Guide to Complaint Handling in Health Care Services

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3. Complaint handling process What complaints are Types of complaint Point of service complaints/enquiries Complaints needing investigation Step 1: Assessment Step 2: Information gathering Step 3: Resolution/outcome Step 4: Implementation External complaints – role of the Health Services Commissioner PROCESS 3
Complaint handling process What complaints are Complaints are an expression of dissatisfaction – they may be an informal, verbal complaint or they may be a more formal, written complaint. Consumers complain about various aspects of health care, ranging from the minor to the catastrophic. However, even the most minor complaint can reveal issues that potentially affect patients’ health outcomes, and all complaints should be taken seriously. Consumers are not only focused on themselves when they make a complaint – they are often concerned with the quality of the health system generally. The sorts of outcomes consumers commonly want are: • an explanation, • an apology, • to get reassurance, • to prevent the same thing happening to other people. Sometimes people are also seeking compensation for financial loss. Types of complaint Complaints can be grouped into three broad categories – some complaints will move through all three. These categories are as follows: Point of service These are straightforward complaints/ complaints, which can be dealt enquiries with promptly and to the health consumer’s satisfaction at the point of service. Sometimes all that is needed to resolve an issue is for the consumer to speak directly to the staff involved. Complaints needing investigation More serious or complex matters or unresolved complaints may need to be referred to more senior staff or the complaints manager. There is a need for investigation and a clear outcome identified. This may involve different levels within the organisation. External complaints These are complaints that are unresolved by the organisation. They need to be referred on to external bodies or insurers to deal with. Also, some complaints first come to the organisation from the Health Services Commissioner. Complaint handling process 17
Page 1 and 2: Guide to Complaint Handling in Heal
Page 3 and 4: Guide to Complaint Handling in Heal
Page 5 and 6: Contents ABOUT THE GUIDE 2 Why comp
Page 7 and 8: How the Guide works The Guide is di
Page 9 and 10: 1. Guiding principles for an effect
Page 11 and 12: Guiding principles The complaints m
Page 13 and 14: 3. Commitment The health service an
Page 15 and 16: Putting the principles into practic
Page 17 and 18: 2. Organisational foundations Polic
Page 19 and 20: staff feel they will be listened to
Page 21: Reporting This is an essential elem
Page 25 and 26: Complaints needing investigation Th
Page 27 and 28: The organisation needs to decide wh
Page 29 and 30: Flow chart of complaint management
Page 31 and 32: Complaint handling skills Why peopl
Page 33 and 34: Dealing with difficult situations S
Page 35 and 36: Conducting meetings Convening a mee
Page 37 and 38: Setting up your system/tools Each o
Page 39 and 40: 3. Commitment Adequate resources ar
Page 41 and 42: Complaints are dealt with in a time
Page 43 and 44: List areas where action is required
Page 45 and 46: Complaints Register Department Numb
Page 47 and 48: Complaint follow-up record (to be c
Page 49 and 50: 6. Feedback Outcome communicated to
Page 51 and 52: Dealing with complaints- checklist
Page 53 and 54: Using the Seriousness Assessment Ma
Page 55 and 56: SAM score Whether SAM is done elect

Guide to Complaint Handling in Health Care Services

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