Published: 16/05/2002, Volume II2, No. 5805 Page 5

Plans for patients' complaints to come under the remit of the new Commission for Healthcare Audit and Inspection were announced with little or no consultation among the bodies involved, HSJ has learnt.

HSJ sources believe the proposal was added in 'as an afterthought', and has since been overlooked in discussions following publication of the NHS delivery plan, the paper issued by health secretary Alan Milburn in the wake of the Budget.

Many of those currently involved in the complaints system were caught completely unawares by the proposal, HSJ understands.

Both the Patients Association and the Association of Community Health Councils in England and Wales are furious at the way the proposals have been announced.

'Every time this sort of thing happens, we are the last to hear about it, ' said Patients Association's policy director Simon Williams. 'They do not have the courtesy to let you know about what is being recommended. We are not alone in thinking this.'

ACHCEW director Peter Walsh was equally concerned: 'One of the biggest problems is with the independent review stage, in which the trust [that is] complained about is far too involved in the review process, ' he said.

'There is potential for a body like CHAI having a useful role to play here, but we are disappointed not to have been consulted.'

CHAI will take over the valuefor-money work of the Audit Commission, the Commission for Health Improvement, and the private healthcare role of the National Care Standards Commission. The NHS delivery plan describes the independent scrutiny of complaints as one of its 'principal roles'. It is not clear how this might fit in with the work of the health service ombudsman, who last year considered 900 complaints from patients who had exhausted all other channels.

When the Department of Health was asked what consultation had taken place before the decision was taken to put independent scrutiny of complaints under the auspices of CHAI, a spokesperson stressed that 'no final decision' had been taken about 'what we mean by independent scrutiny of complaints' and said 'it is very early days'.

A briefing paper issued by the patient and public involvement branch of the DoH shortly after the NHS delivery plan was published said the handover of independent scrutiny of complaints to CHAI 'would provide an opportunity to develop new structures and processes for handling complaints after local resolution'. It added: 'The precise detail of this is still to be worked out and may be the subject of primary legislation.'

HSJ understands key players are due to meet at the end of this month to discuss the proposals, though neither the Patients Association nor ACHCEW were aware of the meeting. Mr Walsh said he would be very worried if ACHCEW was not consulted.

But one source from the scrutiny field suggested the lack of attention paid to independent scrutiny of complaints, following Mr Milburn's announcement, meant there was still time for change, and advised patients' groups that 'they still have everything to play for'.

Consultation document backed independent system The current NHS complaints system was reviewed in 2000 and, as a result, a consultation document, Reforming the NHS Complaints Procedure, was issued in September 2001. It emphasised the importance of a more independent system.Despite there being an independent review stage in the existing system, this was not generally regarded as being truly independent by the public, the document said. It also said the Department of Health aimed 'to implement the reformed complaints procedure in 2002 at the very latest'.This week, the DoH said consultation on reform of the procedure was still ongoing, along with overlapping work by the chief medical officer's group on clinical negligence.