Support for complainants

Accepted in part.
We agree that expert advice should be provided in appropriate cases, and in appropriate cases, the providers of NHS complaints advocacy would obtain advice from an independent clinical expert. However complaints advocacy services are no longer commissioned nationally. From April 2013, Local Authorities have been responsible for commissioning NHS complaints advocacy services, and are able to determine the appropriate model of delivery for these services for their local community.
We consider that the need for expert clinical advice ought not to be determined by how complicated a case might be, but whether it is appropriate in the individual case. In those cases, the trust should offer that advice, along with independent investigation.
The Review of the Handling of Complaints in NHS Hospitals recommends:
• When Trusts have a conversation with patients at the start of the complaints process they must ensure the true independence of the clinical and lay advice and advocacy support offered to the complainant.
The Department of Health will work with Healthwatch England and the Local Government Association to develop a set of ‘good practice’ standards for NHS Complaints advocacy services; these standards may be expected to include access to clinical advice in appropriate cases.

Under section 223A of the Local Government and Public Involvement in Health Act 2007, local authorities must make arrangements it considers appropriate for the provision of independent advocacy services in its area which are intended to provide assistance to persons making or proposing to make complaints under the complaint procedures operated by health service providers.

The Parliamentary and Health Service Ombudsman also provides signposting to how these services can be accessed and has published a guide about the independent support and advice services available to people making a complaint, including specialist independent advice and support services.

The Department of Health, with key partners, will consider different aspects of PALS and identify if there are any areas where more substantial work may need to be commissioned to gain a better understanding. Work on this project has started, and it is envisaged the initial review and identification of areas for more detailed consideration, will be complete by Spring 2015.

The Health and Social Care Act 2012 gave responsibility for commissioning NHS complaints advocacy to individual Local Authorities from April 2013. The Clwyd/Hart Review of the handling of NHS complaints recommended that “the independent NHS Complaints Advocacy Service should be re-branded, better resourced and publicised. It should also be developed to embrace greater independence and support to those who complain. Funding should be protected and the service attached to local Healthwatch organisations.” The Government accepted that a review of NHS complaints advocacy services should be conducted to measure the effectiveness of the provision of advocacy services to the public. This review is expected to be complete by Spring 2015.

Healthwatch England have also developed a set of national standards for complaints advocacy services, generated from workshops and interviews with people who use advocacy services.

This recommendation was accepted in part by the Government.

In the January 2014 Hard Truths report, As complaints advocacy services had been the responsibility of local authorities since April 2013, the Government considered this was a matter for local authorities. The Government expressed its view that the need for expert clinical advice ought not to be determined by how complicated a case might be, but whether it was appropriate in the individual case.

In the February 2015 Culture Change report, the Government said that the Department of Health would consider different aspects of Patient Advice and Liaison Services and identify any areas where substantial work might be commission ed to gain a better understanding.