The Practice takes it very seriously if a member of staff or one of the doctors or nursing team is treated in an abusive or violent way.

The Practice supports the government’s ‘Zero Tolerance’ campaign for Health Service Staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place. All our staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time.  The staff understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint.

However, aggressive behaviour, be it violent, abusive, or verbally abusive will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.

In order for the practice to maintain good relations with their patients the practice would like to ask all its patients to read and take note of the occasional types of behaviour that would be found unacceptable:

• Using bad language, shouting or swearing at practice staff
• Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving
• Verbal abuse towards the staff in any form including verbally insulting the staff
• Racial abuse and sexual harassment will not be tolerated within this practice
• Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot
• Causing damage/stealing from the Practice’s premises, staff or patients
• Obtaining drugs and/or medical services fraudulently
• We ask you to treat your GPs and their staff courteously at all times.

Removal from the practice list

A good patient-doctor relationship, based on mutual respect and trust, is the cornerstone of good patient care. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of the practice, that they should find a new practice. An exception to this is on immediate removal on the grounds of violence e.g. when the Police are involved.

Removing other members of the household

In rare cases, however, because of the possible need to visit patients at home it may be necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.

Care professionals in England use an electronic record called the Summary Care Record (SCR). This can provide those involved in your care with faster secure access to key information from your GP record

For more information talk to the staff at your GP practice or visit www.hscic.gov.uk/scr/patients

You can also phone the Health and Social Care Information Centre (HSCIC) on 0300 303 5678

What is a SCR?

If you are registered with a GP practice in England, you will already have an SCR unless you have previously chosen not to have one. It includes the following basic information:

• Medicines you are taking
• Allergies you suffer from
• Any bad reactions to medicines.

It also includes your name, address, date of birth and unique NHS Number which helps to identify you correctly.

What choices do you have?

You can now choose to include more information in your SCR, such as significant medical history (past and present), information about management of long term conditions, immunisations and patient preferences such as end of life care information, particular care needs and communication preferences.

If you would like to do this, talk to your GP practice as it can only be added with your permission.

Remember, you can change your mind about your SCR at any time. Talk to your GP practice if you want to discuss your option to add more information or decide you no longer want an SCR.

Who can see my SCR?

Only authorised care professional staff in England who are involved in your direct care can have access to your SCR. Your SCR will not be used for any other purposes.

These staff:

• Need to have a Smartcard with a chip and passcode
• Will only see the information they need to do their job
• Will have their details recorded every time they look at your record.

Care professionals will ask for your permission if they need to look at your SCR. If they cannot ask you because you are unconscious or otherwise unable to communicate, they may decide to look at your record because doing so is in your best interest. This access is recorded and checked to ensure that it is appropriate.

SCRs for children

If you are the parent or guardian of a child under 16, and feel they are able to understand this information you should show it to them. You can then support them to come to a decision about having an SCR and whether to include additional information.

Vulnerable patients and carers

Having an SCR that includes extra information can be of particular benefit to patients with detailed and complex health problems. If you are a Carer for someone and believe that this may benefit them, you could discuss it with them and their GP practice.

Confidentiality

For information on how the NHS will collect, store and allow access to your electronic records visit NHS Choices at www.nhs.uk/records.

As a teaching practice, medical students spend part of their training with us from the University of Birmingham Medical School. The practice is also involved with medical research in partnership with the University of Birmingham.

We would value your co-operation with both of these, but we understand if you do not want to be involved.

Please sign a consent form when seeing a medical student for your consultation.

We are always happy to hear suggestions patients may have to improve the services we provide. We do try to give the best possible service but there may be times when you feel this is not happening.

If you have a complaint about any aspect of the service you have received, from doctors or staff, please let us know.

We operate a practice complaints procedure in line with national NHS guidelines, copies of the procedure are available from reception staff. You may also reference leaflets and posters in the waiting room.

The Health Service Ombudsman

The Health Service Ombudsman has published a booklet that describes the ‘six principles for remedy’ in relation to complaints handling and involves:

• Getting it right
• Being customer focused
• Being open and accountable
• Acting fairly and proportionately
• Putting things right
• Seeking continuous improvements

If you remain unhappy after everything has been done to try to resolve your concern or complaint you have the right to approach the Ombudsman.

Complaints and Comments Procedure

This Policy and Procedure complies with The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, introduced on 1st April 2009 across health and social care.

Policy

The Practice will take all reasonable steps to ensure that it’s staff are aware of and comply with this Procedure.

The Practice has nominated Paula Dudley (Practice Manager), as it’s Complaints Manager, to be responsible for managing the procedures for handling and considering complaints in accordance with the Policy and Procedure.

The Practice has nominated Dr Samuel Muthuveloe – Lead GP as its Responsible Person, to be responsible for ensuring compliance with the Policy and Procedure, and in particular ensuring that action is taken if necessary in the light of the outcome of a complaint.

