The National Health Service (General Dental Services Contracts) (Wales) Regulations 2006

PART 6 COMPLAINTS

Complaints procedure

47.—(1) The contractor will establish and operate a complaints procedure to deal with any complaints in relation to any matter reasonably connected with the provision of services under the contract which will comply with the requirements of paragraphs 48 to 50 and 52.

(2) The contractor will take reasonable steps to ensure that patients are aware of—

(a) the complaints procedure;

(b) the role of the Local Health Board and other bodies in relation to complaints about services under the contract; and

(c) their right to assistance with any complaint from independent advocacy services provided under section 19A of the Act(1) (independent advocacy services).

(3) The contractor will take reasonable steps to ensure that the complaints procedure is accessible to all patients.

Making of complaints

48.—(1) A complaint may be made by or, with his or her consent, on behalf of a patient or former patient, who is receiving or has received services under the contract, or—

(a) where the patient is a child, by—

(i) a parent;

(ii) a person duly authorised by a local authority to whose care the child has been committed under the provisions of the Children Act 1989(2); or

(iii) a person duly authorised by a voluntary organisation by which the child is being accommodated under the provisions of that Act; or

(b) where the patient is incapable of making a complaint, by a relative or other adult person who has an interest in his or her welfare.

(2) Where a patient has died, a complaint may be made by a relative or other adult person who had an interest in his or her welfare or, where the patient falls within sub-paragraph (1)(a)(ii) or (iii) by the authority of a voluntary organisation.

Period for making complaints

49.—(1) Subject to sub-paragraph (2), the period for making a complaint is—

(a) six months beginning with the date on which the matter which is the subject of the complaint occurred; or

(b) six months beginning with the date on which the matter which is the subject of the complaint comes to the complainant’s notice provided that the complaint is made no later than 12 months after the date on which the matter which is the subject of the complaint occurred.

(2) Where a complaint is not made during the period specified in sub-paragraph (1), it will be referred to the person nominated under paragraph 50(2)(a) and if he or she is of the opinion that—

(a) having regard to all the circumstances of the case, it would have been unreasonable for the complainant to make the complaint within that period; and

(b) notwithstanding the time that has elapsed since the date on which the matter which is the subject matter of the complaint occurred, it is still possible to investigate the complaint properly,

the complaint will be treated as if it had been received during the period specified in sub-paragraph (1).

Further requirements for complaints procedures

50.—(1) A complaints procedure will also comply with the requirements set out in sub-paragraphs (2) to (6).

(2) The contractor must nominate—

(a) a person (who need not be connected with the contractor and who, in the case of an individual, may be specified by his or her job title) to be responsible for the operation of the complaints procedure and the investigation of complaints; and

(b) a partner, or other senior person associated with the contractor, to be responsible for the effective management of the complaints procedure and for ensuring that action is taken in the light of the outcome of any investigation.

(3) All complaints must be—

(a) either made or recorded in writing;

(b) acknowledged in writing within the period of three working days beginning with the day on which the complaint was made or, where that is not possible, as soon as reasonably practicable; and

(c) properly investigated.

(4) Within the period of 10 working days beginning with the day on which the complaint was received by the person specified under sub-paragraph (2)(a) or, where that is not possible, as soon as reasonably practicable, the complainant must be given a written summary of the investigation and its conclusions.

(5) Where the investigation of the complaint requires consideration of the patient’s dental records, the person specified in sub-paragraph (2)(a) must inform the patient or person acting on his or her behalf if the investigation will involve disclosure of information contained in those records to a person other than the contractor or an employee of the contractor.

(6) The contractor must keep a record of all complaints and copies of all correspondence relating to complaints for a period of at least two years from the date on which such complaints were made, but such records will be kept separate from the patients' dental records.

Co-operation with investigations

51.—(1) The contractor will co-operate with—

(a) any investigation of a complaint in relation to any matter reasonably connected with the provision of services under the contract undertaken by—

(i) the Local Health Board; and

(ii) the Commission for Healthcare Audit and Inspection;

(iii) the Assembly; and

(b) any investigation of a complaint by an NHS body or local authority which relates to a patient or former patient of the contractor.

(2) In sub-paragraph (1)—

“NHS body” means a Local Health Board, an NHS trust, an NHS foundation trust, a Strategic Health Authority, a Primary Care Trust or an equivalent body constituted in Scotland or Northern Ireland;

“local authority” means—

(a)

any of the bodies listed in section 1 of the Local Authority Social Services Act 1970(3) (local authorities);

(b)

the Council of the Isles of Scilly; or

(c)

a council constituted under section 2 of the Local Government etc, (Scotland) Act 1994(4) (constitution of councils).

(3) The co-operation required by sub-paragraph (1) includes—

(a) answering questions reasonably put to the contractor by the Local Health Board;

(b) providing any information relating to the complaint reasonably required by the Local Health Board; and

(c) attending any meeting to consider the complaint (if held at a reasonably accessible place and at a reasonable hour, and due notice has been given) if the contractor’s presence at the meeting is reasonably required by the Local Health Board.

Provision of information

52.  The contractor will inform the Local Health Board, at such intervals as the Local Health Board requires, of the number of complaints it has received under the procedure established in accordance with this Part.

(1)

Section 19A was inserted by the 2001 Act, section 12.

(2)

1989 c. 41.

(3)

1970 c. 42; section 1 was amended by the Local Government Act 1972 (c. 70), section 195 and by the Local Government (Wales) Act 1994 (c. 19), Schedule 10, paragraph 7.

(4)

1994 c. 39.