Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
SALFORD ROYAL HOSPITALS NHS TRUST
Subject:
Patient Responsiveness
Quarter 4 - 1 January – 1 March 2005 and
Year - 1st April 2004 – 31st March 2005
Prepared by:
Margaret Hadfield, Complaints Team Manager
Pam Woods, Patient Advice & Liaison Service
Manager
Elaine Inglesby – Executive Nurse Director
Presented by:
1.
Introduction
1.1
As the Trust Board is aware, the Trust must operate the NHS Complaints
Procedure and achieve national targets for responding to complaints. The
Trust must also provide a Patient Advice & Liaison Service (PALS).
1.2
This report details the numbers of complaints received by the Trust
through the formal complaints procedure and PALS contacts between 1
January and 31 March 2005 (Quarter 4) and for the year 1 April 2004 – 31
March 2005. The report also details the Trust’s performance in responding
to the complaints made.
1.3
The Trust Board has an obligation as detailed in Statutory Instrument
2004 No 1768 to receive a report which:a) Specifies the number of complaints
b) Identifies the subject matter of those complaints
c) Summarises how they were handled including the outcome of the
investigations, and
d) Identified any complaints where the recommendations of the
Healthcare Commission were not acted upon giving the reasons why
not.
1
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
2.
Complaints and PALS Contacts quarter 4
2.1
In the period 1 January to 31 March 2005, the Trust received a total of
122 complaints. In the corresponding period last year there were 132
complaints received.
2.2
Of the 455 PALS contacts, 26, (5.7%), proceeded to make an official
complaint
2.3
Performance for the quarter against the two national complaints targets in
respect of response times was:
Target
%
Complaints should be acknowledged in writing within two working days 99.3
Complaints should receive a written response to their complaint within 95.0
twenty working days
2.4
The table below shows the breakdown of complaints and PALS contacts
received by Directorate
Complaints Received and PALS Contacts by Directorate/Service
1 January to 31 March 2005
Directorate of Emergency, Critical Care
and
Clinical Support Services
Directorates
Radiology
Intensive Care
Pathology
Accident and Emergency
Pharmacy
Bed Management
Other Units in Group
Emergency Medical Admissions Unit
Medical High Dependency Unit
Emergency Clinical Decision Unit
Directorate Total
Directorate of Medicine & Elderly Care
Cardiology
Palliative Care
Respiratory Medicine
Allied Health Professionals? Dieticians
Complaints
Received
PALS
Contacts
3
1
12
10
1
2
17
Complaints
Received
5
4
1
2
2
11
1
0
0
0
0
28
PALS
Contacts
3
0
0
4
2
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
Physiotherapy
Weight Management
Podiatry
Elderly Care
Renal
Gastroenterology
Dermatology
Rheumatology
Diabetes and Endocrinology
General Medicine
Directorate Total
Directorate of Neurosciences and
Orthopaedics (including Ear, Nose and
Throat and Oral Surgery)
Neurology
Neurosurgery
Neuro-Rehabilitation
Neurophysiology
Pain Management
Spinal Services
Orthopaedics
Ear Nose and Throat
Oral Surgery
Stroke Unit
Directorate Total
Directorate of Women’s, Children’s and
Sexual Health Services and General
Surgery and Urology
Gynaecology
Obstetrics
Day Case Surgery
General Surgery
Intestinal Failure
Gastroenterology
Urology
Theatres
Directorate Total
Directorate of Facilities
1
3
4
2
4
1
0
1
26
3
0
0
3
4
3
16
6
0
19
61
Complaints
Received
PALS
Contacts
2
13
1
1
1
6
24
1
0
2
51
20
37
0
0
6
31
44
4
2
0
144
Complaints
Received
PALS
Contacts
3
2
11
6
1
2
1
15
Complaints
Received
1
27
0
0
28
1
68
PALS
Contacts
3
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
Portering and Security
Accommodation
Car Parking
Communications
Estates
Domestic Services
Transport
Directorate Total
2
1
3
2
0
5
2
6
2
7
24
4
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
Corporate Services
Medical Records
Call Centre
Access Booking and Choice
Outpatients
PALS
Not our complaint
Corporate Services Total
Grand Totals
Complaints
Received
4
4
PALS
Contacts
2
78
1
1
10
122
25
25
130
455
5
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
3.
