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					Policy for the Management of Concerns Raised through Patient Advice and Liaison Service (PALS)

Policy Trail and Version Control Sheet

Policy Reference: Version: 1.0 Approval PEC Risk Management Executive Group Purpose Distribution Extranet PCT Website

Trust Board

Intranet

To provide the Primary Care Trust with a robust procedure for managing concerns raised through the Patient Advice Liaison Service Raising concerns has previously been incorporated into the Complaints Policy. This policy is the first of its kind for the Primary Care Trust All Staff Quality Assurance Practitioner/ Governance Directorate Risk Management Executive Group October 2008 October 2009

Status

Policy Application Author and Directorate Approving Committee Date of Review Date of Next Review

This Policy has been assessed using the Date of Assessment: 16/09/08 Equality Impact Assessment Tool as required by the Race Relations (Amendment) Act 2000 Responsibility for implementation Policy Statement Directors and Heads of Service Staff at all levels are responsible to ensure they are working to the most up-to-date and relevant policies and procedures. By so doing, the quality of services offered will be maintained and the chances of staff making erroneous decisions, which may affect patient, staff or visitor safety, will be reduced. All current policies can be found on the PCT website. (www.bournemouthandpoole-pct.nhs.uk)

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Contents Section Page

1 2 3 4 5 6 7 8 9 10 Appendices Appendix A

Introduction Purpose Definitions Duties General Procedure for Concerns raised via the Trusts Patient Advice and Liaison Service (PALS)

3 3 3-4 4-5 5-6

Process for ensuring that patient’s relatives and carers are not 6 treated differently after raising a concern Process by which the Trust aims to make changes as a result of 6 concerns being raised Process for monitoring the effectiveness of; the organisational wide 6 policy for the management of concerns raised through PALS. Dissemination, implementation and access to this policy Associated Documents 6 6

Equality Impact Assessment form

7-10

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1. 1.1

INTRODUCTION The Patient Advice and Liaison Service (PALS) serves to offer users of health services provided and commissioned by the PCT with confidential, quick resolution to their concerns and requests for information. In receiving a concern the Bournemouth and Poole Teaching Primary Care Trust (the Trust) will: • • • • • • • • • • Advise and support patients, their families and carers; Provide information on NHS Services (including how to complaint); Listen and respond to concerns suggestions or queries; Help sort out problems quickly on behalf of a patient, their family and carers; Provide a confidential and sensitive advice service wherever possible; Act impartially when handling concerns; Ask permission before personal information is discussed with others; With permission talk to staff, management, and other organisations on behalf of a patient, their family and carers; Agree the best way to deal with a problem and get it resolved quickly; Ensure that concerns are recorded (in line with data protection) so that the Trust can learn from the experiences of its service users.

1.2

2. 2.1

PURPOSE The purpose of this policy is to: • • • Provide a consistent approach to the handling of PALS concerns; To ensure that significant issues arising from the concerns are highlighted to the Patient and Public Engagement and Communications Steering Group; Ensure that there are effective systems of communication in place so that Directors and key Senior Managers are kept informed about concerns that may have implications for the Trust.

3.

DEFINITIONS PALS Concern

3.1

‘PALS’ is the Patient Advice and Liaison Service, where all NHS Trusts have a duty to offer advice and help to resolve any concern or query raised by a member of the public about any aspect of the PCT’s services or about any care or treatment received by a service provided or commissioned by the PCT’.

