Welcome to SPSO NEWS. In this edition you will find our latest decisions on complaints about public services and the Ombudsman's commentary on this month's reported cases. We also have an update on the work of our Complaints Standards Authority.
I laid seven investigation reports before the Scottish Parliament today, all about health boards. I also laid a report on 65 decisions about all of the sectors under our remit. All of the reports can be read on the ‘Our findings’ section of our website at www.spso.org.uk/our-findings.
Overview
Prison healthcare
One of today’s reports (201203514) highlights serious concerns that I have publicised before about prisoners’ access to the NHS complaints procedure. The NHS became responsible for prison healthcare in November 2011 – a Scottish Government change, which made my office the final stage for such complaints. Since then, we have received dozens of contacts from prisoners across the Scottish prison estate. From this, I have concluded that in some health boards at least, there is confusion about the process, which is leading to prisoners being denied access to the NHS complaints procedure. Today’s investigation report is further evidence of this.
Like members of the public who are concerned about their health, some of the prisoners phoning my office are, as well as needing medical attention, very anxious and upset. Those feelings are compounded by frustration at being unable to access the NHS complaints procedure. I have been advised by Scottish Prison Service staff that this can lead to potentially difficult situations arising. I have shared this warning with Scottish Government officials and am pleased to have seen some progress in the form of reminders to relevant health boards about the correct process and the need for complaints forms to be made available. I have also raised my concerns in Parliament, most publicly in evidence to the Health and Sport Committee on 15 January 2013. It is now 18 months since the transfer of responsibility and it is high time that these issues were fully addressed.
There appear to be two main obstacles. Many of the prisoners who phone my advice team say it is difficult to get beyond the feedback stage. They say that when they want to complain, they are given a feedback form, and that complaints forms are not being provided. Others say that because of misunderstanding by prison medical centres about the process that should be used, prisoners are effectively forced to go through an additional ‘feedback’ stage before they can reach the complaints stage.
This is at odds with the Scottish Government guidance, Can I help you?, which was published in March 2012 to further the provisions of the Patients’ Rights Act 2011. The guidance sets out best practice for relevant NHS bodies and health service providers to ensure their frontline staff are trained, supported and empowered to deal with feedback, comments, concerns and complaints. It is clear from the guidance that NHS users are not required to complete a feedback process before accessing the complaints procedure, and that the same applies to those receiving NHS care and treatment in prison. Relevant boards should read my investigation report and ensure that their healthcare complaints process for prisoners complies with the Can I help you? guidance.
Pressure sores
Another issue that needs to be urgently addressed is the treatment of pressure sores. As I have highlighted in previous commentaries, apart from in rare and exceptional situations, pressure sores should be a thing of the past in Scottish hospitals. In two of today’s reports (201103459 and 201104025) patients suffered these painful sores because of poor treatment. Such low standards of nursing care are simply unacceptable.
NHS sounding board
I have welcomed the opportunity to discuss such issues in a newly established health forum. This has been established as a sounding board for sharing developments about health matters at SPSO and to provide an opportunity for feedback to help us improve our performance and service. The group comprises senior health professionals, including chief executives and chairs of boards, a medical director, a nursing director, a lead officer on infection control and a patient relations manager. The inaugural meeting was held in March and the group plans to meet again in September.
E-learning for NHS staff
We are continuing to support good complaints handling through new e-learning modules for NHS frontline staff on feedback and complaints handling. We have developed these with NHS Education for Scotland (NES) as part of the Scottish Government sponsored ‘Feedback, Comments, Concerns and Complaints’ project. The project aims to provide training and education for NHS staff to support the requirements of the Patients’ Rights Act. The modules will be launched this month, either via internal NHS systems or via NES’ ‘Little Things Make a Big Difference’ website. They are a useful tool for helping staff understand the process and requirements correctly, and should help avoid the kinds of problems highlighted in today’s investigation reports.
Further training and education for NHS staff on feedback and complaints handling will be delivered later this year. This will aim to provide more focused training for complaints officers, managers and senior managers on various aspects of their complaints handling responsibilities.
MSP and MP Guide
We have updated our guide for MSPs, MPs and Parliamentary staff. This provides information about our service, role, governance and remit. While most members of the public bring complaints to the SPSO directly, we know that some people ask their elected representative for support. In these instances, it is important that those helping someone make a complaint understand our work. We also need to be sure that complainants are happy to be represented by their MSP or MP and that they give us their consent. The guide provides information about consent and about helping a constituent through a public body’s complaints procedure, a list of bodies under the SPSO’s jurisdiction, examples of the kinds of complaints we can and cannot look at, and some of the outcomes we can achieve.
