Annual Complaints Report 2019/20 NHS Brighton and Hove CCG NHS High Weald Lewes Havens CCG NHS East Surrey CCG Date: 24 June 2020 Version: V1 Name of originator/ author: Emily Dwyer, Senior Corporate Governance Manager Introduction The CCGs recognise the value of feedback from service users and they use learning from complaints where available to improve service delivery and performance, and in the development of services. The CCGs’ Complaints Policy follow the requirements of the NHS (Complaints) Regulations 2009, the Parliamentary and Health Service Ombudsman Principles of Good Complaint Handling (2009) and the NHS England Complaints Handling for CCGs (2013). Accordingly, complaints should be made within twelve months of the date on which the subject of the complaint occurred or within twelve months of it coming to the notice of the complainant. The time limit will not apply if the CCGs are satisfied that the complainant had good reason for not making the complaint within the time limit and it is still possible to investigate the complaint effectively and fairly. Background information Prior to the inception of NHS East Sussex and NHS West Sussex CCGs, the complaints management function for the organisations that previously comprised the Sussex CCGs was managed as a joint function between an in-house complaints team and a service provided by South Central West Commissioning Support Unit (SCW CSU). For NHS Brighton and Hove (BH), NHS Coastal West Sussex (CWS), NHS East Surrey (ES) and NHS High Weald Lewes (HWLH) CCGs the complaints function was retained in-house. For NHS Crawley, NHS Horsham and Mid Sussex, NHS Hasting and Rother and NHS Eastbourne, Hailsham and Seaford CCGs the function was performed by the SCW CSU. The CSU does not handle commissioning queries from MPs; the Corporate Governance Directorate carries out this function. Between 1 April and 31 October 2019, the BH and HWLH CCGs’ complaints team also handled ES complaints. Due to the transfer of ES into the Surrey system, the responsibility for complaints transferred to NHS Surrey Downs CCG on 1 November 2019. During 2019/20 the complaints team dealt with 10 formal complaints and 6 informal concerns on behalf of NHS East Surrey CCG. These figures are not included in the following statistics as they are only a part-year representation. Scope of Complaints The CCGs deal with complaints relating to: CCG commissioning decisions (whether for a whole population, a specific group or an individual) CCG appeals process for example funding requests made to the Individual Funding Requests (IFR) panel or Continuing Health Care (CHC) panel, where a complaint can be made about the process (not the clinical decision) Complaints against CCG staff such as those relating to poor service The CCGs do not handle formal complaints relating to Primary Care; these are dealt with either directly by the primary care service provider or by NHS England. The team will try to assist in resolving these informal concerns before they escalate into formal complaints. Complainants can specifically ask the CCGs to ‘lead’ on complaints if they relate to a commissioned service or if there are multiple parties involved. Summary During 2019/20 there were 151 complaints or contacts received by BH and HWLH. These contacts include formal complaints, MP enquiries, corporate correspondence, signposting / informal (PALS) contacts and plaudits. This report details the number of contacts received during 2019/20, themes or trends identified, outcomes and lessons learned. Between April 2019 and March 2020, there were at total of 62 formal complaints and MP enquiries received across the two CCGs (BH / HWLH). Complaints and MP enquiries 2019/20 50 48 45 40 35 30 25 20 14 15 10 5 0 BH HWLH The table below shows a breakdown of formal complaints and MP concerns received across the two CCGs (BH / HWLH) by quarter. Complaints received by Quarter 2019/20 20 19 18 16 16 6 15 14 3 12 12 5 10 8 6 12 13 13 10 4 2 0 19/20 Q1 19/20 Q2 19/20 Q3 19/20 Q4 BH HWLH Of the 62 formal complaints and MP concerns received, the table below shows a breakdown of complaints receievd by type of request. Type of request 30 25 3 7 20 15 22 10 19 4 5 4 3 0 Complaint (25 days) Complaint to provider Corporate MP/Politcal Correspondence Brighton and Hove High Weald Lewes Havens The source of complaints is shown below; this shows 26 (42%) of the concerns received by the Complaints Team were received from MPs, closely followed by 21 (34%) received directly from patients. Source of complaint 28 26 24 22 7 20 3 18 16 14 12 10 19 18 4 8 6 4 7 2 2 0 1 1 Charity / MP/Political NHS Patient Relative Solicitior / Campaign Organisation Advocate BH CCG HWLH CCG Responding to complaints There is no definitive timeframe set out in the NHS (Complaints) Regulations 