Policy for dealing with habitually demanding or vexatious complainants and/or habitually demanding or Version: Ratified by: Date ratified: Name of originator/author: Name of responsible committee: Final Quality and Safety Committee 28 th February 2011 minor amendments made Simon Trickett Quality and Safety Committee Date issued for publication: 28 th February 2011 Review date: January 2013 Expiry date: 27 th February 2013 Target audience: All Staff including agency and temporary staff CONTRIBUTION LIST Key individuals involved in developing the document Name Simon Trickett Sonia Spurr Designation Head of Communications and Community Engagement Patient Relations and Involvement Manager 22 February 2011 Page 1 of 9
CONTENTS 1 Introduction 3 2 Purpose of Policy 3 3 Definition 3 4 Roles and Responsibilities 4.1 Management responsibilities 4.2 Employee responsibilities 5 Options for dealing with habitually demanding or vexatious complainants and/or habitually demanding or vexatious behaviour, including: Stage 1 Stage 2 Stage 3 5 5 6 Withdrawing habitual or vexatious status 6 7 Freedom of Information Act 2000 7 8 Document Archiving 7 9 Review 7 10 Equality Impact Assessment 8 22 February 2011 Page 2 of 9
1. INTRODUCTION Habitually demanding or vexatious complainants, and/or people who exhibit habitually demanding or, are an increasing problem for NHS staff. Handling such people or complainants could place a strain on time and resources and cause unacceptable stress for staff, who may need support in difficult situations. The following procedures set out the Primary Care Trust s policy in dealing with such people or complainants. It must be stressed that the vast majority of people who do come into contact with staff employed by Worcestershire PCT do not display such behaviour. This procedure is for the small minority who do. Execution of these procedures would only take place in exceptional circumstances. The procedures outlined in this document will only be used as a last resort and after all reasonable measures have been taken to try to resolve issues locally or through the NHS complaints procedure. Judgment and discretion must be used in applying the criteria to identify such behaviour and in deciding on the action to be taken in each case. The procedure will only be implemented following careful consideration by, and with the authorisation of, the Chief Executive of the PCT and any relevant Director (or their deputy). References to habitually demanding or vexatious complainants should be considered in conjunction with the PCT s Compliments and Complaints Policy and Procedure. 2. PURPOSE OF THIS POLICY 2.1 To identify situations where someone might be considered to fall into these categories and establish a procedure whereby they can be treated equitably and fairly. 2.2 To protect staff from the nuisance, abuse and threatened or actual harm, which may be caused by such behaviour. 3. DEFINITION 3.1 It is accepted that complainants, or others coming into contact with the PCT may act out of character. They may show signs of vexatious behaviour for several reasons and may be unaware that their attitude/behaviour is causing unnecessary distress to others. Unacceptable behaviour that continues through several contacts however, should be considered against this procedure. 3.2 One definition of is to harass, distress, annoy, tease, cause trouble, agitate, disturb or pursue issues excessively. 3.3 Behaviour exhibited by a person (and/or anyone acting on their behalf) may be deemed to be habitually demanding or vexatious where 22 February 2011 Page 3 of 9
previous or current contact with them shows that they meet any of the following criteria: a) persisting in pursuing a complaint where the NHS complaints procedure has been fully and properly implemented and exhausted, but no appeal has been made to the Parliamentary Health Service Ombudsman. b) seeking to prolong contact by continually raising further concerns or questions upon receipt of a response. (Care must be taken not to discard new issues, which are significantly different from the original issue. These might need to be addressed as separate issues.) c) unwilling to accept documented evidence as being factual or denying receipt of an adequate response in spite of correspondence specifically answering their questions, or does not accept that facts can sometimes be difficult to verify when a long period of time has elapsed. d) does not clearly identify the precise problem, despite reasonable efforts of PCT staff and, where appropriate, the Independent Complaints and Advocacy Service (ICAS), to help them specify their concerns, and/or where the concerns are not within the remit of the PCT to investigate. e) focuses on a matter to an extent, which is out of proportion to its significance and continues to focus on this point. f) has threatened or used actual physical violence towards staff or their families or associates. This will, of itself, cause personal contact with the person and/or their representatives to be discontinued and the issue will, thereafter, only be pursued through written communication. g) has harassed or been personally abusive or verbally aggressive on more than one occasion towards staff dealing with their issue or their families or associates. However, staff must recognise that people may sometimes act out of character at times of stress, anxiety or illness and should make reasonable allowances for this. h) has had, in the course of addressing an issue, an excessive number of contacts with the PCT, placing unreasonable demands on staff time or resources. (A contact may be in person, or by telephone, letter, fax or e-mail.) Judgement must be used in determining what is an "excessive number" of contacts and this will be based on the specific circumstances of each individual case. i) has electronically recorded meetings or face to face/telephone conversations without the prior knowledge or consent of the other parties involved. 22 February 2011 Page 4 of 9
