What to do if you have concerns

Initially, it is useful to speak to someone you know and trust. A discussion sometimes helps put things into perspective, helps to alleviate the stress and the loneliness that you might be feeling and helps to clarify the ‘is it just me’ feeling that you might have.

When you are ready, speak to the ward manager about your worries. Often, it is little things that niggle that can be best sorted on an informal basis.

Some of the main concerns that patients and their relatives have are:

• being left without a buzzer
• being left without a drink
• not being helped with eating meals
• not being helped with hygiene needs or toileting - worst of all being told to soil the bed and be cleaned up later
• medications being left on the locker
• not being talked to and involved, etc.

Whilst it is probably the last thing that you want to think about when faced with a stressful and unfamiliar situation we would encourage you to keep a diary of events.  This could be helpful in:

• calming your nerves
• providing a better understanding of the situation in which you are involved
• establishing what information you need to help make an informed decision about your care, or that of a relative
• making a complaint should you feel that this is a necessary course of action

In order to assist you we have developed a writing guide that provides advice on what information you need to document and gives suggestions for keeping a diary. 

Escalation

If your concerns are not resolved at a local level by the ward manager there is guidance below on how you might progress

Wales

A new complaints process has been implemented in Wales. It is called Putting Things Right. If you want to raise a concern you can download a leaflet which will tell you how to go about it.

The new arrangements will see the phasing out of the independent review which forms part of the former cmplaints procedure. The new arrangements provide for NHS organisations to try harder to resolve concerns locally, for example by securing clinical advice, using mediation etc. If a person remains unhappy they can ask the Ombudsman to review their case

Your local Community Health Council has complaints advocates who should be able to help you.

The Citizens Advice Bureau in Wales provides a useful guide on the complaints procedure for the NHS in Wales.

England

If you are not satisfied that your concerns have been heard and actioned at a local level you can get advice and assistance from the Patient Advice & Liaison Service (PALS).

The Independent Complaints Advocacy Service can assist you to make a complaint to the Chief executive of the Trust.

Action Against Medical Accidents provides a useful guide on the NHS Complaints Procedure in England.

Concerns about neglect and/or abuse

Abuse is defined as:

“a single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress"

If you are worried that you, a relative or friend might be receiving inappropriate care i.e. neglect/abuse, you can report your concerns to the Protection of Vulnerable Adults team (POVA) and ask for an investigation to be carried out. There should be a POVA coordinator in the hospital. If you are unable to locate them ring your local authority and ask to speak to the POVA team to discuss your concerns. Information about POVA teams can usually be found on the local authority website. If your relative is in a care home you can report your concerns to the Local Authority POVA team. 

This link gives information about the South Wales Adult Protection Forum, which gives an idea about what the POVA teams role is. Forms for reporting are also available to download 

Alternatively, if you are having difficulties at this level you could contact  the NHS regulatory bodies i.e. the Care Quality Commission in England or Healthcare Inspectorate Wales directly with your concerns. Care Standards Inspectorate Wales deals with the regulation of social care - details of all these organisations is provided below.

Southern Cross Nursing Homes have a dedicated abuse helpline for residents and relatives. The helpline is staffed by trained advisors from the charity Action on Elder Abuse who do not need the permission of Southern Cross to alert authorities to any problems, as they are entirely independent. The helpine number is 0808 8010310

If you would like more information about abuse you can:

visit the Action on Elder Abuse website

Age Concern and Help the Aged have produced a useful booklet entitled Protecting Yourself. It is written for older people who are themselves suffering from, or are at risk of being abused. It encourages people to take practical measures to prevent harm and speak out about any mistreatment. The booklet explains what peoples rights are and who to contact to get support. To a copy call the Information Resources Team on 020 7239 1845 or email

adviceleaflets@helptheaged.org.uk This e-mail address is being protected from spambots. You need JavaScript enabled to view it

download our Aide Memoire from the documents section of our website

Regulatory Bodies

Nursing & Midwifery Council (NMC)

The Nursing & Midwifery Council is the regulatory body for nurses and midwives. Nurses have a duty of care to protect their patients. There is a booklet available from the Nursing & Midwifery Council that provides information about what to do if you are unhappy about the way that a registered nurse has treated you or cared for you. You can also check on the website that the nurse/midwife is registered to practice.

