Making a complaint about independent healthcare services

How to make a complaint about independent healthcare services.

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Summary

Our independent healthcare services complaints handling procedure reflects Healthcare Improvement Scotland’s commitment to addressing complaints made about a registered independent healthcare service in a person-centred way and to respect the rights of everyone involved.

It will support our staff to respond thoroughly, impartially and fairly by providing evidence-based decisions based on the facts of the case.

The procedure has been developed using the model complaints handling procedure developed by the Scottish Public Services Ombudsman (SPSO). We have a standard approach to handling complaints across independent healthcare services in Scotland, which follows the principles of the SPSO’s model complaints handling procedure. This procedure aims to help us ‘get it right first time’. We want quicker, simpler and more streamlined complaints handling with early resolution by capable, well-trained staff.

What is a complaint?

A complaint may relate to:

• the quality of care and treatment experienced by a service user
• actions a service/provider took that the service user deemed inadequate
• a service/provider’s failure to take action when necessary

We can investigate complaints that relate to:

• the quality of care and/or treatment experienced
• care environment or equipment issues
• poor treatment by a member of staff
• operational and procedural issues
• service/provider’s failure to follow the appropriate process
• lack of information provision by the service/provider.

We cannot investigate complaints that relate to:

• services that are not registered with us (that we do not regulate)
• events that occurred more than six months prior to the complaint being made
• refunds for treatment/care received
• fees charged for treatment/care
• clinical decisions (ie informed decisions made by a healthcare professional) about treatment/care received
• a request for a second opinion relating to treatment/care
• ethical standards of an individual registered healthcare professional
• issues about the functions of one service/provider, raised by another
• matters relating to contracts of employment
• issues that fall under the responsibility of another regulator, professional body or public agency
• issues that are currently/have already been investigated and responded to by Healthcare Improvement Scotland
• issues that are currently being investigated by a third party adjudication service (such as the Independent Healthcare Sector Complaints Adjudication Service (ISCAS))
• issues that are currently subject to legal proceedings
• issues that have already been investigated and upheld by the service/provider.

What is an independent healthcare service?

Healthcare Improvement Scotland regulates registered independent healthcare services in Scotland to ensure they comply with standards and regulations.

Services include:

• independent hospitals
• private psychiatric hospitals
• independent hospices
• independent clinics

Independent clinics are defined in the National Health Service (Scotland) Act 1978 as:

Clinics that are not part of a hospital and from which a medical practitioner, dental practitioner, registered nurse, registered midwife or dental care professional (clinical dental technician, dental hygienist, dental nurse, dental technician, dental therapist, orthodontic therapist) provides a service, which is not part of the National Health Service. The term ‘service’ includes consultations, investigations and treatments.

Who can make a complaint

Anyone who is affected by an act or omission of a service or provider can make a complaint.

Sometimes a complainant may be unable or reluctant to do so on their own. In these circumstances, we will accept complaints brought by third parties as long as the complainant has authorised the person to act on their behalf. This can include independent advocacy and support agencies.

The mygov.scot website has information on how to find an advocate.

Where a complaint is brought by a third party, we will ensure that the complainant has also consented to their personal information being shared as part of the complaints handling process, in line with current legal requirements.

In circumstances where no such consent has been given, we will take this into account when handling and responding to the complaint, but are likely to be constrained in terms of any investigation.

How to complain

Complaints can be made to:

Programme Manager
Independent Healthcare Services Team
Healthcare Improvement Scotland
Gyle Square
1 South Gyle Crescent
Edinburgh
EH12 9EB

Email: his.ihcregulation@nhs.scot

Complaints can be made up to six months after the event which is the cause for the complaint. Unless the person making the complaint could not reasonably have known of the basis for the complaint beforehand.

We will not investigate complaints about events that occurred more than six months before the complaint is received.

Complaints can be received in any format, through any of the following methods:

• in writing – email or letter
• during a telephone call
• in person – either in the office or during an inspection

Complainants should ensure that all contact details including their telephone number and/or email address are included to allow us to easily contact them.

Complaints can also be received anonymously or in confidence.

Complainants will be encouraged in the first instance to try and resolve the relevant issue(s) through the service/provider’s own complaints procedure. We will also encourage complainants to use the Independent Healthcare Sector Complaints Adjudication Service (ISCAS) complaints processes or the Consumer Redress Scheme, where the service/provider is a member of such a scheme(s).

If the complainant does not wish to do this, or has already done this and was not satisfied with the outcome, then we will assess the complaint for investigation.

Resources to support you