Complaints and Duty of Candour

Our commitment

Caledonian Psychiatry is the trading name of Edinburgh Psych Limited. We are committed to providing a high standard of care and service to all patients. We take all complaints and concerns seriously and use them as an opportunity to learn and improve.

This policy sets out how you can raise a concern or make a complaint about any aspect of the service you have received. It has been developed in accordance with the requirements of Healthcare Improvement Scotland (HIS) and the Health and Social Care Standards.

The Registered Manager responsible for handling complaints is Dr David Crocker.

Who can make a complaint

A complaint can be made by:

• A patient who is receiving or has received care from Caledonian Psychiatry
• A representative acting on behalf of a patient, with their consent
• A relative, carer or other person who has been affected by the service

Where a complaint is made on behalf of someone else, we may need to confirm that the person has given their consent before we can share information about their care.

How to raise a concern or complaint

You may raise a concern or complaint verbally (by telephone) or in writing (by email or post). There is no requirement to put your complaint in writing at the initial stage.

We encourage you to raise any concerns as soon as possible. Complaints should normally be raised within six months of the event or from when the issue became known. Late complaints may still be considered where there is a good reason for the delay and a fair investigation remains possible.

Our complaints process

We follow a three-stage process to ensure that all concerns are dealt with fairly, thoroughly and promptly.

External organisations

Healthcare Improvement Scotland (HIS)

HIS is the independent regulator of independent healthcare services in Scotland. You have the right to contact HIS about the care or service you have received from Caledonian Psychiatry. You do not need to complete our internal complaints process first, and you do not need to raise the matter with us before contacting HIS. We would welcome the opportunity to address concerns directly where possible, but this is entirely your choice.

Two points are worth knowing before you write to them. HIS applies a firm six-month time limit, running from the event or from when the issue became known to you, and cannot investigate matters older than that. Their remit covers matters such as the quality of care and treatment, communication, delays, and whether a service has followed its own procedures. It does not extend to clinical decisions or clinical competence, the professional conduct of an individual doctor, fees or refunds, or requests for a second opinion. Concerns about clinical decisions, clinical competence or the conduct of an individual doctor are for the General Medical Council, below. Fees, refunds and second opinions are matters we resolve with you directly, with HSCAMP independent adjudication available if our own process does not settle them; in every case we would encourage you to raise them with us first.

HSCAMP independent adjudication

Caledonian Psychiatry is a member of HSCAMP, the Health and Social Care Complaint Adjudication Management Partners. HSCAMP is an independent adjudication scheme for healthcare providers. If our own complaints process has run its course and you remain dissatisfied, your complaint can be referred to HSCAMP for review by an adjudicator who has no connection to this practice. Cases are considered by an adjudicator experienced in resolving disputes, together with a second adjudicator from the relevant clinical field.

Two conditions apply. Adjudication is available only after our internal complaints process has been completed, so it is not a first port of call. It also proceeds only where both you and the practice agree to it, and where both of us consent to the case history being disclosed to the adjudicator.

If adjudication goes ahead, there is no cost to you: the fee is paid by us. The adjudicator aims to reach a decision within 28 business days, and that decision is binding on this practice, with no right of appeal on our part. It is not binding on you. If you are not satisfied with the outcome, you remain free to take the matter further.

Using HSCAMP is entirely optional and does not remove any of your other rights. You can still contact Healthcare Improvement Scotland, the General Medical Council or the courts. It is worth knowing that HIS will not investigate a matter while it is actively with an independent adjudication service, so if you want HIS to look at your complaint, it is sensible to approach them first or to let them know what is happening.

General Medical Council (GMC)

If your concern relates to the professional conduct, performance or fitness to practise of the psychiatrist who saw you, you may raise this with the GMC. This includes concerns about clinical decisions or clinical competence, which are matters for the GMC rather than for Healthcare Improvement Scotland.

Information Commissioner’s Office (ICO)

If your complaint relates to the handling of your personal data, you have the right to complain to the ICO.

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How we handle complaints

All complaints, whether informal or formal, are treated with confidentiality and respect. We will not discriminate against any patient who raises a complaint, and making a complaint will not affect the care you receive.

