PROCEDURE FOR HANDLING HABITUAL COMPLAINANTS 1 INTRODUCTION
1.1 Complaints about Leeds North CCG services are processed in accordance with NHS complaints procedures. During this process Leeds North CCG staff inevitably have contact with a small number of complainants who continue to challenge the complaints process or service or whose complaints and requests absorb a disproportionate amount of NHS resources in managing their concerns. Complainants may also become aggressive, abusive or violent towards those involved in the complaints process. The aim of this procedure is to set out the criteria and options for managing complainants who behave in this way at any point in the complaints process.
1.2 It is emphasised that the identification of a complainant as habitual should only be used as a last resort and after all reasonable measures have been taken to try to resolve complaints following the NHS complaints procedure. The decision must be taken by the Accountable Officer, or their deputy in their absence, with advice from the Head of Corporate Governance and the Governance Team
1.3 The aim of this procedure is to set out the criteria and options for managing habitual complainants. NHS staff should respond with patience and sympathy to the needs of all complainants but there are times when there is nothing further which can reasonably be done to assist them or to rectify a real or perceived problem. This procedure will be followed when a complainant is considered to be habitual i.e. the complainant and/or anyone acting on their behalf meet any of the criteria in this procedure.
2 CRITERIA FOR HABITUAL COMPLAINANTS
Complainants fulfilling any one of these criteria will be managed as habitual:-
2.1 The complainant threatens or uses actual physical violence towards staff or their families or associates at any time.
2.2 The complainant changes the substance of a complaint or continually raises new issues or seeks to prolong contact by continually raising further concerns or questions upon receipt of a response whilst the complaint is being addressed.
2.3 The complainant is unwilling to accept documented evidence of treatment given as being factual, e.g. drug records, General Practitioner manual or computer records, nursing records.
2.4 The complainant denies receipt of an adequate response in spite evidence of correspondence specifically answering their questions being supplied.
2.5 The complainant does not accept that facts can sometimes be difficult to verify when a long period of time has elapsed.
2.6 The complainant does not clearly identify the precise issues which he/she wishes to be investigated.
2.7 The complainant does not accept that the concerns identified are not within the remit of Leeds North CCG to investigate.
2.8 The complainant persists in pursuing a complaint where the NHS complaints procedure has been fully and properly implemented and exhausted (for e.g.
where Leeds North CCG has not investigated a complaint because it is outside the time limits.
2.9 The complainant has harassed or been personally abusive or verbally aggressive on more than one occasion towards staff managing their complaint or their families or associates. This will include racial harassment. (Staff must recognise that complainants may sometimes act out of character at times of stress, anxiety, or distress and should make reasonable allowances for this.
They should document all incidents of harassment).
2.10 The complainant makes an excessive number of contacts with Leeds North CCG placing unreasonable demands on staff.
2.11 The complainant is known to have recorded meetings or face-to-face/telephone conversations without the prior knowledge and consent of other parties involved.
2.12 The complainant makes unreasonable demands and fails to accept that these may be unreasonable (e.g. insists on responses to complaints or enquiries being provided more urgently than is reasonable or normal recognised practice).
3 OPTIONS FOR MANAGING HABITUAL OR POTENTIAL HABITUAL COMPLAINANTS
Where complainants have been identified as habitual in accordance with the above criteria or where complainants are becoming habitual but do not fully satisfy the above criteria the Chief Officer (or appropriate deputy in their absence), the Head of Governance and the Governance Team will agree the actions to be taken appropriate to the individual case.
Once they are satisfied that the complaints procedure has been properly followed and that the response covers all the issues raised the Chief Officer will inform the complainant in writing:
A) That if they persist with the approach they are taking, and explaining their actions causing concern, they will be classed as a habitual complainant. Consideration will be given to the need for a signed agreement with the complainant which sets out a code of behaviour for the parties involved if Leeds North CCG is to continue processing the complaint. If necessary or appropriate, for example where the
complainant may require alternative communication formats other than writing, the complainant will be invited to meet with Leeds North CCG and be issued with a verbal notification. This meeting will explain that all previous issues have been addressed and there is no further resolution. A copy of this procedure will be included so that they understand the next stage of the process if they persist.
Or
B) Inform the complainant, in writing, that that they have been classified as a habitual complainant, the reasons for this and the actions that Leeds North CCG will take. A copy of this procedure will be included.
These communications may be copied for the information of others involved in the complaint e.g. practitioners, conciliator, advocate, Members of Parliament
One, a combination or all of the following actions may be adopted by Leeds North CCG for habitual complainants:
3.1 The Chief Officer will write to the complainant clearly explaining that there is nothing further for Leeds North CCG to do, and remind the complainant of their right to contact the Ombudsman or suggest that the complainant seeks advice in processing their complaint for e.g. through independent advocate. The complainant will be notified that the correspondence is at an end and that further letters will be acknowledged but not answered.
3.2 Inform the complainant that Leeds North CCG will pass unreasonable complaints to their solicitors or the police.
3.3 Remind the patient of their right to ask for an Independent Review by the Parliamentary Health Service Ombudsman.
3.4 Restrict or decline all communication to one channel, (for example correspondence with the Chief Officer) and all staff who are contacted by the complainant should give the same message and a record of the contact by the complainant retained in the complaint file. If necessary an incident form should be completed. Staff will be provided with a standard statement to use in the event of such contacts. The complainant should be reassured that the complaint is being managed.
3.5 The Chief Officer will write to the complainant clearly stating that he/she can not investigate the complaint. If possible, give the name of any organisation that can investigate the matter or provide advice.
3.6 The Chief Officer will inform the complainant that they are being treated as being habitual, stating the reasons why and suspending all contact with the complainant or investigation of a complaint and seek legal advice
3.7 Temporarily suspend all contact with the complainant or investigation is a complaint while legal or other agency advice or guidance is sought.
3.8 The Chief Officer will inform the complainant of arrangements to protect staff. These will reflect the severity of the case but examples include: restricting complainant to correspondence only; informing the police; asking for correspondence to be sent via the Leeds North CCG solicitor or securing an injunction.
4 WITHDRAWING ‘HABITUAL OR ITERATIVE’ STATUS
4.1 Once a complainant has been determined as habitual there needs to be a mechanism for withdrawing this status at a later date if, for example, the complainant subsequently demonstrates a more reasonable approach or if they submit a further complaint for which normal complaints procedures would appear appropriate. Staff should previously have used discretion in recommending habitual status at the outset and discretion should similarly be used in recommending that this status be withdrawn when appropriate. Where this appears to be the case, discussion will be held with the Chief Officer, Head of Governance and the Governance Team. Subject to their approval, normal contact with the complainants and application of NHS complaints procedures will then be resumed.
5 REVIEW OF PROCEDURE
This procedure will be reviewed and revised as appropriate in line with the Complaints, Concerns, Comments and Compliment Policy and will remain in place until June 2015 or sooner if there are any changes to legislation.
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