The Practice will take all reasonable steps to ensure that patients are aware of:

The Complaints and Comments Procedure

The roles of the Practice, NHS England, Clinical Commissioning Group (CCG) and the Health Service Ombudsman with regard to patient complaints.

This includes the alternative facility for the patient to complain directly to the CCG instead of making their complaint to the Practice, as well as their right to escalate their complaint to the Health Service Ombudsman when they are dissatisfied with the initial response.

N.B. ALL escalations must be directed to the Health Service Ombudsman (so when a patient is dissatisfied with the Practice response to their complaint, they must escalate their complaint to the Health Service Ombudsman, not the CCG).

Their right to assistance with any complaint from the Patient Advice and Liaison Service (PALS); The Independent Complaints Advocacy Service (ICAS); Citizens Advice Bureaux, NHS Choices and the Care Quality Commission

The Practice Complaints and Comments Patient Information Leaflet, the Practice Patient Information Leaflet and the Practice Website will be the prime information sources for implementing this Policy and will be kept up to date and be made freely available to all Patients.

Patients will be encouraged to complain in writing where possible.

All complaints will be treated in the strictest confidence.

Patients who make a complaint will not be discriminated against or be subject to any negative effect on their care, treatment or support.

Where a complaint investigation requires access to the patient’s medical records and involves disclosure of this information to a person outside the Practice, Paula Dudley (Practice Manager), the Complaints Manager, will inform the patient or person acting on their behalf.

The Practice will maintain a complete record of all complaints and copies of all related correspondence. These records will be kept separately from patients’ medical records.

Procedure

Complaint initiated on Practice Premises

In the event that a Practice staff member notices that a patient appears to be distressed / upset on the Practice Premises, they should immediately contact Paula Dudley (Practice Manager), who will attempt to identify and resolve the problem personally at that time.

In the event of a Practice staff member being advised that a patient wishes to make a complaint, the patient should be passed a copy of the current Practice Complaints and Comments Patient Information Leaflet.

The patient should be asked if they intend to complete the form in this leaflet there and then, or do they intend to complete it later.

If they intend to complete it later, the Practice staff member should provide them with an envelope.

If they intend to complete it there and then, the Practice staff member to ask if they require assistance in completing it – if so, Paula Dudley (Practice Manager), should be contacted to provide such assistance.

Whichever option is chosen, the patient will be assured that their complaint will be acknowledged within 3 working days from receipt of the form.

Receipt and Acknowledgement of Complaints

The Practice may receive the following complaints:

• A complaint made directly by the patient or former patient, who is receiving or has received treatment at the Practice;
• A complaint made on behalf of a patient or former patient (with his/her consent), who is receiving or has received treatment at the Practice;
• Where the patient is a child:
• By either parent, or in the absence of both parents, the guardian or other adult who has care of the child;
• By a person duly authorised by a Local Authority into whose care the child has been committed under the provisions of the Children Act 1989;
• By a person duly authorised by a voluntary organisation, by which the child is being accommodated.
• Where the patient is incapable of making a complaint, by a representative who has an interest in his/her welfare.

All complaints, whether written or verbal will be recorded by Paula Dudley (Practice Manager), in the dedicated complaints record.

All written complaints will be acknowledged in writing within 3 working days of receipt.

If the Practice identifies that the complaint will involve an additional provider it will agree with that provider which organisation will take the lead in responding and communicating with the complainant.

Periods of time within which complaints can be made

The periods of time within which a complaint can be made is normally:

• 12 months from the date on which the event / incident which is the subject of the complaint occurred; or
• 12 months from the date on which the event / incident which is the subject of the complaint comes to the complainant’s notice.

Initial action upon receipt of a complaint

All complaints, whether verbal or in writing must be forwarded immediately to Paula Dudley (Practice Manager),  the Practice Complaints Manager or, if unavailable to Dr Samuel Muthuveloe Lead GP in his absence Dr Sharon Thayer GP partner, will be the Practice Responsible Person.

Where the complaint is made verbally, a written record will be made of the complaint and a copy of this will be provided to the complainant.

A verbal or written acknowledgement of receipt of the complaint must be made not later than 3 working days after the day on which the Practice receives the complaint.

This written acknowledgement will include:

The name and contact details of the Practice member of staff who will be attending the meeting and investigating the complaint

An offer to meet with the complainant, at a time and location convenient to them, to discuss the manner in which the complaint is to be handled and the response period within which the investigation of the complaint is likely to be completed and the full response is likely to be sent to the complainant.

As much of the following information as possible will be obtained at this initial meeting, to enable their concerns to be assessed correctly, resolved quickly if possible and build a good ongoing relationship with them:

Ascertain they would like to be addressed – as Mr, Mrs, Ms or by their first name.

Ascertain how they wish to be kept informed about how their complaint is being dealt with – by phone, letter, email or through a third party such as an Advocacy or support service.