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PALS Team 3.2 Bournemouth and Poole Teaching PCT has a team of dedicated officers to resolve PALS concerns. The team are based in the Health Information Shop at Asda in Bournemouth and in Healthpoint at the Library in Poole Dolphin Centre. The team offer health information and advice about health conditions, healthier lifestyles and health services, as well as resolving PALS enquiries. The team also provide outreach services in various other locations across the community. All staff attend weekly meetings with the PALS co-ordinator, who has weekly supervision with the Patient and Public Involvement Manager. Regular team meetings with the Governance Directorate are attended and regular communications bulletins from the Head of Communication are received which keep staff up-to-date on internal matters. Staff read the weekly bulletins provided by DOH ‘The Week’, which are circulated by the PA for the Director of Governance. All staff regularly network by telephone and meetings with key staff, phoning other organisations and other local PALS leads for up to date information, as well as attending PALS South West and Dorset wide network meetings. Staff also liaise with other key staff from public health, commissioning and provider services to gather information on resource websites. There is also a national PALS internet site that staff will check daily, as well as checking other NHS and Department of Health sites. DUTIES All Staff’s responsibilities 4.1 All Trust staff are expected to try and resolve concerns raised by patients, their relatives or carers at the time the concern is raised The Chief Executive 4.2 The Chief Executive has overall accountability for the management of informal concerns raised within the Trust and for meeting all statutory requirements and adhering to guidance for ensuring the involvement of patients and the public in all NHS and Primary Care Trust Service Provision in England. The Trust Board 4.3 The Trust Board is responsible for monitoring the Patient Advice and Liaison Service for the Trust by receiving annual reports which provide an overview of the services provided and the numbers and range of enquiries received by the Trust’s PALS teams, as well as receiving an update on developments of the service across Bournemouth and Poole. The Director of Governance 4.4 The Director of Governance is the dedicated director with responsibility for formal complaints and informal queries and will ensure that quarterly reports are provided to the relevant groups, including the QIG (Quality Improvement Group) and the Patient and Public Engagement and Communications Steering Group. The Patient and Public Involvement Manager

3.3

4.

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4.5

The Patient and Public Involvement Manager is responsible for line management of the Health Information Shop and PALS Co-ordinator and managing the PCT PALS team. The Health Information Shop and PALS Co-ordinator

4.6

The Health Information Shop and PALS Co-ordinator is responsible for ensuring daily co-ordination and management of the PALS service and staff and notifying the Patient and Public Involvement Manager of any untoward issues that may arise. The Patient and Public Engagement and Communications Steering Group

4.7

This group is chaired by the Chief Executive and meets on a monthly basis in order to ensure effective patient and public engagement processes are in place across the PCT. The group will monitor the PALS reports and ensure that information is cascaded to help inform commissioning decisions. GENERAL PROCEDURE FOR CONCERNS RAISED VIA THE TRUSTS PATIENT ADVICE AND LIAISON SERVICE (PALS) The Trusts PALS service exists to answer and resolve queries and concerns and offer advice to patients, carers and relatives quickly and effectively. It provides a prompt resolution to the patient, their carer or relative. All concerns will be thoroughly investigated and dealt with. PALS is not a substitute for the complaints procedure, but many concerns can best be handled immediately when a concern is raised. Any member of Trust staff taking an enquiry will be expected to respond and try to resolve a concern directly. If this is not possible the concern should be referred to the Health Information and PALS Team within the PCT and the patient, relative or carer who raised the concern should be informed of this. The patient, relative or carer who raised the concern should also be given a PALS leaflet which is available across the PCT. Any concerns raised through the Health Information and PALS team will be registered and assigned to a PALS officer for action It is the responsibility of the PALS officer to carry forward an enquiry from this point and to ensure that any investigation is dealt with and resolved to the satisfaction and understanding of the person who raised it. The person who raised the concern can ask that it be dealt with through the formal complaints procedure at any time provided that they fulfil the necessary criteria for making a complaint. The NHS Complaints Regulation 2004 (Statutory Instrument 2004 number 1768) prescribes the criteria for making a complaint as being; Anyone who is unhappy with the treatment or service they have received from the NHS is entitled to make a complaint. A complaint can be made by a patient or person affected or likely to be affected by the actions or decisions of a NHS C:\Documents and Settings\sue.cullen\Local Settings\Temporary Internet Files\OLK7F\Policy for the Management of PALS (3).docPage 5

5.

