This Department of Health (DH) consultation suggests a two stage model for complaints handling across health and social care: first, local resolution and, second, the Health Service Ombudsman, bringing to an end the Healthcare Commission's second stage for NHS complaints. This mirrors a commitment in Our Health, Our Care, Our Say (January 2006) for implementation by 2009, and is intended to bring in a single set of complaints arrangements that can cover as many providers and commissioners as possible.

We want to help design a system for effective local resolution that also limits a growth in the volume of Ombudsman cases and are keen to hear members' views.

One concern in this consultation is an intention to offer a two stage model of (1) local resolution and (2) ombudsman - replacing the existing three stage process. That is, it would end the Healthcare Commission's 2nd stage. It will be important to consider how our response can help design a system for effective local resolution of complaints that also limits a growth in volume of Ombudsman cases.

This consultation gives us an opportunity to think about how a complaints system can better help vulnerable service users. Services such as the Patient Advocacy and Liaison Service (PALs) and independent advocacy have been implemented as part of safeguarding patients' interests. However, availability of these services and what each makes available is pretty patchy and it can be unclear about how they connect into the overall complaints service.

In addition, the DH is developing new standard/s for complaints management. Can we help them to find metrics based on cause reduction rather than complaint volume reduction?

The consultation document is available on the Department of Health website.

The key objectives proposed for service providers and commissioners are to:

• deliver a simple, consistent, unified approach across health and social care
• generate a culture within organisations of openness and fairness when dealing with complaints
• emphasise local handling and early and effective local resolution
• make available investigation that is fair and proportionate to circumstances and seriousness
• take account issues of patient/user safety, protection of vulnerable people, and complexity
• facilitate a complaints process at local level and through investigations that is a lever and support for organisations improving quality and safety of services

Criteria proposed for the new arrangements:

• Open and easy to access - flexible about the ways people can complain and with effective information and support for people wishing to do so, including specialist advocacy as appropriate
• Fair - emphasising early resolution and minimising the strain and distress for all those involved
• Responsive - providing appropriate and proportionate response and redress
• Providing an opportunity for learning and developing - ensuring complaints are treated as a positive opportunity to learn from service users' experiences and views; to drive continual improvement in services; and make this demonstrable

NHS Redress Act 2006

Principles in this act are equally applicable to complaints system: when things go wrong the response should be honest and open; people should have a say in how the case is handled; and people should be reassured the organisation learns from their experience.

Regulator

It is proposed that the regulator will no longer have a role in processing individual health complaints. The regulator's role would be to check that all organisations (public and independent sector) have appropriate complaints systems in place, look at outcomes of complaints, focus on standards of complaints handling and implementation of learning.

Ombudsman

The role of the Ombudsman would remain unchanged. That is, if the service provider or commissioner doesn't put things right through local arrangements, the Ombudsman would still investigate and provide the ultimate independent view of what happened.