Advocacy - Working Together

Complaints and your Objectives

NHS complaints

An NHS complaint aims to trigger an investigation, obtain answers and 
explanations, and find out what has gone wrong and how this can be put 
right and prevented from happening again.

NHS complaints in Wales are governed by the NHS Concerns, 
Complaints and Redress Arrangements (Wales) Regulations 2011. If a 
complaint involves a Health Board or NHS Trust in Wales and 
failure/negligence has occurred, which has caused harm, then the NHS 
organisation may need to put it right through a system of ‘Redress’. This 
can involve more treatment, apologising, referring a patient elsewhere or 
making modest compensation payments. Redress is not relevant for all 
complaints.

Social Care or regulated provider complaints

A social care complaint usually aims to resolve service issues quickly, 
and in most cases informally, through a stage 1 local resolution review. If 
concerns about social care are more complex, then a formal 
investigation in the stage 2 will be undertaken by an independent
investigator.

Social Care complaints are governed by the Social Services Complaints 
Procedure (Wales) Regulations 2014 and follow the complaints 
guidance called “A guide to handling complaints and representations by 
local authority social services”.

Timescales 

A complaint should be made as soon as possible and/or within a year of 
an incident. 

The NHS Regulations regarding complaints suggest that complaints 
should be answered in 30 working days, but this is a guideline only. 

Social Care concerns in stage 1 local resolution reviews should be 
answered in 15 working days of the body’s acknowledgement of the 
concern. 

Social Care concerns in stage 2 formal investigations should be 
answered in 25 days from the date that the local authority and the 
person making the compliant agree on the points of concern to be 
investigated. 

Some complaint investigations are complex and will take longer to 
investigate and respond to.

NHS and Social care bodies are expected to “investigate once and
investigate well” although this can mean additional time waiting for a 
response. 

Your responsibilities

• The complaint is yours and although our role is to help you with the 
  complaints process, you remain the decision maker.
• If there are any developments, please let us know. Although the 
  advocacy team regularly monitors all complaints, if you or the 
  relevant NHS/Social Care organisation do not inform us of 
  developments, our records may not be up to date.
• Keep us up to date with your address, telephone numbers and 
  email contact details if they change. You can do this by dropping 
  us any email, letter, or phone call.
• During the complaints process, if your health/care situation or that 
  of the patient/service user changes, please let us know as we are 
  not automatically informed of such changes.
• If we contact you by letter/telephone/email but repeatedly receive 
  no response from you and if there is a long-term absence of 
  communication, we reserve the right to close the case file.

Working with you and some things that we cannot do

• We aim to treat you as we would like to be treated ourselves, 
  courteously and with respect.
• We will listen to your concerns and offer independent advice on the 
  options open to you in the NHS and Social Care Complaints 
  Procedure. We cannot offer validation of your concerns but will do 
  our best to help you have your concerns heard by the right people.
• Llais advocacy staff deal with up to 200 complaints/enquiries at 
  any time, and specific staff may not be immediately available. Advocacy Support Officers are the first point of contact for most 
  queries, as they can access your case files, provide updates, and 
  arrange for a telephone appointment for you to speak to your 
  Advocate if required. We may ask you to contact us on certain 
  days or times to ensure our availability. 
• Unfortunately, we cannot offer walk-in appointments, all meetings 
  should be arranged in good time to allow the team to allocate a 
  meaningful opportunity to discuss your concerns in a suitable 
  environment (private meeting room) and with sufficient time set for 
  the meeting. Initial meetings are expected to last between 1 and 1 
  and half hours.
• We are unable to accept requests for home visits, unless you are 
  house bound, or you care for someone who is house bound, and 
  you do not have alternative care arrangements. Home visits are 
  rare and require two members of staff to attend. All other meetings 
  with the Advocacy team will take place at our office, which is fully 
  accessible for access needs and privacy.
• Whilst we can appreciate that people may be angry, upset or 
  frustrated by their concerns or ill health, Llais has a zero-tolerance
  policy towards abusive, aggressive, or unreasonable behaviour.
  This can include excessively persistent or demanding levels of 
  contact with the team and passive aggressive behaviour that 
  causes the team distress or concern. If requests are 
  unreasonable, excessively persistent or if behaviour is
  unacceptable, we reserve the right to withdraw advocacy support, 
  without warning in some instances.
• If behaviour causes us concern but does not immediately warrant 
  the withdrawal of our service, we may ask that communication be
  undertaken in specific ways e.g., on set days, only via email, post 
  or over the telephone. This request will require your agreement 
  before we can continue and any refusal of or deviation from the 
  agreement may result in the withdrawal of our service. 
• Our confidentiality is not absolute. If you disclose information, 
  even in jest, which suggests that there may be a risk of harm to 
  yourself/others or intent to break the law, we must refer this 
  information to the appropriate authorities.
• We do not provide a 24-hour or emergency service.
• We cannot attend meetings in your place, as your representative. 
• Advocacy staff can only deal with NHS and Social Care matters 
  involving health care, treatment or social care that you have 
  received (unless you are complaining on behalf of a friend or 
  relative with their written authorisation). Anything else is outside of 
  this remit and cannot be addressed through the NHS or Social
  Care complaints processes. 
• We do not provide any kind of health care or medical advice and 
  we do not attend clinic appointments, assessments, multi-disciplinary meetings, or treatment/care reviews. 
• We cannot expedite your treatment or care.
• We do not directly investigate complaints, as we have no clinical, 
  investigatory, or legal expertise and cannot influence the 
  investigation process or the length of time the investigation may 
  take. 
• We cannot give you legal advice. We cannot assist you with 
  complaint matters that are already being dealt with by legal 
  experts.
• We do not provide counselling.
• We are unable to access, obtain or interpret medical records or 
  care plans on your behalf, but we can direct you to the most 
  appropriate team and application route to request a copy of 
  medical records or care plans. Information you have discovered 
  from medical records or care plans, which you feel support your 
  concerns can be shared with us to help us draft complaint letters.