must be followed when a complaint has been made.
The Nursing and Midwifery Council’s (NMC) (2018a) Code requires the nursing associate to respond to any complaints made against them professionally; in order to do this, they must never allow someone’s complaint to affect the care that is provided to them; all complaints should be used as a form of feedback and an opportunity to learn from this through reflection so as to improve practice. In order to uphold your position as a nursing associate, you must refuse all but the most trivial gifts, favours or hospitality; if you accept them, this could be interpreted as an attempt for the patient to gain preferential treatment (Nursing and Midwifery Council 2018a). On admission to the register, the Nursing Associate Proficiencies (Nursing and Midwifery Council 2018b) require the trainee nursing associate to demonstrate they are able to respond to feedback to develop professional knowledge and skills.
Compliments
From time to time, a patient or a member of the patient’s family may wish to express their gratitude to the nursing associate or the team to show that they care for what they have done. The gratitude can be expressed in many ways: verbally, a thank you card, a box of chocolates, a bowl of fruit or a packet of biscuits. All of these can be gratefully received with thanks and used as evidence to support the quality of care given, yet the NMC (2018a) compels you to refuse all but the most trivial gifts, favours or hospitality.
Green Flag
NHS England (2017a) has produced guidance for staff regarding managing conflicts of interest in the NHS.
Indeed, revalidation, the process that allows nursing associates to maintain their registration with the NMC, demands that you receive feedback, written or verbal, formal or informal. The feedback may come from patients and service users or colleagues and management (Nursing and Midwifery Council 2019).
Blue Flag
Individuals might derive great pleasure from giving gifts, and if a gift is rejected, this has the potential to hurt or offend the person who is giving.
There is pleasure in both giving and receiving, and usually no harm is done; however, the nursing associate must always be cautious about accepting any gift. Organisational guidelines (local policy and procedure) may help to decide on the appropriateness or inappropriateness of receiving any kind of gift, monetary or otherwise. There are alternatives to gift giving, for example, the patients or their family could:
Make a donation to a charity
Make a contribution to the hospital, clinic, unit charity fund if there is one
Complete an employee recognition form or write a letter
Provide feedback via the Friend and Family Test
Touch Point
If you are given a gift (a tangible gift) regardless of value, you should politely refuse it. Always seek advice about accepting a gift from patients or their family.
Managing Complaints
Most of the time, the care that is provided to people in the NHS and by other care providers such as those in the independent and voluntary sectors is of a high standard with positive outcomes. However, things can and do go wrong from time to time and complaints are made.
The total number of all reported written complaints in 2017–2018 was 208,626. This is the equivalent to 4,012 written complaints a week or 572 complaints per day (NHS Digital 2018). The NHS has a single approach that deals with complaints allowing flexibility to respond and to learn from mistakes that may have been made.
The NHS Constitution (DHSC 2015) describes principles and values of the NHS in England and also provides information on how complaints can be made about NHS services. The Constitution has been updated and includes additions and developments associated with:
Patient engagement
Feedback
Duty of candour
End‐of‐life care
Integrated care provision
Complaints
Patient information
Staff rights, responsibilities and commitments
Dignity, respect and compassion
When a person is unhappy with the services they receive, it is important for the nursing associate to inform them (and, if appropriate, their family) of their rights. People have the right to make a complaint about any aspect of NHS care, treatment or service. The Local Authority Social Services and NHS Complaints (England) Regulations 2009 is the legislation that governs NHS complaints. These regulations make provision for complaints made on or after 1 April 2009; they introduced a revised procedure for the handling of complaints by local authorities, in respect of complaints about adult social care and by NHS bodies, primary care providers and independent providers in respect of provision of NHS care. The regulations united adult social care and health complaints processes into a single set of arrangements.
Each organisation will have arrangements for people to raise concerns or make complaints. Referral to the Patient Advisory Liaison Service (PALS) can help people navigate the complaints process. The creation of PALS was as a result of the NHS Plan (Department of Health 2000). PALS are intended to enable patients and the public to access information and raise concerns with their Trust; they offer confidential advice, support and information on health‐related matters. They provide a point of contact for patients, their families and their carers. PALS provides help in many ways, it can:
help with health‐related questions
help resolve concerns or problems when using the NHS
advise people how to get more involved in their own healthcare.
PALS are not a part of the complaint’s procedure; they can provide information about:
the NHS
the NHS’s complaints procedure, including how to get independent help if the person wishes to make a complaint
support groups outside the NHS.
