/domestic Other (where no definition applies) 7 Aids & appliances, equipment, premises (including access) 2 Catering 2 Cleanliness/laundry Patient privacy/dignity Patient property/expenses Patient status/discrimination (e.g. race, gender, age) Personal records (including medical, complaints) Shortage of beds
Greater Glasgow Primary Care NHS Trust (Community & Mental Health) Local Resolution (a) Number of complaints completed at Local Resolution (all complainants) 14 (b) Number of complaints completed at Local Resolution within 2 working days 6 (c) (b) shown as a percentage of (a) [The Board's target is to complete 7% of Local Resolution Complaints within 2 working days] 43% Outcome of complaints completed at Local Resolution: Number upheld 4 Number upheld in part 5 Number not upheld 5 Independent Review (a) Number of requests for Independent Review received (b) Outcome of requests for Independent Review received: Number referred back to Local Resolution Number refused Number proceeding Decision Awaited (c) Number of requests for Independent Review completed Outcome of Independent Review Panel Hearings completed: Number upheld Number upheld in part Number not upheld Ombudsman Notification from the Ombudsman this quarter that he is investigating any Trust complaint. If so: (a) Number: (b) Of these: Number from Independent Review refusal Number gone through Independent Review Action Taken and Lessons Learned for Patient Care as a Result of Complaints Completed this Quarter As a result of an assumption being made with regard to the wishes of a family not to have a relative admitted to a specific hospital, staff have been reminded that all such matters should initially be discussed with families. Additional training has been provided by the Patient Affairs Manager following a complaint about a pension book not being transferred appropriately with the patient from ward to ward. Staff have been reminded about the correct procedures to be followed when medical records are required from outwith the Trust. The approach to assessing physically frail patients prior to transfer to partnership homes will be more flexible and based on individual cases. Breakdown of the Three Issues Attracting Most Complaints this Quarter and the Reasons for this 1. Clinical Treatment ) 2. Communication ) 3. ) These remain constant as the main issues attracting most complaints but were not specific to any particular area. Trends of Complaints Noticed this Quarter On a positive note, no trends of complaints can be identified in this quarter and the total number of complaints is comparatively low
Specific Service Improvements Made as a Result of Complaints Completed As a result of a communication received in relation to the administrative element of the Breast Screening Service, timescales for the dispatch of assessment letters have been clarified and regulated so that a more consistent message can be given when patients telephone for information. It should be noted that as a result of the Service s response to this communication, a letter of appreciation was received in the Complaints Office. This was shared with the Breast Screening Service.
COMPLAINT CATEGORIES ISSUES RAISED NUMBER ISSUES RAISED NUMBER Staff Attitude/behaviour Procedural issues Medical/Dental 1 Failure to follow agreed procedure 2 Nursing 2 Policy and commercial decisions (of trusts) PAMS NHS Board commissioning Ambulance (& paramedics) Mortuary/post mortem arrangements Administration Code of Openness complaints Other Complaint handling Treatment Communication (written/oral) 5 Clinical treatment (all aspects) 7 Shortage/availability 1 Medical/Dental 6 Nursing Other Staff 1 Waiting times for Date for admission/attendance 1 Date for appointment Consent Result of tests Delays in/at Transport Arrangements (including ambulances) Admission/transfer/discharge 1 procedures Outpatient and other clinics A & E Environment/domestic Other (where no definition applies) 3 Aids & appliances, equipment, premises (including access) 1 Catering Cleanliness/laundry Patient privacy/dignity Patient property/expenses 1 Patient status/discrimination (e.g. race, gender, age) Personal records (including medical, complaints) Shortage of beds
Greater Glasgow Primary Care NHS Trust (Family Health Service Practitioners) Family Health Service Practitioners (that is, doctors, dentists, pharmacists and opticians) are not required to report the number of complaints they receive at Local Resolution quarterly - they report their Local Resolution figures annually to Greater Glasgow Primary Care NHS Trust. Similarly, FHS Practitioners are not required to advise the Trust (or NHS Board) on any action taken or lessons learned as a result of Local Resolution complaints. Independent Review (a) Number of requests for Independent Review received 5 (b) Outcome of requests for Independent Review received: Number referred back to Local Resolution 2 Number refused 2 Number proceeding Decision Awaited 1 (c) Number of requests for Independent Review completed Outcome of Independent Review Panel Hearings completed: Number upheld Number upheld in part Number not upheld Ombudsman Notification from the Ombudsman this quarter that he is investigating any Trust complaint. If so: (a) Number: (b) Of these: Number from Independent Review refusal Number gone through Independent Review
ANNEX 1 SCOTTISH PUBLIC SERVICES OMBUDSMAN The Ombudsman generally will not investigate any case where the relevant local Complaints Procedure has not been evoked and exhausted, unless the Ombudsman is satisfied that in the circumstances it is not reasonable to expect the procedure to be evoked or exhausted. The main stages at which complaints may be made to the Ombudsman, therefore, are where:- the NHS Board has refused to investigate a complaint because it fell outside the NHS time limits and the relevant Convener upheld that decision; a complainant is dissatisfied following Local Resolution and the Convener has refused the request for an Independent Review; a complainant disagrees with the Terms of Reference as set out by the Convener; a complainant is dissatisfied with the process or the outcome of the Independent Review. A complaint may be made to the Ombudsman by an aggrieved person. This may be made by a patient s representative, authorised in writing by the aggrieved person to complain on their behalf. This may be an MSP, local councillor or any person whom the aggrieved person considers suitable to represent their interests. A complaint must be submitted to the Ombudsman within twelve months after the day on which the person aggrieved first had notice of the matter complained of, unless the Ombudsman is satisfied that there are special circumstances which make it appropriate to consider a complaint made outwith that period. There is an assumption that complaints will be submitted in writing or by electronic communications, however, the Ombudsman will have discretion to accept oral complaints in special circumstances, for example, where the complainant has difficulty reading or writing or there is exceptional urgency. The Ombudsman can conduct investigations as she sees fit, provided that investigations are conducted in private and that any individual named in the complaint is given an opportunity to comment on the allegations contained in the complaint. The Ombudsman is entitled to investigate matters of mal-administration in connection with any action taken by, or on behalf of, a Health Service body. The Ombudsman may investigate these matters only where there is a claim that a member of the public has sustained injustice or hardship in consequence of the maladministration, service failure or other action as appropriate. Following any investigation of a complaint about the NHS Board, we will receive from the Ombudsman an investigation report. This will have been laid before parliament and we will make arrangements, for a period of at least three weeks, to allow any person to:- inspect the investigation report at any reasonable time; obtain a copy of the report, or any part of it. The address for the Scottish Public Services Ombudsman is as follows:- Professor Alice Brown Scottish Public Services Ombudsman 23 Walker Street EDINBURGH EH3 7HX (Telephone: 87 11 5378) (Fax: 87 11 5379). www.ombudsmanscotland.org.uk