PALS & Complaints – TO-BE Process Flow (PDF)

The brief

The Solent NHS Q Exchange project started in summer 2022 with a view to creating a digital solution to help increase the ways in which we can gather feedback from our communities particularly some of our seldom heard from groups within our community.

We know that our existing methods for gathering feedback from our communities do not work for all our communities for example we know that parts of our minority ethnic communities rarely use our standard feedback facilities such as the Family and Friends Test or the Patient Advice and Liaison (PALS) & Complaints Service.

Our ambition is to develop a digital solution that will provide people with further opportunity to provide us feedback. Our objectives are detailed below:

1.      To develop a digital solution in partnership with people from our local communities which allows easy access for people to raise a concern.

2.      To improve access for people from seldom heard communities who are currently underrepresented in those we receive complaints from.

3.      Enable more effective and timely communication with the person who has raised a concern, either self-facilitated by personal log ins, or by ensuring one single point of access for information and progress updates.

4.      Improve our understanding of the experience of care of using services from a broader range of our community, supporting our ambition to reduce health inequalities by facilitating learning and service improvement.

Progress Update

Our working group

We have set up a working group to drive this project forward. To ensure that our communities and people who use our services are at the heart of this work we included some of our community partners to be part of the working group.  Others on the working group include our IT colleagues, member from the Complaints and PALs team, representatives from some of our services and also members of the community enagement team.

The role of the working group has been to consider and develop what the key components ot of the digital solution should be. The working group has met regulalry providing oversight to the project.

Understanding our communities needs

A key component in the development of this project has been the need to understand some of the challenges that may be preventing some of our communities from providing feedback and to also understand the sort of thing that would encourage them to provide us with feedback.

We spoke to different community group with a focus on some of more seldom heard from groups. The groups that provided us feedback are:

·        A faith group made up of people primarily from minoritized communities – mixed ages;

·        3 different groups of teenagers

·        Black Heritage group made up of elderly members from minority ethnic

·        Group of mothers from minoritised ethnic group

·        A mother with a child with special educational needs and disabilities.

·        A group of young mothers (from primarily white back ground)

Some key points raised by our communities in the conversations include;

a)      The need to something that is easily accessible on their phone (i.e. an app or portal).

b)     The solution should be available 24/7.

c)      The solution should enable feedback to be logged without having to speak to a member of staff (although available if required or after case closed).

d)     Users should be able to track the progress of their feedback within the same portal/app on their phone.

e)     Easy read with prompts so as to ensure accessibility for people with a learning difficulty (no jargon).

f)       A quick process.

g)      Option for anonymity throughout the process.

It was interesting to note that although focus of our conversations was seldom heard from groups all the communities told us similar messages and all agreed that many people use apps and the internet regularly and being able to do this whilst being assured of feedback would encourage them to provide feedback or to make a complaint if the need ever arose.

We also gained feedback from staff about the project and discussed concerns and key questions that needed to be addressed such as:

1)     Scope of the solution i.e. what type of feedback should this be used for? Complaints, feedback only etc.

2)     What solutions have been used within Solent or across other Trusts?

3)     How do we ensure the solution is used to compliment the current PALS & Complaints systems and help to reduce workload, not add further pressures?

4)     Who would manage this solution on a daily basis?

Feedback portal versus complaints portal

When we started the project, we envisaged this being solely a complaints port. However, following our conversations at the working group and also conversations with our communities it became evident that we should broaden the digital solution to one that would also capture wider feedback.

The Working group agreed that the system should be able to capture feedback not requiring follow up to allow for anonymity but also the full complaints process where necessary.  It would be managed by the PALS & Complaints team to ensure triage of each contact and the solution would be available for all to use and it was hoped that some of our underrepresented groups would also use the system.

Developing the portal

Using feedback from our community conversations both Community stakeholder and Internal stakeholder feedback over several sessions, we have devised a Requirements Specification list with priority categorisation covering 21 key points.  This will be used to ensure the expectations and needs of our communities are not lost whilst also ensuring the digital solution can integrate and function fully with the PALS & Complaints service, IT and processes.  See copy of this spreadsheet

A large proportion of the project so far has been working with the PALS & Complaints team to map out clear processes for the current contact routes to give feedback and also how this should look following project completion.  This has been a challenging section of the project as the feedback and complaints processes are often complex with added elements or processes to consider such as: patient consent, PALS triage, feedback type resulting in varying levels of response type, auto-communications, service team inputs/meetings, re-opening case and case number referencing.  We now have developed a full process map detailing how the solution would link into our complaints process and allow users to interact with Solent, digitally, from beginning to end.  Please see fig 2 or for a fully viewable version, the attachments.

Fig 2: Current process vs proposed digital solution processes

Delays and Challenges

The main challenges have been in trying to identify the best way to provide this digital solution.

It was agreed early on in the project from Internal Stakeholder feedback that the solution should be able to integrate or communicate directly with our current Complaints Management System (Ulysses) or better still be developed within our current system.

After exploration into this need, it has become clear that Ulysses does not have a suitable add-on function which could be developed so we are now looking at other IT providers who could develop this solution to communicate with Ulysses.

The mapping of PALS & Complaints processes was also challenging due to the depth and bespoke aspects of this service.  It was felt that to get this right before moving forward would be key to the success of the project, so all members of the PALS & Complaints team have been involved in this process to ensure all feedback has been factored in, which inevitably took time.

Next steps

Our next steps will include horizon scanning of solutions that are currently available on digital frameworks. In addition to this we will be collaborating with our new IT providers to look at options that include the use of Robotic Process Automation to overcome some potential administrative barriers.

How can the community get involved?

Going forward, our community will be involved further by helping us to develop a prototype and testing of our digital solution so that we can determine if this will really be something to help us reach those community groups.  Further feedback will be gained here to help us make the solution fit for purpose against our original brief.