What if Ihave difficulty getting the care I need?15. What if I have difficulty getting the care I need?
You can use your council’s complaints system if you are unhappy about any aspect of the council’s care, including your assessment. So you can complain if, for example:
- the council refuses to assess you or leaves you waiting a long time to be assessed;
- you are not happy with how the assessment was done;
- you think you are not getting the services you need;
- you think you are being asked to pay too much for the services you use; or
- you have problems with the services themselves.
If a care trust did your assessment, you should complain to the trust in the first place, but you could also complain to the council, as it provides the services.
By law, social services departments must have a complaints procedure and must be able to give you information about:
- how to make a complaint;
- how quickly they should deal with it; and
- where you can get help with making a complaint.
Normally, councils will try to deal with complaints informally, perhaps by seeing if you and the social services officer you usually deal with can sort out things between you. If this ‘informal stage’ doesn’t solve your problem, you may want (or be asked) to go on to a more ‘formal’ stage. This is usually an investigation, by either:
- someone who is not involved in the local service; or
- the Complaints Manager (in England) or Complaints Officer (in Wales), or someone they appoint.
If you’re unhappy with the result of the formal stage, you can ask for your complaint to be examined by an independent panel (in Wales) or a review panel (in England). These panels will include at least two people who are separate from the council. You can go to the panel meeting and you can have someone there to speak for you if you want.
If you are still unhappy, you should contact the Local Government Ombudsman (England) or the Public Services Ombudsman (Wales) – see ‘Further help’.
If you think your council has broken the law (for example, if it won’t pay for your residential care when you think the law says it should), you can ask the council’s ‘monitoring officer’ to look at your case. Your local councillor or Member of Parliament may also be able to help. If these steps don’t sort out your problem, you can take your case to the Secretary of State for Health (in England) or the Welsh Assembly (in Wales). However, you will need to get legal advice before you do this.
Another possibility is to use (or threaten to use) the courts to sue the council or get a judge to rule on whether its actions were legal and reasonable. In either case, you will need to get legal advice. If you cannot afford to pay for a solicitor, and you meet other conditions, you may be able to get public funding (legal aid). See ‘The Community Legal Service’ for how to find out more about this.
What if I have a problem with NHS care?
You can complain about any area of healthcare provided by the NHS (See ‘What if I’m unhappy with the decision about my eligibility?’ if you want to complain about your assessment for NHS continuing healthcare). Your local Patient Advice and Liaison Service (PALS) (in England) or Community Health Council (in Wales) should have information about the NHS complaints system and about independent help (complaints advocacy) in your area (see ‘Further help’ for details).
The government is currently planning changes to the NHS complaints system. For now, if you have a problem, you must first contact the hospital, Foundation Trust, surgery or clinic involved. It should have a leaflet telling you how to make your complaint. You can also get help to make a complaint from a local independent complaints advocate in England (through the Independent Complaints Advocacy Service) or your Community Health Council in Wales.
If you can’t resolve things at this stage:
- in England, you can ask the independent Healthcare Commission to review your complaint; or
- in Wales, you can ask the Independent Complaints Secretariat for your area to review your complaint.
If you are still unhappy with the result of your complaint, you may be able to take it to the Parliamentary and Health Service Ombudsman (in England) or the Public Services Ombudsman (in Wales).
What if my complaint covers health and social care?
The government has set out plans to move towards a unified system for complaints about health and adult social care. Before this comes into effect, health and local authorities should be working together so that if your complaint involves both, you only need to complain to one service and you should get a joint response. So if your complaint involves NHS services, the council can pass it on to the NHS (or the other way around) if you wish.
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