5.1

5.2

5.3

5.4

5.5

5.6

5.7

organisation or primary care practitioner. A complaint can also be made by someone acting on behalf of the patient or person, with their consent. 5.8 Formal complaints are normally of a more serious nature than PALS queries. They are an expression of concern requiring a response which may be received orally or in writing from the patient or their representative (if appropriate). A written communication may indicate at the outset that a formal complaint is being made. PALS concerns are a more informal way of raising an issue. They may be received orally or in writing from the patient or their representative (if appropriate). These concerns should normally be resolved promptly without the need to resort to formal complaint, although if appropriate the way in which an individual can access the Trust’s complaints procedure should also be explained to them. A complainant making an oral complaint may wish the issue to be dealt with formally or in a more informal way through the PALS Procedure, having had the choices explained to them. PALS staff will always seek to resolve concerns as locally as possible. Approaches taken may include accessing a range of written or online resources including Department of Health Helplines, relevant staff and the Primary Care Trust or other agencies, and other PALS officers for expert advice. If PALS staff are unable to resolve a query, they will normally refer the matter to their line manager. The Patient and Public Involvement Manager, or Director of Governance may also provide support and resolution. Should a concern need to be escalated perhaps through the formal complaints route, PALS staff will always speak to the client to agree on how they will proceed and give clients a copy of the complaints leaflet. The staff will liaise with the Complaints Manager at the PCT and usually ask the client to put the complaint in writing if this is appropriate. Should the nature of the enquiry cause concern about the safety or welfare of an individual, the PALS staff will implement the relevant trust policy. In the case of children, staff should discuss their concerns with their manager and contact the Named Nurse/Named Doctor Safeguarding Children for the Trust or the Safeguarding Children Team prior to referral if necessary. If the individual concerned is an adult, report any allegations or suspicions of abuse or potential abuse of a vulnerable adult to a senior member of staff or their manager. This also includes abuse carried out by someone else with whom the vulnerable adult has a personal or professional relationship external or internal to the Primary Care Trust. Process for ensuring that patient’s relatives and carers are not treated differently after raising a concern 5.16 The Trust is committed to ensuring that patients, carers and relatives will not be discriminated against, nor their care or treatment adversely affected by having raised a concern through the PALS service.

5.9

5.10

5.11

5.12

5.13

5.14

5.15

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5.17

There are processes in place to ensure that individuals who register formal complaints and raise informal concerns are not treated differently as a result of doing so. These processes include: • • • • Ensuring that individuals can raise concerns anonymously if they wish, via PALS Officer; Ensuring that investigations are standardised across the Trust with procedures in place that comply with external standards; Any documentation relating to investigations regarding concerns/complaints are not filed within the service users health records; If an individual does report that they have been treated differently as a result of raising a concern or registering a formal complaint, this would be investigated.

6. 6.1

PROCESS BY WHICH THE TRUST AIMS TO MAKE CHANGES AS A RESULT OF CONCERNS BEING RAISED All concerns offer an opportunity for the Trust to learn from patients, their relatives and carers experiences. The Patient and Public Involvement and PALS Leads will therefore collate information on the number of concerns raised, provide comparison on the number of concerns raised against the previous quarter and categorise the types of concerns raised into themes for the Patient and Public Engagement and Communications Steering Group. These reports will help to inform commissioners of areas needing improvement will be used in developing action plans to improve the patient, relative or carers experience. Reports are also made annually to the Trust Board. MONITORING THE EFFECTIVENESS OF; THE ORGANISATIONAL WIDE POLICY FOR THE MANAGEMENT OF CONCERNS RAISED THROUGH PALS The Trust Board will monitor the implementation and audit compliance with this policy. The Patient and Public Involvement and PALS Leads will be responsible for ensuring that the policy is monitored, reviewed and, if necessary, revised in the event of new legislative or organisational change. PROCESS FOR REVIEWING, APPROVING AND ARCHIVING THIS DOCUMENT This document will be reviewed annually or whenever national policy or guideline changes are required to be considered (whichever occurs first), by the Trust Board following which it will be subject to re-ratification by the Trust Board. Archiving of this document should be conducted in accordance with the organisation’s Records Management archiving procedure.

6.2 7. 7.1 7.2

8. 8.1

8.2

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9. 9.1

DISSEMINATION, IMPLEMENTATION AND ACCESS TO THIS DOCUMENT This policy should be implemented and disseminated throughout the organisation immediately following ratification and will be published on the organisations intranet site. Access to this document is open to all. ASSOCIATED DOCUMENTS This policy should be read in conjunction with this policy, include the Patient and Public Engagement Strategy and Action Plan, the Communications Strategy and Action Plan, the Complaints Policy and other related national policies and procedures.

