North Derbyshire Clinical Commissioning Group
Complaints & Patient Concerns Report for Quarter 2 2015/16
1.
SUMMARY OF COMPLAINTS RECEIVED IN THE QUARTER
In Quarter 2 2015/16, the complaints service received 4 complaints from North Derbyshire
CCG’s resident population, of which 3 related to the CCG’s statutory functions. This is a
50% reduction on the overall total number of complaints received in Quarter 1 2015/16.
Breakdown of Complaints Received
Total
Cases relating to the CCG’s statutory functions and duties
3
Lead commissioner services
1
Cases referred to other bodies
0
Parliamentary Health Service Ombudsman (PHSO) cases managed on behalf
of the CCG
0
Lead Commissioner Services:
Derbyshire Health United (DHU)
111 Service (1)
 Concerns – Patient was unable to access non-emergency healthcare for over
90 minutes, resulting in the family calling 999 as there was no information available
to advise what to do in the event of the 111 Service telephone number failing.
 Outcome – Not upheld, after thorough investigation no problem could be identified
with the telephone line on that date. Apology offered to client and explanation of the
contingency in place if a telephone line failure occurs.
Breakdown of informal concerns received in
Quarter 2 2015/16
Issues raised by patients
regarding services
commissioned by NDCCG
25%
75%
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Concerns raised by NDCCG
residents regarding services
commissioned by other CCG’s
NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16
Other cases received by NDCCG in Quarter 1 2015/16, which were still under
investigation at that time:
Lead Commissioner Services:
Derbyshire Community Health Service (DCHS)
Wheelchair Services (1)
 Concerns – the safety of patient’s wheelchair and poor service provided by Clarke
and Partners.
 Outcome – still under investigation.
Chesterfield Royal Hospital (CRH)
Orthopaedics (1)
 Concerns – the Orthopaedic Consultant’s management of post-surgical care.
 Outcome – still under investigation.
Cases Referred to other bodies:
Derbyshire Heath Foundation Trust (DHFT)
Adult Pathfinder Service (1)
 Concerns – the inappropriate discharge from the service. Client feels their
confidentiality has been breached, as personal information was discussed in a public
place. Client feels left unsupported and vulnerable.
 Outcome – Partially upheld, recommendations that staff need to ensure that neutral
venues are used, to ensure they maintain confidentiality awareness. The team
should reflect on how the support staff report back concerns raised and record the
decision making process. To ensure sickness cover is managed appropriately.
Other cases received by NDCCG in Quarter 4 2014/15, which were still under
investigation at that time:
Lead Commissioner Services:
Derbyshire Health United (DHU)
111 Service (1)
 Concerns – the actions of the 111 call handlers, who would not speak to the caller
about the patient’s condition even though the patient was unable to speak for
themselves and had given the call handler permission to. Resulted in police visiting
home as call handler raised concerns about the patient’s wellbeing.
 Outcome – partially upheld, the call handler could have shown more empathy whilst
dealing with the difficult call, however it was concluded that the call handler had
acted in the best interest of the patient.
Chesterfield Royal Hospital (CRH)
Calow Hospital discharge (1)
 Concerns – the care provision, assessment and discharge of a vulnerable elderly
patient with suspected dementia, also the lack of and conflicting information given to
family regarding care, assessments and discharge arrangements.
 Outcome – partially upheld, all appropriate assessment completed prior to discharge,
however, it was identified that communication between services and the family could
have been better.
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NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16
Other cases received by NDCCG in Quarter 3 2014/15, which were still under
investigation at that time:
Lead Commissioner Services:
Chesterfield Royal Hospital (CRH)
Robinson Ward (1)
 Concerns – lack of discharge letter to nursing home, no medication provided and
community physiotherapy not arranged.
 Outcome – partially upheld, the patient was discharged with medication and a letter
was given to the ambulance staff. Apologies that community physiotherapy was not
advised that discharge was taking place.