NMC have recently produced guidance on what older people should expect when receiving care. tel: 020 7637 7181.

Note: Anyone can report concerns about a nurses fitness to practice to the NMC. The NMC has also clarified that it may investigate when a potential public protection issue comes to its attention in a way other  than a formal complaint.

General Medical Council (GMC)

The General Medical Council is the regulatory body for doctors. There is information on the GMC website regarding making a complaint about a doctor and you can check a doctor’s registration online

Standards and Inspection Bodies

Healthcare Inspectorate Wales (HIW)

Healthcare Inspectorate Wales is responsible for undertaking reviews and investigations into the provision of NHS funded and independent care settings. They  would like to hear about your experiences of the NHS in Wales  as it will help them to represent your views during an inspection. Email: hiw@wales.gsi.gov.uk or tel: 029 2092 8850. Healthcare Inspectorate Wales has published a booklet about complaints and concerns. Click here to download a copy.

Care and Social Services Inspectorate Wales (CSSIW)

CSSIW's role is to make professional assessments and judgements about social care, early years and social services and so encourage improvement by the service providers. It regulates Care homes for adults, including care homes which provide nursing care, domiciliary care agencies, adult placement schemes and nurses agencies. Email: cssiw@wales.gsi.gov.uk This e-mail address is being protected from spambots. You need JavaScript enabled to view it   Tel: 01443 848450

Care Qualities Commission (England)

The Care Quality Commission is the independent regulator of health and social care in England. It regulates health and adult social care services, whether provided by the NHS, local authorities, private companies or voluntary organisations. There is a comprehensive section on how to raise a complaint  Email: enquiries@cqc.org.uk This e-mail address is being protected from spambots. You need JavaScript enabled to view it   Tel: 03000 616161    

Equalities & Human Rights Commission (EHRC)

EHRC promotes equality and human rights by providing advice and guidance. England, Scotland and Wales have their own specific offices, details of which can be found on the EHRC website 

Other Organisations

Older People's Commissioner (Wales)

In Wales, an Older People's Commissioner has been appointed to ensure that the interests of older people in Wales, who are aged 60 or more, are safeguarded and promoted.  The Commissioner will provide strategic leadership and act as an ambassador and authority on older people’s issues and will speak on their behalf.Tel: 08442 64 06 70

Public Service Ombudsman Wales

The Public Services Ombudsman for Wales (PSOW) has timescales in place when investigating cvomplaints but sometimes these timescales are stretched if a case is complex or a body being investigated does not comply as quickly as it should. An investigation is normally completed within 12 months; many are concluded earlier than this and some take longer.

The PSOW is not legally obliged to share the report with the complainant or any body investigated, but does so in order to iron out any inaccuracies prior to the final report being formally submitted. If the complainant disagrees with the facts of the draft report, and needs more time to bring forward new evidence or even seek representation, it is possible to request more time to respond to the draft report. If after submitting a response to the draft report the complainant still disagrees with the facts or wishes to appeal the decision of the draft report, there is a complaints process. The complaints process is subject to strict timescales – acknowledgment of the complaint within 2 working days and a response to the complainant within 20 working days. If you are still unhappy about the way you have been dealt with by the Ombudsman you should write to your MP and Assembly Member.

National Patient Safety Agency (NPSA)

NPSA aims to improve patient care in the NHS through analysis of incidents received via the National Reporting and Learning System. Staff or patients can report incidents online. Whilst individual reports are not investigated, the information submitted is used by the NPSA to improve safety

Other Action

There are a number of groups and organisations that can offer support and advice

UK Clostridium Difficile Support

c-diff support provides information, advice and support to members of the public

MRSA Support

MRSA support provides information, advice and practical support for sufferers and dependents. Tel: 0121 476 6583

Action Againts Medical Accidents (AVMA)

AvMA is the independent charity which promotes better patient safety and justice for people who have been affected by a medical accident. A 'medical accident' is where avoidable harm has been caused as a result of treatment or failure to treat appropriately 

If there aare any other groups or organisations that you fel should be listed here email info@dignifiedrevolution.org.uk This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Write to your Assembly Member (AM Wales)

If you are finding that your complaint is not being dealt with appropriately you could appraoch your local AM. This website will help you to locate contact details

Write to your MP

This website will help you to locate your MP