j) displays unreasonable demands or expectations and fails to accept that these may be unreasonable (e.g. insists on responses to enquiries being provided more urgently than is reasonable or normally recognised practice). 4 ROLES AND RESPONSIBILITIES 4.1 Management Responsibilities The Head of Communications and Community Engagement is responsible for overseeing the complaints function. The PCT has a complaints manager to oversee the investigation of each complaint. 4.2 Employee Responsibilities Staff need to fully record any suggestion of. Good documented evidence will be required and the completion of incident forms is mandatory for incidents relating to possible verbal or physical abuse (this includes telephone conversations). 5 OPTIONS FOR DEALING WITH HABITUALLY DEMANDING OR VEXATIOUS COMPLAINANTS AND/OR HABITUALLY DEMANDING OR VEXATIOUS BEHAVIOUR 5.1 Where people have been identified as exhibiting "habitual or vexatious" behaviour in accordance with the above criteria, the Chief Executive and the relevant Director (or their deputy) will decide what action to take. The Chief Executive will then implement the action and will notify complainants in writing of the action that has been taken and the reasons for it. 5.2 If appropriate, notifications under this policy may be copied for the information of others already involved e.g. General Practitioners, ICAS, and Member of Parliament. A record will be kept of the reasons why someone has been classified as "habitual or vexatious". Once classified as "habitual or vexatious", people will be dealt with as follows: Stage 1: Once it is clear that an individual meets the criteria above, it may be appropriate to inform them, in writing, that their conduct is unacceptable and that, if it continues, they may be classified as "habitual or vexatious". The letter should state clearly which elements of their behaviour are causing problems and be accompanied by a copy of this policy. If people are using the NHS complaints procedure, they should also be advised to seek advice e.g. from their local ICAS provider in presenting their complaint. 22 February 2011 Page 5 of 9
Stage 2: It may be appropriate to try to resolve matters by drawing up a signed agreement with the person, which sets out a code of behaviour for the parties involved, if the PCT is to continue communication or to process a complaint. If these terms are contravened consideration will be given to implementing Stage 3 of the procedure. A code of behaviour could include the following: An agreement relating to appropriate behaviour and conduct. Any such agreement should normally not extend beyond six months. Restricting contact to one or two individuals within the PCT. Restricting the method of communication (e.g. by letter only, not fax/email). Offering a meeting to attempt to resolve outstanding issues. Stage 3: Where the PCT has responded fully to the points raised by the person and has tried to resolve the issues, without success, and continuing contact on the matter would serve no useful purpose, the individual will be notified by the Chief Executive that the contact is at an end and that further contact will be acknowledged, but not answered. In extreme cases, or where the safety of staff is at risk, the individual will be informed that the PCT reserves the right to pass habitually unreasonable or to their solicitors. All contact with the person and/or investigation of the complaint will be suspended whilst seeking legal advice or guidance from the West Midlands Strategic Health Authority or other relevant agencies. Any further complaints received from a person who has been designated as habitually demanding or vexatious, under this policy, will be subject to a reasonable investigation as deemed necessary by the Chief Executive in conjunction with advice received from staff dealing with complaints. The Chief Executive (or deputy), in conjunction with the Chairman, may, at their discretion, choose to omit one or two of the above stages. 6 WITHDRAWING HABITUAL OR VEXATIOUS STATUS 6.1 When individuals have been classified as habitual or vexatious, the status will continue to apply for six months, at the end of which period habitual or vexatious status will automatically be withdrawn. In exceptional circumstances, the PCT will consider withdrawing this status earlier if, for example, the person subsequently demonstrates a more reasonable approach. The status of habitual or vexatious will only apply to specific issues, not general. If a new issue comes to light, an individual may not be deemed habitual or vexatious unless their 22 February 2011 Page 6 of 9
behaviour demonstrated this relating to the new issue. Where it appears to be appropriate to withdraw "habitually demanding or vexatious" behaviour status, the approval of the Chief Executive and relevant Director (or their deputy) will be required. Subject to this approval, normal contact with the person will be resumed. 7 FREEDOM OF INFORMATION ACT 2000 7.1 Where a freedom of information act request is made by a complainant or person who has been designated as habitually demanding or vexatious, the PCT may, in assessing whether that individual request is a vexatious request, take into account the habitually demanding or vexatious complainants/behaviour if it considers this to be relevant. In doing so, the PCT will also follow information commissioner guidance on vexatious requests. 8. DOCUMENT ARCHIVING 8.1 Documents will be archived in accordance with the PCT policy. 9. REVIEW 9.1 This policy/procedure will be reviewed two years from publication, unless circumstances arise requiring an early review or updating of the policy. Minor amendments made Sonia Spurr February 2011 22 February 2011 Page 7 of 9
Equality Impact Assessment Tool To be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval. Title of the policy/guidance: Policy for dealing with habitually demanding or vexatious complainants and/or habitually demanding or vexatious behaviour 1 Does the policy/guidance affect one group less or more favourably than another on the basis of: Race Ethnic origins (including gypsies and travellers) Nationality Gender Culture Religion or belief Sexual orientation including lesbian, gay and bisexual people Age Disability - learning disabilities, physical disability, sensory impairment and mental health problems 2 Is there any evidence that some groups are affected differently? 3 If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable? 4 Is the impact of the policy/guidance likely to be negative? (If no, please go to question 5.) If so can the impact be avoided? What alternatives are there to achieving the policy/guidance without the impact? Can we reduce the impact by taking Yes/ N/A Comments 22 February 2011 Page 8 of 9
different action? Yes/ Comments 5 Health inequalities 6 Please consider the following questions relating to Human Rights Act: Will it affect a person s right to life? Will someone be deprived of their liberty or have their security threatened? Could this result in a person being treated in a degrading or inhuman manner? Is there a possibility that a person will be prevented from exercising their beliefs? Will anyone s private and family life be interfered with? If you have identified a potential discriminatory impact of this procedural document, please complete Impact Assessment Action Plan identifying the action required to avoid/reduce this impact. For advice in respect of answering the above questions, please contact the PCT Equality and Diversity Manager.. Is further detailed impact assessment required? Yes/ If yes, please detail how this is to be processed and by whom Details (names and roles) of staff involved in this impact assessment Name Role Completed Outcome Simon Trickett Sonia Spurr Communications and Corporate Director Patient Relations and Involvement Manager Yes Yes further action further action 22 February 2011 Page 9 of 9