10. 10.1

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Appendix A EQUALITY IMPACT ASSESSMENT FORM PART 1 – INITIAL SCREENING Department/Service area: Governance Person responsible for completing the assessment: Kathy Nicholson-Banks Name of the strategy or policy: Policy for the Management of Concerns Raised through Patient Advice and Liaison Service (PALS)

To which equality targets groups does this strategy/policy apply? (Please circle all relevant groups)

Race Disability Gender/transgender Sexual Orientation Age Religion/Belief ALL

What is the main purpose or aims of the strategy or policy? To ensure people are able to raise concerns, and that they will be dealt with effectively Has the strategy/policy been explained to those it might affect directly or indirectly YES Through posters and leaflets across the community PALS team contributed to development of policy Have you consulted on this strategy/policy?

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Equality target Groups Race (BME communities)

Summary of consultation carried out or planned YES – discussed with BME panel

Disability

YES – presentation at RHID event and through Strategic health Facilitator for people with learning disabilities

Gender/transgender Sexual orientation (lesbian, gay men or bisexual) Through website Age (older people, young people/children) Through health promotion facilitator and stroke PPI days

Please complete the following table and give reasons/comments for where: The strategy/policy could have a positive impact on any of the equality target groups or contributes to promoting equality, equal opportunities and improving relations within equality target groups. Anyone who feels they have been treated in a discriminatory way can express concerns and ensure that a satisfactory outcome is reached. Feedback will be cascaded to commissioners to ensure that services are improved as a result The strategy/policy could have a negative impact on any of the equality target groups, that is, disadvantage them in any way. If the impact is high, a full Equality Impact Assessment should be completed. Equality Target Group (a) Positive Impact High Asian or Asian British people Black or Black British people White people (including Irish people) Chinese people Other racial / ethnic group (please specify) Mixed race Disabled people Women Transgender C:\Documents and Settings\sue.cullen\Local Settings\Temporary Internet Files\OLK7F\Policy for the Management of PALS (3).docPage 10 Low (b) Negative Impact High Low Reason/Comment Evidence of information gained to aid decision

Equality Target Group

(a) Positive Impact High Low

(b) Negative Impact High Low

Reason/Comment

Evidence of information gained to aid decision

people Gay, Lesbian and Bisexual people Older people (50+) Younger people (17-25) and children Faith groups (please specify) Notes Faith groups cover a wide range of groupings, the most common of which are Muslims, Buddhists, Jews, Christians, Sikhs, Hindus. The categories used in the Race section are those used in the 2001 census. Consideration should be given to the needs of specific communities within the broad categories such as Bangladeshi people and to the needs of other communities such as Turkish/Turkish Cypriot, Greek/Greek Cypriot, Italian and Polish that do not appear as separate categories in the census. Please give a brief description of how this strategy/policy benefits the equality target groups identified in the above table, or how it promotes equality. Anyone who feels they have been treated in a discriminatory way can express concerns and ensure that a satisfactory outcome is reached. Feedback will be cascaded to commissioners to ensure that services are improved as a result

If there is a negative impact on any equality target group, is the impact intended or legal?

If the negative impact is not intended, discriminatory and/or high in impact, complete part 1 and move on to the full assessment (part 2). What actions could be taken to amend the strategy/policy to minimise the low negative impact? N/A

If there is no evidence that the strategy/policy promotes equality, equal opportunities or improves relations within equality target groups, what amendments could be made to achieve this? C:\Documents and Settings\sue.cullen\Local Settings\Temporary Internet Files\OLK7F\Policy for the Management of PALS (3).docPage 11

How will the strategy or policy be implemented including any necessary training? All Health Information and Advice staff are trained to deal with PALS enquiries All PCT staff receive customer services training including PALS

Full Assessment necessary:

Yes / No

Date completed: 16/09/08 Signed by Line Manager: Kathy Nicholson-Banks

Please return a copy to the Lead for Patient and Public Involvement once completed (mailto:nicholson-banks.kathy@bp-pct.nhs.uk). A signed hard copy and electronic copy should be kept within your department for audit purposes.

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