Cause for Complaint or concern quarter 4
3.1
The cause of the contacts received January to March 2005 is shown in the
table below:
Complaints Received and PALS Contacts by Subject of Concern
1st January 2005 – 31st March 2005
Complaints
PALS
Subject
Received
Contact
Admissions,
discharge
and
transfer
4
19
arrangements
Aids and appliances, equipment and premises
0
1
(including access)
Appointments, delay/cancellation (outpatient)
14
121
Appointments, delay/cancellation (inpatient)
16
Appreciation of Care
0
0
Attitude of staff
6
16
Call Centre
52
0
Clinical Treatment- Medical
29
35
Clinical Treatment- Nursing
22
0
Communication/information to patients- Written
19
16
Communication/information to patients- Oral
24
Compliment
0
0
Consent to Treatment
0
0
Complaints handling
0
0
Donations
4
0
Environment and Facilities
20
0
Failure to follow agreed procedures
4
0
General Enquiries
0
0
Independent Services/Not Our Complaint
12
0
Information
37
0
Investigation results
20
0
Other
11
0
Patient’s privacy and dignity
0
3
Patient’s property and expenses
2
3
Personal records (including medical and/or
3
10
complaints)
Patient’s status, discrimination (e.g. racial,
0
1
gender, age)
Mortuary and post mortem arrangements
0
0
Transport (ambulances and other)
10
0
Hotel services (including food)
0
0
6
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
Policy/commercial Decisions
0
Waiting Lists
0
Waiting Times
0
Others
12
TOTAL
122
4.
Complaints from Older People January to March 05
4.1
455
It is a National Service Framework (NSF) requirement to collect details of
the number of complaints received from older people and therefore the
information below captures the age range, the number of complaints and
PALS contacts and follows with charts showing the subject of the
concerns.
Age Range
No of
Complaints
Rec’d
No of PALS
Contacts
4.2
0
11
20
65-70
8
71-75
11
76-80
11
81+
5
44
47
18
28
Cause for Complaints Received
7
Patient Responsiveness Report to Trust Board – May 2005
Ad
m
Ai iss
ds ion
/ s/T
Ap r
pl ans
ia fe
nc r
es /Di
/ E sch
Ap
pr Ap qui arg
ec po pm e
ia in e
C
C
At tion tme nt
lin
C om
tit o n
om m C ic
ud f ts
a
l
m u n in l t
e C
un ic ica re C of are
a
a
ic t l t tm al S
at io re e l C ta
io n a n e ff
n of tm t M n
of In e e tre
In fo nt di
fo rm N ca
rm a ur l
at tio sin
C
io n g
on
se C n W Ora
D nt om rit l
el to p te
ay T li n
/ C re me
an atm nt
ce en
Fa
ci E D llati t
lit n on on
Fa
i
Fa cil F es viro atio
ci itie ac Ca nm n
lit s ili r
ie C tie P en
s o s ar t
D m C ki
om m a ng
e u n te
Fa sti ica ring
ci c S tio
Fa
li e n
ilu F Fac ties rvi s
re ac ilit E ce
ilit ies sta s
H
t
o
ot
Fo ies P te
el
llo T ort s
Se
r
rv G w P ans ers
ic en ro p
e
In s er c or
de / al ed t
pe En E ur
nd vi nq e
en ron uir
In
tS m y
ve
st In er ent
ig fo vi
at rm ce
Is ion a s
su R tio
Pa
e es n
tie
un u
nt
kn lts
ow
Pe Dis
rs cri O n
on m th
al ina er
R t
Pr Pr P ec ion
op iva h or
er cy arm ds
ty & a
& D cy
Ex ig
p ni
R e ty
W ad nse
a i io s
W tin log
ai g y
tin Li
g sts
Ti
m
e
Subject of Concern
At
t it
ud
e
tig C (m
a
at n ed
io ce ic
D n w lle al)
ia a d
gn iti O
Ap
o n p
po At sis g ti .
in t it u M me
tm d e
en e ( dic
n a
M t wa urs l
W edi itin ing
ai ca g )
tin l t ti
g re me
Ex
t im at
te
e m
rn
I
al nd in ent
co iv cl
m idu inic
In
m a
te
un l s
rn
ic ta
al
co los atio ff
m t p ns
Ad
m ro
u p
m
iss N nic erty
a
i
R on urs tion
es W in s
ul a g c
ts it
a
In D W ing re
fo isc ai Ti
rm h tin m
at arg g e
Ti
io
m
n e
Tr oth Pol e
ea e ici
Pe tm r C es
rs en lin
on t ica
al nu l
ity rs
& ing
So
cia
l
es
In
v
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
7
6
5
4
3
2
1
0
4.3
81 +
76-80
71-75
65-70
Areas Of Concern For Older People in PALS
Areas Of Concern for Older People in PALS
12
10
8
6
65-70
71-75
76-80
81+
4
2
0
Number of Contacts
8
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
5.
Complaints & PALS Contacts-1 April 2004 – 31 March 2005
5.1
In the year 1 April 2004 to 31 March 2005, the Trust received 434
complaints. This compares with 523 in 2003/04, 519 in 2002/03 and 554
in 2001/02. The Trust’s overall performance for the year in respect of the
target to respond to complaints within 20 working date was 95.0% placing
the Trust in the top band for performance rating. This is a significant
improvement on last year’s figure of 73.2%.
5.2
The figures for PALS continue to increase, in 2002/2003 there were 177
Contacts, in 2003/2004, 839 and during the past year we have had
1,212.
We have responded to all contacts within one working day and keep in
Regular contact until the issue is resolved.
