If you are unhappy about the response at the Local Resolution stage, you may take your complaint to the Healthcare Commission.

The Healthcare Commission is completely independent of the NHS and Government and may investigate any matters that were not answered fully during Local Resolution. They will take an independent view of your complaint. This is called “Independent review”.

The Healthcare Commission cannot normally review a complaint that is received more than six months after the date of the final response letter from the Complaints Manager. If however Local Resolution is not completed within six months, you have the right to immediately refer your complaint to the Healthcare Commission.

Should I go to Stage 2?
Going to the next stage of the NHS Complaints Procedure may be the best route to follow if, in your view, the response from the Trust or GP practice was:

• incomplete – not all your points were answered or fully understood
• unreasonable – they have not proposed anything to put right the harm or damage you suffered
• inadequate – there is no indication that action is being taken to prevent the same thing happening to someone else, including who will do what to put things right and by when

or if there are still serious questions about the standards of care.

Going on to the next stage may not be the best option if the healthcare provider has carried out a full investigation into what happened and:

• explained who was involved
• explained why actions were taken, or treatment given, or decisions made
• explained what the findings of the investigation were
• examined records, interviewed or took statements from witnesses
• gave you the results of the investigation in full (subject to any exclusions allowed under the Data Protection Act)
• offered you some options to resolve what went wrong (for example, a meeting or second opinion on your treatment)
• proposed or took action to put right any harm or damage you have suffered
• has shown you how the Trust or GP practice has learned
any lessons and reviewed its procedures and practices as a result.

The Healthcare Commission cannot investigate a complaint:

• if you have taken, or intend to take, legal action
• about private health care in non-NHS hospitals or nursing homes
• about staff matters - such as recruitment, pay and discipline.

How do I complain to the Healthcare Commission?
You need to put your complaint in writing. The easiest way is to download and fill in the “review request form” from their website (www.healthcarecommission.org.uk). If you do not have access to the internet, ICAS can help you.

Alternatively, you can write a letter (please refer to the Useful Addresses leaflet in this pack for the address to write to).

If writing is difficult, you can ring the Commission’s helpline (0845 601 3012) and they will take down all the details for you, sending you a copy to confirm it is correct, or help you complete the form. ICAS can also help you complete the form or write a letter.

You will need to explain why you:

• believe your complaint was poorly handled by the healthcare provider that you have complained about

or

• do not accept what was written in the final response letter.

In your letter, you may want to provide:

• copies of all the relevant correspondence, including a copy of your original letter of complaint
• a copy of the “final response” letter to your complaint from the healthcare provider.

If you need help in putting the letter and the copies together, or with photocopying, ICAS can help you.

What will happen next?
The Healthcare Commission will clarify the facts of your complaint and then decide what to do next. This is called “initial review”. On the basis of the information you provide, the Healthcare Commission can decide to:

• carry out a full investigation
• refer your complaint back to the Local Resolution stage, if they feel that more can still be done at this stage to resolve the complaint
• refer your case to an independent panel
• take no further action because they believe your complaint has already been fully addressed at the local resolution stage.

Investigation
If the Healthcare Commission decides they will investigate, a case manager will work with you (usually by telephone or writing to you) and the organisation or individual you are complaining about to resolve your complaint.

The case manager will probably need your health records and other papers about your case: you will be asked to give your written agreement (consent) to this.

The case manager will identify the matters for investigation and send these to everyone involved for their comments.

Healthcare Commission staff may also ask to interview you, those you have complained about, and any witnesses, in person. You can take a relative, friend or advocate with you to support you.

The investigation can take up to six months, sometimes longer. When it is finished, the Healthcare Commission will write to everyone involved to advise them of their findings. This report will summarise the facts, the Healthcare Commission’s conclusions, the reasons for them and any recommendations.

Independent Panel
In exceptional cases, a Panel may be set up to hear your complaint. The Panel process is normally completed within four months from the date it is set up.

A Panel consists of three members of the public who will consider your complaint and look at the information that is still in dispute. They hear the views of all parties involved in the complaint. Everyone involved is asked to attend, but noone can be forced to go. You can take a friend, relative or advocate with you for support.

When the Panel review is completed, the Panel will report their findings, summarising the facts, conclusions and their recommendations.

At any point the Healthcare Commission has the right to reject your complaint or refer it to another body, for example, the General Medical Council or the Health Service Ombudsman. They will always explain the reasons why.

If you are unhappy with the findings of the Healthcare Commission, you can appeal against their decision to the Health Service Ombudsman.