If it’s by phone, ascertain the times when it is convenient to call and verify that they are happy for messages to be left on their answer phone.

If it’s by post, make sure that they are happy to receive correspondence at the address given.

Check if consent is needed to access someone’s personal records

Check if they have any disabilities or circumstances that need to be taken account of.

Ensure they are aware that they can request an advocate to support them throughout the complaints process, including at the first meeting.

Systematically go through the reasons for the complaint so that there is a clear understanding why they are dissatisfied.

Ascertain what they would like to happen as a result of the complaint (for example, an apology, new appointment, reimbursement for costs or loss of personal belongings or an explanation).

Advise them at the outset if their expectations are not feasible or realistic.

Formulate and agree a plan of action, including when and how the complainant will hear back from the Practice.

If it is considered that the matter can be resolved quickly without further investigation, the Practice will do so, providing the complainant agrees and there is no risk to other service users.

In the event the complainant does not accept the offer of a discussion, the Practice will itself determine the response period and notify the complainant in writing of that period.

Investigation and response

Complaints should be resolved within a “relevant period” i.e. 6 months from the day on which the complaint was received.

However, at any time during the “relevant period”, the Practice Complaints Manager or Responsible Person has the discretion to liaise with the complainant to extend this time frame to a mutually agreeable date, provided it is still possible to carry out a full and proper investigation of the complaint effectively and fairly.

When an extension to the 6 months time frame is being considered, it is essential that the Complaints Manager or Responsible Person takes into account that either party may not be able to remember accurately the essential details of the event / incident and also the feasibility of being able to obtain other essential evidence specific to the time of the event.

The Practice will investigate the complaint speedily and efficiently and as far as reasonably practicable, keep the complainant informed of the progress of the investigation.

After the investigation is completed, the Practice will compile a written report which incorporates:

• A summary of each element of the complaint
• Details of policies or guidelines followed
• A summary of the investigation
• Details of key issues or facts identified by an investigation
• Conclusions of the investigation: was there an error, omission or shortfall by your organisation?
• Did this disadvantage the complainant, and if so, how?
• What needs to be done to put things right
• An apology, if one is needed
• An explanation of what will happens next (e.g. what will be done, who will do it, and when)
• Information on what the person complaining should do if they are still unhappy and wish to escalate the complaint, including full contact information on the Health Service Ombudsman.

The Practice will send the complainant a response within the 6 months “relevant period”, signed by Dr Samuel Muthuveloe Lead GP, the Practice Responsible Person. The response will incorporate:

The written report

Confirmation as to whether the Practice is satisfied that any necessary action has been taken or is proposed to be taken;

A statement of the complainant’s right to take their complaint to the Parliamentary and Health Service Ombudsman.

If the Practice does not send the complainant a response within the 6 month “relevant period”, it will

Notify the complainant in writing accordingly and explain the reason why; and.

Send the complainant in writing a response as soon as reasonably practicable after the 6 month “relevant period”.

In the event that the complaint has been incorrectly sent to the Practice, the Practice will advise the patient of this fact within 3 working days from its initial receipt and ask them if they want it to be forwarded to the correct organisation. If it is sent on, the Practice will advise the patient of the correct organisation’s full contact and address details.

Handling Unreasonable Complaints

In situations where the person making the complaint can become aggressive or unreasonable, the Practice will instigate the appropriate actions from the list below and will advise the complainant accordingly:

Ensure contact is being overseen by an appropriate senior member of staff who will act as the single point of contact and make it clear to the complainant that other members of staff will be unable to help them.

• Ask that they make contact in only one way, appropriate to their needs (e.g. in writing).
• Place a time limit on any contact.
• Restrict the number of calls or meetings during a specified period.
• Ensure that a witness will be involved in each contact
• Refuse to register repeated complaints about the same issue.
• Do not respond to correspondence regarding a matter that has already been closed, only acknowledge it.
• Explain that you do not respond to correspondence that is abusive.
• Make contact through a third person such as a specialist advocate.
• Ask the complainant to agree how they will behave when dealing with your service in the future.
• Return any irrelevant documentation and remind them that it will not be returned again.
• When using any of these approaches to manage contact with unreasonable or aggressive people, provide an explanation of what is occurring and why.
• Maintain a detailed record of each contact during the ongoing relationship.

Complaints Register

To ensure the Practice monitors, handles and reviews complaints in a logical and timely manner, and to keep an Audit trail of steps taken and decisions reached, the Practice records all complaints received on a dedicated complaints register.

Annual Review of Complaints

In line with National Guidance, the Practice will supply the following information to NHS England:

• The number of complaints received;
• The issues that these complaints raised;
• Whether complaints have been upheld;
• The number of cases referred to the Ombudsman.

Reporting a Summary of Complaints to the Care Quality Commission

The Practice will adhere to the Care Quality Commission’s requirement of producing a summary of complaints at a time and in a format set out by the CQC and then send the summary within the time frame specified.