Health Services: Complaints

John Mann
To ask the Secretary of State for Health (1) how many responses his Department received to its consultation on proposed changes to the legislative framework for health and social care complaints;

(2) in what ways the proposed new social care complaints procedure for adults will differ from the procedure for complaints in social care for children;

(3) what mechanisms there are in the proposed new social care complaints procedure to enable a director of adult care to highlight faults in the system;

(4) whether complainants will retain their right to independent scrutiny of their complaint under the proposed new social care complaints procedure; and if he will make a statement;

(5) what assessment he has made of the merits of the proposed changes to the social care complaints system whereby complaints would be dealt with by front line staff who provide the complainant’s care.

Ann Keen
There were 191 responses to the consultation on “Reform of health and social care complaints: Proposed changes to the legislative framework”. Prior to this the Department ran a consultation on the policy and principles of the new approach to complaints handling in the national health service and social care in 2007, entitled “Making experiences count: a new approach to responding to complaints”. There were 376 written responses to this earlier consultation, the majority of which were positive and supportive of the new approach.

Under the new approach as provided for in the forthcoming legislative framework the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 laid before Parliament on the 27 February and coming into force on 1 April 2009, every local authority, NHS body, and primary care provider must designate a complaints manager to be responsible for managing the procedures for handling and considering complaints in accordance with the complaints regulations. Front line staff who provide the complainant’s care may be required to contribute to investigations of complaints and provide explanations or reports as necessary, but not to take responsibility for managing complaints.

Under the new system, complainants will retain the same rights as now to take their complaints either to the parliamentary and health service ombudsman for NHS complaints, or to the local government ombudsman for social care complaints for independent investigation, where they are dissatisfied with the response they have received from the local organisation. In addition the flexibility of the new system allows for local independent investigation of complaints where appropriate.

In social care this will give adult social care complaints managers greater freedom to determine whether their handling will contain a single response, or stages, and at what point senior managers will become involved in considering the complaint. They will also decide whether and how independent consideration of the complaint will be addressed (i.e. whether there will be investigating officers conducting an investigation, and whether these will be independent of the organisation, and also whether there will be independent advocacy).

The procedures for complaints about social care for children are remaining separate and unchanged under the Children Act 1989, and complainants will continue to receive a three stage procedure. This features an automatic right to advocacy for any young person, independent consideration of all stage 2 complaints through an independent person, and also a review panel (with a minimum of two independent people on it) for all stage 3 complaints. The director of children’s services will normally become involved with complaints that reach stage 3 (though s/he will be briefed on complaints in general and all significant cases by the complaints manager).

Under the Children Act, the complaints manager must be a direct employee of the local authority; this is no longer a feature of the reforms for adult services.

The new system for the NHS and adult social care will require chief executives of local authorities and NHS bodies to be responsible for ensuring compliance with the new arrangements and in particular ensuring that action is taken if necessary in the light of the outcome of a complaint. It is envisaged that in local authorities chief executives may delegate this role to directors of adult social services.