2.
QUARTER 2 COMPLAINTS BREAKDOWN
The following table provides a summary of each of the CCG complaints received in
Quarter 2 and confirms the outcome/status:
Commissioning
Subject Area
Detail
Outcomes
Planned Care –
Individual
Funding Request
(IFR)
The CCG has taken the
decision to reject an
application for IVF with embryo
storage and a view to
surrogacy and request that the
CCG reconsiders its position,
taking into consideration the
additional information
provided.
The CCG’s IVF policy criteria
does not follow NICE guidance
regarding the limitation placed
upon the FSH levels.
Delay in revised Needs
Portrayal Document (NPD).
Request for action to be taken
to expedite this case.
Explanation given for declined funding.
Issue identified with processing of IFR
in that supporting clinician was not
given the opportunity to supply further
supporting evidence. Apology given for
the error. Outcome letter to be sent to
the supporting Clinician with the
additional information presented with
the complaint. Partially upheld
Still under investigation
Planned Care IVF
Retrospective
Review Service
(RRS)
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Still under investigation
NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16
The following table provides a summary of each of the CCG complaints received in
Quarter 1 2015/16; confirming the outcome/status, that were still under investigation at that
time:
Commissioning
Subject Area
Continuing
Healthcare
(CHC) - Joint with
Derbyshire Social
Services
Children’s
Commissioning Continence
Products
3.
Detail
Outcomes
The conduct and
relevance of the DST
review meeting for Funded
Nursing Care (FNC).
Explanation provided regarding the
information given on initial contact to invite
representatives, the assessment process
and the appeals process. Clarification also
given for the use of evidence and
professionals involved in the assessment,
and the reason why the previous DST is
not used in the review. Apologies offered
for the impression that the family’s views
were not listened to. Partially Upheld
Information leaflet to be compiled and
shared with carers. Crisis Resolution &
Home Treatment Service (CRHT) criteria
policy review to take place. Process to be
drawn up to assist case management.
Reinforcement of details to be included in
patient’s care plan and staff training on
exceptional cases to be provided. Upheld
The availability of pull-up
pants for children and
young people with ongoing continence needs.
QUARTER 2, CCG COMMISSIONING COMPLAINTS SUMMARY
*It should be noted that the number of themes identified in the tables may be more than the overall number of
complaints; due to complainants identifying more than one area of concern.
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NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16
The majority of complaints received 67% are regarding Planned Care Commissioning and
relate to the CCG’s IVF policy criteria and IFR process. Communication is also the theme
highlighted in these complaints. The RRS is also cause for concern this quarter, with
concerns raised regarding process and communication.
4.
COMPLAINTS CLOSED IN QUARTER 2, 2015/16
Following investigation, three complaints received from NDCCG residents were closed in
Quarter 2. The number of complaints considered as being well-founded or otherwise is
recorded in the table below:
Outcomes
5.
No. of complaints
Upheld
1
Partially upheld
2
Not upheld
0
APRIL 2013 TO DATE CCG STATUTORY DUTIES & FUNCTIONS COMPLAINTS SUMMARY
The majority of CCG complaints received since April 2013 relate to the CHC Service;
however, there has been a reduction in the numbers since April 2015. The most common
themes are communication and process; more specifically lack of explanation for decisions
made and updates to clients and their families. The CCG’s commissioning policies,
specifically related to the IVF and IFR process are also cause for concern. We continue to
receive complaints relating to the criteria within the CCG’s IVF treatment policy.
*It should be noted that the number of subject matters identified in the tables may be more than the overall
number of complaints; due to complainants identifying more than one area of concern.
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NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16
6.
LEARNING FROM CCG COMPLAINTS
As a result of the CCG complaints received and resolved since April 2015, the following
learning/changes have been identified and introduced:
Service Change and Organisational Learning
NDCCG
CHC Service
 Assessment Nurse to be made aware of feedback regarding the impression she gave
that the families views were not acknowledged, fully considered or treated with respect.
