The NHS Complaints Procedure in Wales is slightly different to the current system in England following an overhaul in April 2011, it was rebranded as 'Putting Things Right'.
The system is separated into 2 parts:
Under the redress, the NHS may be responsible for causing harm and therefore may offer compensation
PART 1: RAISING A CONCERN
What is a concern?
If you feel dissatisfied with any service provided by NHS Wales then that is a concern you can raise with them.
You cannot raise a concern under this process if your concern is about private healthcare or treatment, or if the complaint that falls under the arrangements in place before 1 April 2011.
Why should I raise this with the NHS?
If they know about it, they can apologise to you, investigate, and attempt to resolve the issue. It may also help them improve their services in that area for the future so the same thing does not happen again.
How do I start to raise a concern?
You can raise the concern yourself, or a trusted friend, relative or even your local Community Health Council (CHC) can represent you (though you’ll be asked to consent to this). Your local CHC provides free and independent advocacy services to help you out, along with advice and support.
You can start by talking to the medical staff involved with your care to see if the issue can be sorted out straight away. If this isn’t helpful, or you do not want to speak with them due to the concerns you have, contact a member of the concerns team at your Local Health Board or the relevant NHS Trust. If your concern is about a GP, Pharmacist, Dentist or Optician you can ask the practice to investigate, or you can ask your Local Health Board to do this.
How long do I have to raise a concern?
Within 12 months of the incident that you are concerned about. If 12 months have already passed, but there is good reason for delay, tell the NHS anyway; they may still be able to deal with it.
What is the process after I have raised a concern?
Some concerns might be investigated further under the redress arrangements. For more information on this, see Part 2 of this factsheet.
What if I’m not satisfied once I receive the NHS response?
If you’re still not happy, you can contact the Public Services Ombudsman for Wales.
PART 2: SEEKING REDRESS
What is ‘redress’?
Redress refers to a response from the NHS where you have suffered harm/injury. The response can be one or a combination of the following:
What if I am considering making a civil claim (through the courts)?
There is a time limit (called the “limitation period”) for making a civil claim for clinical negligence that expires 3 years from the date of the incident or 3 years from the date you knew you may have received negligent care.
If your concern may be subject to the redress arrangements, the limitation period is paused from the date your concern is first received by the NHS. If the NHS decides to offer you redress in the form of financial compensation, you have a maximum of 9 months to accept that offer, or the clock will start again.
How do I get redress?
Once you have raised your concern with the NHS (see above, in Part 1) you will receive an interim response within 30 days. During their investigations the NHS may decide to offer you redress.
In order to offer you redress, the relevant NHS body has to be liable under the law. This means they have to have breached their duty of care to you, and that breach must have caused the harm you suffered. If both these points are satisfied, the NHS can contemplate redress arrangements. It is therefore important to keep in mind that poor care alone may not satisfy the legal test.
If that liability can be proven, the NHS must consider an offer of redress if that liability may attract financial compensation of £25,000 or less. The arrangements will not be initiated if the value of the compensation would exceed £25,000.
The NHS will not offer redress if the concern is already or has already been subject to civil proceedings (ie court proceedings have been issued).
The redress arrangements are not applicable to issues with primary care providers or independent providers.
The offer of redress, or decision not to make an offer, must be communicated to you within 12 months of the date the NHS first received your concern. If there are exceptional circumstances for the time period being longer, the NHS will write to you with an explanation.
You have 6 months to respond to this. If you need more time, you have to write to the relevant NHS body and explain why you are delaying your response. They may then decide to extend your time limit to 9 months. As explained above, if the maximum 9 months expires, the limitation clock on your civil claim will start to run again.
You only have 9 months to consider a financial offer. After that expires, the redress arrangements will no longer apply.
If you want to accept the offer, this will be made by way of formal agreement. You or your personal representative has to sign a form waiving any right to take the same concern to court.
If you do not want to accept the offer, that is your choice. You are not bound to accept it, and if you don’t accept it you can still continue with pursuing the claim through the courts. However, this may be a point on which you should see specialist legal advice, as the offer may be reasonable. If you tried to pursue the claim down the civil route, there are likely to be cost implications for you.
Can I get help with the redress process?
Once the redress arrangements are initiated, you can get legal advice without charge in relation to getting expert evidence, any offers you receive and agreeing settlement. The legal advice can only be sought from a recognised firm of solicitors with expertise in clinical negligence matters and who are accredited by the Law Society or by AvMA.
What if an offer is not made?
You could make the choice to seek independent legal advice from a specialist clinical negligence solicitor about the concern. They will review the issue and see whether they think there are prospects of your claim being successful.
Cases worth more than £25,000?
As explained above, the NHS will not make an offer of redress in this case.
You could seek independent legal advice from a specialist clinical negligence solicitor to see whether there are prospects of pursuing your claim down the civil route.