The Healthcare Commission ceases to exist on 1 April. Patients who remain unhappy after local resolution is complete may request a review of their complaint by the Ombudsman. (The Parliamentary and Health Service Ombudsman, Millbank Tower, Millbank, London SW1P 4QP, telephone 0345 015 4033.) The person responding to the complaint must inform the complainant of their right to take their complaint to the Ombudsman (Health Service Commissioner). Effectively what was a three stage complaints procedure is simplified into a two stage complaints procedure.
One aspect of the new Regulations is that it allows for a more informal flexible approach to resolving complaints at the outset.
The complainant can complain to the practice or to the PCT. If the PCT considers that it is appropriate, it will deal with the complaint itself. Otherwise the complaint will be passed to the primary care provider (contractor), but only with the patient's consent.
The time limit for making a complaint is 12 months from the date of treatment or 12 months from the date of knowledge, but the primary care provider has the discretion to waive these limits.
The Regulations introduce the concept of the responsible person which is the person in the practice who ensures compliance with these Regulations and ensures any appropriate action is taken following investigation of a complaint.
The Regulations also introduce the concept of the responsible body which is the primary care provider or independent provider.
A complaint must now be acknowledged not later than 3 working days after the day on which it is received. There is no scope within the Regulations to relax this provision and this means that the complaints manager must be able to deal initially with complaints if the practitioner is away. This may be particularly onerous for single-handed practices.
In addition to this the primary care provider must offer to discuss the investigation and the likely response time with the complainant at the time when the complaint is acknowledged. This may very difficult for single-handed practices that need input from the dentist to assist in this.
However, the definitive response time is more flexible, the 10 day limit no longer exists and the response should be provided "as soon as reasonably practicable after completing the investigation".
A complaint which is made verbally and resolved by the next working day does not require a formal response, and it may well be that having procedures in place to capture verbal complaints at an early stage can result in fewer formal written complaints being made.
The Regulations require a practice to have a responsible person who ensures compliance with these Regulations and ensures any appropriate action is taken following investigation of a complaint. This should be a senior person in the practice. The practice must also have a complaints manager who is responsible for managing complaints. The same person can fulfil both roles.
After the investigation of the complaint is complete the response to the patient must be signed off by the responsible person. The response must include a report explaining how the complaint has been investigated, the conclusions reached, and that any action required as a consequence of the complaint has been or will be taken. Details of how to complain to the Ombudsman must also be included.
Under the new Regulations a GDC complaint or a legal claim can run at the same time as an NHS complaint.
The new Regulations do not specifically refer to conciliation. However, conciliation can be a helpful tool and there is still the opportunity for the dentist to offer the patient conciliation where appropriate. Past experience has shown that where both parties enter into conciliation with an open mind then this can be a helpful way of resolving the complaint. There may be the opportunity for this to be discussed at the acknowledgement stage. This gives the dentist and the team the opportunity to deal with complaints more informally.