Health and Social Care Complaints Process - Modernisation

Background to the Complaint Regulations - Modernisation

The Department in its new redesigned form is responsible for oversight of the Island’s health and social care system including matters of strategy, planning, finance, regulation and assurance.

This includes ensuring complaints about health and care services are handled in accordance with recognised best practice and standards. The current complaints Regulations made under the under the National Health Service Act 2001 and Social Services Act 2011 set out a process to be followed for complaints about health services and set up an NHS Independent Review Body (“IRB”) to provide an independent review of unresolved complaints about health services and a Social Services Independent Review Body to provide an independent review of unresolved complaints about social services.

In April 2021, the Department was required by Tynwald to review the Regulations and return to November 2021 Tynwald with updated Regulations, which include a clear procedure for handling complaints at the local resolution stage (where the service was provided) and at the independent review stage. The Regulations must also give clarity on the role and function of the IRB.

However, it has not been possible to progress the revised Regulations by November 2021 – the General Election and complex inter-relationships of the revised Complaint Regulations resulted in additional work to establish clear policy principles and outcomes for the new Regulations.

Public Consultation - What we did

In September 2021, the Department published 2 consultations in relation to modernisation of the legislation for health and social care complaints.

The consultation was in 2 parts:

Part 1 – Short term – by Regulations

The purpose of part 1 was to seek views on the proposed content the draft Regulations.

A key proposals was to offer enhanced support for members of the public with concerns about services, alongside clear guidance and information about how to make a complaint.

Feedback was invited on whether support services such as the new Manx Care Advice and Liaison Service should be provided on a statutory basis. This service aims to resolve patients and service users concerns at an early stage preventing them escalating into complaints.

Other proposals include creating a simpler complaints process, increasing the timescale for lodging a complaint, improving the training of those handling complaints, keeping complainants better informed about the progress of investigations and a requirement for prompt remedial action to be taken to improve services when lessons are learned from a complaint.

Part 2 – Longer term – reform

The second consultation posed some questions to help shape the approach to the handling of complaints in the longer-term, as part of a comprehensive review under the Department's National Health and Social Care Services Bill ("the Reform Bill").

The questions included whether the Department should set complaints handling quality standards for providers, and whether all health and care providers, including private operators, should have a statutory complaints process.

This consultation also considered the creation of an independent adjudicator or Ombudsman for the review of all health and social care complaints.

Public Consultation - What did we achieve?

Fifty-four responses were received to part 1 of the consultation via the online consultation hub and 8 substantial separate written responses were also received. In relation to part 2 of the consultation, 12 responses were received via the hub and 2 separate written responses were also received.

In November 2021 the Department reviewed the approach to determine whether the proposed Regulations were the best way to make the changes or whether a small Bill (primary legislation) could be developed to address all issues in one go.

The Department determined that it remained committed to the Tynwald resolution to complete the modernisation of the existing Regulations as far as these Regulations would permit, noting that there would be plans for further reform within the Reform Bill.

The Department also considered the practicality of setting up a new Independent Review Body for an interim period, and decided that it would be of greater benefit to the public to move towards setting up an Ombudsman at the earliest opportunity.

Following review of the consultation responses, the Department's preference would be for an Independent Ombudsman to be set up as a statutory board, operationally independent from the Department and Manx Care. However, it is not possible to set up such a body under the Regulations; therefore, as an interim solution, an Ombudsman will be set up as statutory body under the Social Services Act 2011.

Progress – February to June 2022

The Department has:

Published the Consultation Response Report on 1 April 2022
Published drafts of the Regulations – these have been on Tynwald’s Register of Business since 10 May 2022
Received Royal Assent for the Manx Care (Amendment) Act 2022 and laid some enabling Regulations before the Tynwald sitting in June, which were approved
Continued engagement with Manx Care and the NHS IRB and Social Services IRB on the changes expected as a result of the introduction of the amended Regulations

Next steps – July to October 2022

While not an exhaustive list, the Department will:

Lay the Regulations setting out the process to be followed by service providers and the newly established Health and Social Care Ombudsman Body before Tynwald at the July sitting for approval
Work with the Appointments Commission to ensure that it has the necessary information to be able to appoint members to the Health and Social Care Ombudsman Body by 31 October 2022
Draft new guidance for patients and service users in relation to how the Procedural Regulations should be interpreted and operated
Issue guidance to the public on how to access medical records
Publish a model complaints handling process for service providers
provide a template standard form for complaints to be made (at local resolution stage and to the Health and Social Care Ombudsman Body)
Issue guidance/signpost to where complainants should direct their complaints in various scenarios
Issue guidance on when a complaint should be referred to Health and Social Care Ombudsman Body
Appoint a secretary to the Health and Social Care Ombudsman Body