Our approach to complaints handling includes the following principles:

• Fairness: All complaints are investigated impartially and without prejudice.
• Thoroughness: We examine all relevant information and, where appropriate, seek independent advice.
• Transparency: We provide clear and honest responses, including acknowledgement of any failings identified.
• Timeliness: We respond within the stated timeframes and keep you informed of progress.
• Learning: We use complaints as an opportunity to improve our service.

Record keeping and learning

All complaints are logged in a confidential complaints register, recording the nature of the complaint, the investigation undertaken, the outcome and any actions taken. This register is reviewed regularly to identify trends, themes and areas for improvement.

Where a complaint identifies a need for change, we will implement appropriate improvements to our policies, procedures or clinical practice. Significant findings are incorporated into our ongoing quality improvement processes in line with HIS requirements.

Support and advocacy

If you need support in making a complaint, you may find it helpful to contact an independent advocacy service. In Scotland, you can find local advocacy services through the Scottish Independent Advocacy Alliance (SIAA).

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Duty of Candour

The Duty of Candour is a legal requirement for all health and social care organisations in Scotland. It was introduced by the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 and is set out in the Duty of Candour Procedure (Scotland) Regulations 2018.

The Duty of Candour requires Caledonian Psychiatry (the trading name of Edinburgh Psych Limited) to follow a specific procedure whenever an unintended or unexpected incident occurs during the provision of care that results in death or harm to a patient, as defined in the legislation.

The purpose of the Duty of Candour is to ensure openness, honesty and transparency when things go wrong. It recognises that patients and their families have a right to be told about incidents that have affected them, and to receive a sincere apology.

When the Duty of Candour applies

The Duty of Candour is activated when an unintended or unexpected incident occurs during the provision of care and the incident results in any of the following outcomes:

• The death of the person
• A permanent lessening of bodily, sensory, motor, physiological or intellectual functions
• An increase in the person’s treatment
• Changes to the structure of the person’s body
• The shortening of life expectancy
• Pain or psychological harm experienced for a continuous period of at least 28 days
• The person requiring treatment to prevent their death or any injury which, if left untreated, would lead to one of the outcomes above

The duty applies only to incidents that were not intended and were not expected as part of the care or treatment being provided.

What we will do

When a qualifying incident is identified, Caledonian Psychiatry will follow the procedure set out in the Regulations. This involves three key steps:

1. Notify the relevant person

We will contact the patient (or their family, carer or representative where appropriate) as soon as reasonably practicable after the incident has been identified. This initial contact will be made in person or by telephone wherever possible, and will be followed up in writing.

2. Provide an apology

We will offer a sincere apology to the patient or relevant person. This apology is an expression of genuine regret and sorrow for the incident and its consequences. In accordance with the legislation, an apology does not constitute an admission of negligence or a breach of any statutory duty.

3. Review and investigate

We will carry out a thorough review of the incident to understand what happened, why it happened, and what steps can be taken to prevent a recurrence. The findings of the review and any actions taken will be shared with the patient or relevant person in writing.

Our responsibilities

As a healthcare provider, Caledonian Psychiatry is committed to the following principles in relation to the Duty of Candour:

• Openness: We will be open with patients and their families about incidents that have caused harm, and provide them with the information they need to understand what happened.
• Honesty: We will give an honest account of the incident, including what went wrong and why, based on the information available at the time.
• Support: We will offer appropriate support to patients and their families following an incident, including signposting to external organisations where helpful.
• Learning: We will use the findings of incident reviews to make meaningful improvements to our clinical practice, policies and procedures.
• Accountability: The Registered Manager, Dr David Crocker, has overall responsibility for ensuring compliance with the Duty of Candour within Caledonian Psychiatry.

Annual reporting

In accordance with the Duty of Candour Procedure (Scotland) Regulations 2018, Caledonian Psychiatry is required to prepare and publish an annual report on Duty of Candour. This report covers each financial year and includes:

• The number of incidents to which the Duty of Candour procedure was applied
• The nature of the incidents
• What action was taken in relation to each incident
• Any changes or improvements made as a result
• Information about the organisation’s policies and procedures relating to the Duty of Candour

The annual report is made available on request and, where applicable, is submitted to Healthcare Improvement Scotland as part of our regulatory obligations.

Further information

For more information about the Duty of Candour in Scotland, you may wish to refer to the following resources:

• Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016, Part 2: Duty of Candour
• Duty of Candour Procedure (Scotland) Regulations 2018
• Healthcare Improvement Scotland