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A complaint resolution service, often referred to as ‘adjudication,’ typically refers to a process where a neutral third party, separate from the independent healthcare provider being complained about, investigates, and resolves the complaint.
For patient, the adjudication process ensures fairness for patients by providing them with a platform to voice their concerns and seek timely resolutions when their complaints cannot be satisfactorily resolved through the independent healthcare provider’s internal complaint pathway.
For independent healthcare providers, providing access to adjudication to patient aligns the healthcare provider with the CQC’s expectations for best practices. It also acts as a safeguard, minimising the risk of a patient taking an unresolved complaint to the courts prematurely.
While the CQC has announced its plans to strengthen guidance on complaint procedures in the near future, making it clear that it will expect independent healthcare providers to have measures in place for patients to seek independent resolution of their complaints there is no requirement at this time, from either the CQC, HIS, HIW, or RQIA for providers to subscribe to a complaint resolution service.
The current CQC guidance states that there is an expectation that patients should have access to independent resolution, and providers who do not offer such a mechanism must be able to demonstrate that patients are not disadvantaged by this.
A robust 2-stage internal resolution process could potentially show the CQC that patients aren’t negatively affected by the absence of an independent resolution mechanism. The second stage must operate independently from the provider, making decisions impartially, even if not aligned with the provider’s interests, which is challenging within a company-centric environment.
Due to the increasing significance of ‘no win, no fee’ solicitors in the healthcare space patients with no access to adjudication will have no other option but to seek redress through the Courts. ‘No win no fee solicitors’ makes it easy for a patient to bring a claim by eliminating upfront legal fees and enabling those who might not be able to afford traditional legal services to pursue their claim. By subscribing to cost-effective adjudication and including an expedited adjudication clause in the patient consent form, healthcare providers can require patients to engage in complaint resolution through adjudication before seeking assistance from no-win, no-fee solicitors. This safeguards providers from incurring significant costs until such time a determination of liability is made against them.
An expedited adjudication clause is a contractual provision included that outlines a process for resolving disputes or conflicts in a swift and accelerated manner.
The HSCAMP independent adjudication service specialises in the evaluation and resolution of patient complaints. Each case is assigned to a primary adjudicator with expertise in dispute mediation, and a secondary adjudicator from the corresponding medical field to provide an expert opinion.
Before HSCAMP’s arrival, ISCAS and the CRS predominantly serviced the complaint resolution market for independent providers.
Membership Cost:
CRS: £15 per annum for single practitioner
HSCAMP: Annual fee of £295 for single practitioner and £495 for multiple practitioner
ISCAS: Membership fees are dependent on healthcare providers turnover, ranging between £800 and £5,000.
Types of Complaints:
CRS: Handles basic complaints such as breaches of consumer legislation, breaches of signed codes of practice, and unfair treatment (rudeness, poor service, etc.). They explicitly do not handle complaints regarding treatment errors, damages from treatments, medical side effects, or clinical concern.
HSCAMP: Addresses almost all complaints except those circumstances arising to include matters of clinical concern, dissatisfaction with results or complication from the treatment where it is reasonable to predict that the complaint cannot be satisfactorily resolved within HSCAMP’s maximum monetary allowable goodwill gesture (£5,000 GBP).
ISCAS: Covers the same scope of complaints as HSCAMP.
Maximum Awards:
CRS: £25,000.
HSCAMP: £5,000.
ISCAS: £5,000.
Adjudication Costs:
CRS: Charges between £80 and £150 for bringing forth a complaint raising questions around the ability and expertise of the adjudicators given the low fees.
HSCAMP: Charges a flat fee of £800 for per case adjudication.
ISCAS: Costs average around £2,500 per case but can go as high as £5,000 if expert opinions are required.
Time for Adjudication Decision:
HSCAMP: 28 business days
ISCAS: 3-6 months
CRS: 3 months
HSCAMP’s membership is an annual subscription payment which is dependent on the membership package. It will not auto-renew as we do not hold credit
card information. The Members access to adjudication will terminate 1-year from the HSCAMP membership anniversary date unless membership is renewed. HSCAMP will contact the Member 28 calendar days prior to the 1-year anniversary, and every year thereafter, to notify them of the upcoming
renewal date.
For a single practitioner looking to join HSCAMP, the membership fee is set at £295 annually. If you’re registering multiple practitioners, the membership cost
increases to £495 per year.
Fees for the membership are fixed and include log-in credentials for 1 user. The cost of adjudicating a complaint is not included in the membership package which is capped at £800 a case. Active Patient feedback is an add-on service and is charged at £15 a patient.
You can cancel at any time. The value of your refund will be dependent on the number of unused months and an administration fee.
Upon successful registration, you will receive a welcome email which will include the HSCAMP Service Agreement, invoice, and your log-in credentials
for the Member’s Area on the hscamp.co.uk website. Once you have signed the agreement and made the payment your log-in credentials will be activated,
and you will have access to HSCAMP’s Member’s Portal.
Active patient active feedback refers to the process of actively seeking and collecting feedback from patients about their experiences, perceptions, and satisfaction with healthcare services. Unlike passive feedback, where providers wait for comments, complaints, or compliments to come in organically, active feedback involves intentional efforts to gather patient opinions enabling providers to make real time changes or improvements and in turn reducing the number of complaints.
Member can request feedback from patients that have recently visited the member’s business at a cost of £15 per patient. Prior to HSCAMP contacting
the patient, the member will need to gain consent from the patient that HSCAMP can contact him/her. The member will not provide any sensitive information about the patient, including their treatment and HSCAMP will request feedback based on their experience.
Complaint policy tools include a variety of documents and templates including a complaint handing policy, a complaint procedure checklist, complaint best
practices, apology templates and adjudication consent form as well as a patient lifetime value calculator.
A patient lifetime value calculator (PLV) looks at the lifetime value of a client and compares that to the value of the goodwill payment that might have to be made to turn a dissatisfied patient into a satisfied patient. As the cost of acquiring new patients is always higher than the cost of retaining an existing one it often makes sense to try and resolve the complaint fast and offer “compensation”. Patients that see you value them are likely to remain loyal and increase their spend in your business. The PLV calculator will calculate the value of the patient based on how long you expect then to stay with your business, the number of treatments per year and average cost of those treatments. Once you have a PLV value you can assess if the making the goodwill payment will provide the right result for your business.
The mission of HSCAMP is to provide Health and Social Care providers with the tools and insights to turn dissatisfied patients into satisfied patients and to provide an independent adjudication service for patients who are not satisfied with the resolution proposed by the Health and Social Care providers’ internal complaint process.
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Health and Social Care Complaint Adjudication Management Partners