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Annual Report 2014

Independent Adjudication

Weighing up the mitigating and aggravating factors in the handling of a complaint helps each Adjudicator decide how much a goodwill payment should be. This is done using a new four tier scale:

Scale Tier 1 (moderate) Tier 2 (significant) Tier 3 (serious)

Tier 4 (very serious)

Up to £500

£500 - £1,000 £1,000 - £3,000 £3,000 - £5,000

To date, most goodwill payments have been for less than £1,000 and have exceeded £3,000 in only a small number of cases.

The Goodwill Payments Guide (which can be found on the ISCAS website) is already helping the adjudicators to be more consistent in the language used to convey adjudication decisions, which in time should further assist in identifying recurring themes with regard to those areas where providers are responding well, and those areas that require attention.

Greater accountability An important feature of ISCAS Independent Adjudication is that the adjudicators are independent of the organisations and individuals complained about. It is this independence that allows a fair and impartial review of complaints to take place at the Independent Adjudication stage. It is also important that we demonstrate accountability for our performance. To this end, we have begun to explore mechanisms for peer review, to develop our skills as adjudicators.

Striving for improvements Independent adjudicators have a bird’s eye view on the way healthcare providers handle complaints, and our independence means we have no vested interest that might inhibit our ability to speak openly about what we find. Each adjudication decision is copied to the provider, accompanied by a letter that, depending on the outcome, may contain advice on areas that the provider should give attention to. We have also strengthened the quarterly report we submit to the ISCAS Governance Board to draw out more clearly the learning from complaints.

The following are examples of the types of learning points we have identified around complaints handling:

• Weaknesses in the investigation of complaints at local level – particularly in gathering statements from the operating surgeon or doctor providing treatment, failing to document evidence in a systematic way, or to make a record of discussions between staff investigating a complaint and clinical staff (particularly doctors);

• Breach of the timeframes set out on the Code, and reflected in the complaints procedures of all ISCAS members; • Lack of a process for dealing with communications from patients by email; • Confusing messages regarding the scope of the complaints process in respect of negligence and compensation.


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