2009 for responding to complaints. However, the CCGs consider it best practice that formal complaints and MP enquiries should be responded to within 25 working days. If the complaint is particularly complex or involving more than one department or organisation, regulations allow for a longer response date (up to a maximum of six months) which would be discussed and agreed with the complainant on receipt of the complaint. Of the 62 formal complaints and MP concerns received during 2019/20, 61 are closed and one remains open, currently awaiting sign off. Days to respond 12 11 10 10 8 7 6 6 5 4 4 4 4 3 2 2 2 2 1 0 1-5 6-10 11-15 16-20 21-25 26 -30 31-35 35-40 41-45 46-50 56-60 61-65 66-70 Of the 62 formal complaints and MP concerns responded to within the reporting period, 42% were responded to within the 25 working days target and 58% in under 30 working days. Delays to responses were mainly due to internal processes and procedures. As of April 2020, a new Complaints Policy for the Sussex CCGs was approved and implemented with a specific aim to deliver more effective processes to improve the complainant’s experience. The table below shows a breakdown of complaints received by directorate. The areas receiving the highest number of concerns were Planned Care at 26% followed by Mental Health at 13%, Commissioning at 11% and Acute at 10%. Planned Care also received the highest number of complaints in 2018/19 with 24% of complaints received. Area of Complaint Number Percentage Acute 6 10% Commissioning 7 11% Communications, Media And PR 2 3% Community Care 4 6% Continuing Health Care - CHC 5 8% COVID--19 Related 1 2% GPs 1 2% Local Authority 1 2% Medicines Management 4 6% Mental Health 8 13% Patient And Public Engagement 1 2% Planned Care 17 26% Planning And Delivery 1 2% STP 1 2% Urgent/Unscheduled Care 3 5% Grand Total 62 100% In some areas, there was marked difference in the number of complaints received by the CCGs, for example: BH received 94% of the planned care complaints HWLH received four complaints regarding the acute trusts with BH receiving only two Outcome The chart below shows that of the 62 complaints received, there were 31 complaints not upheld, 21 partially upheld, six upheld and one complaint was closed due to consent not having been received. The remaining were either forwarded to the provider to lead on the complaint (with the complainant’s agreement), or no further information was received following a request for further information to enable the team to fully investigate the complaint. *Note the one remaining open complaint has been included within the chart below. Outcome No further contact Referred to 1 provider No consent 2 received 1 Upheld 6 Partially upheld Not upheld 21 31 Lessons learned from complaints BH and HWLH welcome feedback, whether adverse or complimentary, as it enables learning from the experiences of patients, carers and service users, and allows measures to be put in place to improve services for everyone. Complaint responses may outline specific actions to be taken, where appropriate, and these are logged on Ulysses (the electronic portal where complaints are registered). The complaints team follow up on the progress of these actions in order to ensure service improvements take place and to hold responsible managers to account. For BH and HWLH the vast majority of complaints have concerned Continuing Healthcare (including decisions of eligibility) and also eligibility for commissioned services (including, for example, for in vitro fertilisation (IVF). In these instances the service managers are made aware of patient concerns and feedback although these do not lend themselves to ‘lessons learnt’. The table below shows examples of lessons learnt: Complaint Outcome Learning Concerns regarding incorrect The complainant was provided Updated forms sent to the referral forms used and issue with assurance that the CCG medical centre who have when attending outpatient will share the correct referral confirmed they have shared clinic. forms with the medical centre with all GPs to ensure they are and ensure all clinic staff are using the correct forms. appropriately trained to cover reception areas. Clinic have confirmed that all reception staff (and covering staff) have been reminded of their responsibility to contact surgery’s directly when issues occur rather than advising patients they need to go back to their GP. Provision of appropriate CCG provided assurance that Engagement team reminded interpreters appropriate interpreters will of patient accessibility attend future events to enable responsibilities when planning all patients to attend. events to ensure future events are better managed. Serious Incidents Of the complaints received during 2019/20, none were identified as being a Serious Incident (SI).