5.3
Top Five Causes for Complaints
April 04 - March 05
Communication
42
Medical Care Diagnosis
25
77
236
Medical Care Treatment
Appointment Waiting
Times
27
Cancelled Operation
27
All Others
5.4
9
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
% of Complaints by Directorate
April 04 - March 05
CC&CSS
4% 6%
15%
Medicine and Elderly
Care
13%
Neurosciences and
Orthopaedics
22%
Womens and Childrens
Facilities
40%
Corporate Services
5.5 Table of the Top Complaints Issues For Each Directorate for April 04-March
05
Directorate
Corporate Services
CC & CSS
Facilities
Medical & Elderly
Orthopaedics & Neurosciences
Women's & Children's/Surgery/Urology
Top Issue
Communication
Internal
Medical
Treatment
Cleanliness
Medical
Treatment
Medical
Treatment
Medical
Treatment
No Of Contacts
6
16
4
18
28
15
10
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
5.6
Top 5 Causes for PALS Contacts April 04 - March 05
Communication of Information
Oral
75
Delay / Cancellation
216
78
Clinical treatment Medical
Information
103
Appointments
103
5.7
% Of PALS Contacts By Directorate April 04 - March 05
Corporate Services
6%
13%
CC & CSS
13%
9%
Facilities
6%
Medical & Elderly
Orthopaedics & Neurosciences
16%
37%
Women's &
Children's/Surgery/Urology
Other/External
5.8 Table of the Top PALS Issue For Each Directorate for April 04-March 05
Directorate
Corporate Services
Top Issue
Call Centre
No Of Contacts
49
11
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
CC & CSS
Facilities
Medical & Elderly
Orthopaedics & Neurosciences
Women's & Children's/Surgery/Urology
Appointments
Transport
Appointments
Appointments
Appointments
15
15
32
114
45
6.
Independent Review of Complaints
6.1
During the period from 1st January 2005 to 1st March 2005 we have
received eight new requests for Independent Review from the Healthcare
Commission (HCC).
No cases declined during this period.
One case HCC seeking Independent Clinical Advice.
6.2
There remains one case open with the Trust’s Convenor with respect to
Independent Review (pre Healthcare Commission).
Healthcare Commission Requests.
6.3
In July 2004 the Healthcare Commission, took over responsibility from the
Trust’s Convenor and Independent lay Chair for reviewing NHS
complaints that have not been resolved at a local level. It will be noted
that the numbers of Complaints referred to the Healthcare Commission
are increasing. It is perhaps understandable that complainants are
choosing to go straight to the Healthcare Commission’s independent
status.
6.4
This Trust informs all complainants in its response letter, of the next stage
in the complaints procedure i.e. the Healthcare Commission, though asks
that they contact us directly if there are any issues, which remain
unresolved as we are committed to resolving complaints to the
complainant’s satisfaction ‘in house’. We have seen a pattern developing,
although it is early days, in that complainants are choosing to involve the
Healthcare Commission before local resolution is exhausted.
6.5
The recommendations received from the Healthcare Commission to date
have related to further local resolution, which the Trust is very happy to
pursue.
12
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
7.
Health Service Ombudsman
7.1
In the time period, 1st January to 31st March there have been the following
communications with the Ombudsman.
There have been no new requests received during this period.
Reference
Number
Speciality
C0219/01
SPINAL SURGERY
C0478/01
EMERGENCY MEDICINE
C0131/03
RESPIRATORY MEDICINE
Progress
Investigation
complete,
recommendations
are the subject of an
Action Plan to be
approved by Trust
Board
.
Investigation
complete,
recommendations
are the subject of an
Action Plan to be
approved by the
Trust Board.
Investigation
complete,
recommendations
are the subject of an
Action Plan to be
approved by the
Trust Board.
8.
Changes to Practice as a result of Complaints and PALS
8.1
A procedure for Dealing with Vexatious Complainants is being prepared
by our Complaints Team Manager and will come before the relevant
Board subgroup for approval in due course.
8.2
An integrated care pathway for miscarriage is to be developed and the
patient information leaflets
8.3
The external lighting levels to and around Entrance 1a will be improved.
8.4
The “In Touch with Health” kiosk in the PALS department continues to
provide excellent information for our Service Users.
In February 2005 there were 279 “hits”, of these 157 people sought
information regarding medical conditions. A further machine has now
13
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
been installed in our Out Patient area. We are in the process of providing
some information on the screen in sign language, filmed by one of our
own staff!
8.5
The Trust has established an external partnership with Job Centre Plus,
and PALS has provided a workplace opportunity, the recruitment is
extremely successful as part of our welcome at Entrance 4, solving the
problem for our GMAS colleagues and providing valuable “back to work”
skills.
8.6
We provide refreshments to patients at Outpatient Reception whilst they
are waiting for their case notes to be located.
9.
Recommendations
9.1
The Trust Board is asked to receive and note this report, and confirm the
risk score of 10 for this corporate plan item
14
Patient Responsiveness Report to Trust Board – May 2005
Community Health and Social Care Scrutiny Committtee
18 August 2005
Item 6
15
Patient Responsiveness Report to Trust Board – May 2005