WAQ78602 (e) Tabled on 16/07/2019

How will the Welsh Government ensure that NHS patients continue to have their voice heard with particular reference to complaints?

Answered by Minister for Health and Social Services | Answered on 23/07/2019

Community Health Councils (CHCs) represent the interests of patients in the health service in their area.

The Health and Social Care (Quality and Engagement) (Wales) Bill, which is being scrutinised by the National Assembly, proposes introducing a new Citizen Voice Body for Wales, in place of the current network of CHCs. The new Citizen Voice Body would exercise functions across both health and social care services.

A comprehensive and statutory complaints procedure exists in the Welsh NHS – Putting Things Right. This is an easy-to-access process, which operates on the principle of being open and adopts an investigate-once-investigate-well approach to complaints handling. Complainants are involved in the complaints process to ensure their concerns are fully understood and responded to.

Most health bodies also have a patient advice and liaison service to help people with enquiries and concerns. A complainant who is dissatisfied with the way their complaint has been dealt with may take their complaint to the Public Services Ombudsman for Wales.   

CHCs currently provide complaints advice and assistance to adults who wish to pursue an NHS complaint. Welsh Ministers have directed health boards to put in place arrangements to support children who wish to make a complaint.

Under the proposed changes set out in the Bill, the new Citizen Voice Body will provide an extended complaints advice and assistance service. It will provide complaints advice and assistance to adults complaining about NHS and social services and provide support to children complaining about health services. Children and young people already have a statutory right to an advocate under the Social Services and Wellbeing (Wales) Act 2014.

The functions of the Citizen Voice Body will not be exactly the same as those of  CHCs. It will not have an inspection function. The establishment of the CHCs pre-dated the creation of Healthcare Inspectorate Wales and Care Inspectorate Wales. Inspection functions should rest with the inspectorates.

The 2016 OECD review noted that CHCs should focus their activities on representing the patient voice. It concluded the potential for the CHCs to engage with local communities and advocate for patients around their concerns was key, but the value added by some of the CHCs’ other functions – notably inspections and on-site scrutiny of healthcare was less clear. These independent and expert findings have been reflected in the legislation and development of the new Citizen Voice Body.

The Citizen Voice Body’s overarching function will be to represent the interests of the public in respect of health services and social services. The Bill states that it must seek the views of the public and the complaints advice and assistance service will represent and support patients across health and social services. 

The new Citizen Voice Body will have the power to make representations about any matter related to health or social services to health boards, trusts, special health authorities and local authorities. The Bill places these bodies under a duty to have regard to the representations made. Additionally, the Citizen Voice Body’s will have the ability to ask those bodies for information it reasonably requires for the exercise of its functions. These are powerful tools, which will enable the Citizen Voice Body’s to fulfil its functions, including representing the interests of the public in matters relating to health and social services. 

The Bill also places health boards, trusts, special health authorities and local authorities under a duty to promote the activities of the Citizen Voice Body with service users. NHS organisations will be under a duty to promote the Citizen Voice Body and its activities to service users. Other health and social care stakeholders will be able to signpost the public to the Citizen Voice Body.