Read my Overview and summary of today's reports here, or by accessing the links below.
Investigation Reports
“I am satisfied that Mr C was unreasonably denied access to the NHS complaints procedure.”
Prison healthcare; complaints handling; policy/administration (full report)
Ayrshire and Arran NHS Board (Ref 201203514)
> Read full report
> Read summary
"I upheld Mrs C’s complaint that she was not given reasonable information, advice or support.”
Clinical treatment; diagnosis; follow-up care (full report)
Ayrshire and Arran NHS Board (Ref 201104810)
> Read full report
> Read summary
“I am very critical of the board’s handling of Miss C’s complaints.”
Clinical treatment; complaints handling; policy/administration (full report)
Tayside NHS Board (Ref 201004234)
> Read full report
> Read summary
“I disagreed with the board’s view that the scanner was of a reasonable standard.”
Clinical treatment; policy/administration (full report)
Lanarkshire NHS Board (Ref 201201639)
> Read full report
> Read summary
“There were reasonable clinical decisions and nursing care, but also what I conclude to be clear and unacceptable failings.”
Care of the elderly; clinical treatment; consent; communication (full report)
Greater Glasgow and Clyde NHS Board (Ref 201104025)
> Read full report
> Read summary
“Communication between hospital and community nursing staff was poor.”
Clinical treatment; discharge planning; record-keeping; communication (full report)
Lothian NHS Board (Ref 201103459)
> Read full report
> Read summary
“I am very critical of the fact that Mr C did not receive timely assessment."
Care of the elderly; clinical treatment; communication (full report)
Greater Glasgow and Clyde NHS Board – Acute Services Division (Ref 201201570)
> Read full report
> Read summary
Complaints Standards Authority update
Our work to create standardised complaints procedures and improve complaints handling standards across Scotland’s public services continues. For previous updates and further information, visit our dedicated website at www.valuingcomplaints.org.uk.
Higher and further education – compliance statement and e-learning materials
Following on from our complaints procedures standardisation work in other sectors, all universities and colleges are required to implement the model Complaints Handling Procedure (CHP) by 30 August 2013. Using the online self-assessment and pro-forma, each university and college should, by 28 June 2013, provide the SPSO with a statement confirming that they will comply.
We are currently developing e-learning materials for the higher and further education sectors, to help organisations provide training and awareness-raising for frontline staff involved in complaints handling. We aim to have these available online by June.
NHS complaints handling training
As the Ombudsman notes in his Commentary, e-learning modules for NHS frontline staff on feedback and complaints handling will be launched this month. We have developed these with NHS Education for Scotland (NES) as part of the Scottish Government sponsored ‘Feedback, Comments, Concerns and Complaints’ project. The project aims to provide training and education for NHS staff to support the requirements of the Patients’ Rights Act 2011.
Further training and education for NHS staff on feedback and complaints handling will be delivered later this year. This will aim to provide more focused training for complaints officers, managers and senior managers on various aspects of their responsibilities for complaints handling.
Local authority complaints handlers network – performance indicators
The local authority complaints handlers network, which was established in September 2012, met on 26 April at Stirling Council. The key area for discussion was the performance reporting framework, including performance indicators and a suggested best practice internal reporting framework. The final performance indicators, against which local authorities will be required to report annually, will shortly be circulated to the network and will be published on the CSA website: www.valuingcomplaints.org.uk.
The next meeting of the network will take place on 21 June, hosted by Glasgow City Council. If you are interested in joining please contact CSA@spso.org.uk and we will provide your details to North Lanarkshire Council, who co-ordinate the network.
Housing complaints handlers network
In response to requests, a further meeting of the network for RSL complaints handlers is being planned. We will issue further information about this shortly.
Model CHP for the Scottish Government, Scottish Parliament and associated public authorities in Scotland
A number of organisations have contacted us for further information about this model CHP. For clarification, it applies to all central government public authorities, including executive agencies, executive, advisory and tribunal non-departmental public bodies, non-ministerial departments and the Scottish Parliamentary Corporate Body and associated Parliamentary bodies and commissioners.
Each organisation is required to comply with the model CHP by the end of March 2014. By 30 September 2013 each organisation should provide the SPSO with a compliance statement, and a self-assessment confirming that their CHP complies with the published model CHP, or that it will comply by the end of March.
The model CHP and associated documents are available on the CSA website: www.valuingcomplaints.org.uk. Please contact CSA@spso.org.uk if you have any questions about the model CHP, or your obligation to implement it.
The CSA is always available to provide specific advice or support to complaints handlers across the public sector. Please address any questions to CSA@spso.org.uk.
Jim Martin, Ombudsman | 22 May 2013