(Qtr 1)
Children’s Commissioning
 Continence Service Provider to develop an information flyer to be shared with carers, to
include information on products and how to renew orders. (Qtr 1)
 CRHT to review their policy criteria for assessment and provision of products and to
clarify the process for exceptional cases. (Qtr 1)
 The service to develop a process for managing cases when parents are unhappy with a
review outcome. (Qtr 1)
 Reinforcement that management and provision should be detailed in the patient’s care
plan. (Qtr 1)
 Additional training required for staff to offer guidance on exceptional cases. (Qtr 1)
IFR
 The IFR Team to review the outcome notification process to ensure the clinician
supporting the funding request is always given the opportunity to submit further evidence
on appeal. (Qtr 2)
7.
QUARTER 2 INFORMAL CONCERNS BREAKDOWN
During this period the Complaints & Customer Care Team received a total of 101 contacts,
of which 13 have been informal concerns and 88 information requests. This is a slight
increase on the total number of contacts received in Quarter 1, 2015/16.
Breakdown of Informal Concerns Received
8.
Total
%
Issues raised by patients regarding services commissioned by NDCCG
12
92%
Concerns raised by NDCCG residents regarding services commissioned
by other CCG’s
1
8%
QUARTER 2 INFORMAL CONCERNS SUMMARY
The following table provides a summary of the 13 informal concerns received in Quarter 2
with an overview of the service areas and specific areas within this service:
Service Area
NDCCG
Detail & Main themes
Specific Area
 Wheelchair Services
 Access to funding (specialist
wheelchair & power pack)
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No of concerns
9
NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16

Derbyshire Community
Health Service (DCHS)
Derbyshire Health
United (DHU)
NHS England
CHC Service
 Process
 Communication
 Access to service
 IVF
 Criteria for eligibility
 Medicines Management
 Access to medication
 Nursing Homes
 Care and treatment
Specific Area
 Clay Cross Hospital Intermediate Care
 Care and treatment
 Staff Attitude
 Communication
 District Nursing
 Process for CHC assessment
Specific Area
 111 Service
 Access to service
Specific Area
 GP Services
 Access to treatment
 Access to service
Totals
2
1
1
13
*It should be noted that the number of issues identified in the table may be more or less than the overall number
of complaints; due to more areas being identified, or same theme being highlighted
9. MAIN AREAS OF LEARNING FROM CONCERNS
Organisational Learning
NDCCG
Wheelchair Services
 There is an ongoing issue for patients requiring help to purchase specialised equipment
which is not normally provided by the wheelchair services contract. (Qtr 2)
IVF
 This is an ongoing issue from patients seeking clarification regarding access to fertility
treatment. (Qtr 2)
CHC Service
 There is an issue with poor communication from the CHC Service to families’ and Legal
representatives in relation to updates and outcomes. (Qtr 2)
 The RRS not consistently following the National Framework Guidelines for the assessment
of claims for Previously unassessed Periods of Care. (Qtr 2)
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NORTH DERBYSHIRE CCG COMPLAINTS & PATIENT CONCERNS REPORT Q2 2015/16
10.
QUARTER 2 INFORMATION REQUESTS BREAKDOWN
During this period the Complaints & Customer Care Service received and dealt with a total of
88 information requests. This is a 21% increase on the number of information requests
handled during Quarter 1 2015/16.
Since April 2014, 527 information requests have been received and dealt with by the
Complaints & Customer Care Service, this averages out at 29.3 calls per month. The calls
received have varying degrees of complexity, some are signing posting, whilst others require
more intervention from the Complaints & Customer Care Service.
Report Author: Emma Bowler, Assistant Complaints & Customer Care Manager,
NHS Arden & GEM CSU
Sponsor:
Jayne Stringfellow, Chief Nurse & Quality Officer, NHS North Derbyshire CCG
Date:
October 2015
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