Bradford GP Dr Uzma Qureshi works as a lead clinical adviser for the PHSO and tells Neil Durham (of GP Magazine) about her role

Learning that your work is the subject of an investigation by the Parliamentary and Health Service Ombudsman (PHSO) could feel like a GP's worst nightmare, but Bradford GP Dr Uzma Qureshi, who works part-time as a PHSO lead clinical adviser, can empathise.

'Like a lot of doctors, I've been on the receiving end of a patient complaint,' explains the portfolio GP, who works as a PMS partner for the two-and-a-half days a week she is not investigating for the PHSO, 'and I fully understand what it feels like'.

'I want to reassure GPs that they will have people like me looking at their complaint. It will get a fair response. I'm not here to pull people up. I have to make sure the guidelines are followed if appropriate and that patients receive the quality of care they are entitled to.'

Dr Qureshi, whose complaint was not referred to the PHSO, is speaking from its Millbank Tower offices in central London, which overlook parliament.

She explains that she joined the PHSO in summer 2011 and was recently promoted to lead clinician. 'I was keen to develop a portfolio career outside the NHS, but making the most of my clinical knowledge.'

Dr Qureshi believes there remains a place for independent contractor GPs, despite pressure to become salaried. She says: 'I think GP partners can bring about innovation and change. I would have concerns about being directed in a certain way.'

Complaints

She divides her time between her Bradford practice and the Manchester and central London offices of the PHSO. 'I'm involved in the broad range of complaints against GPs, which could include end-of-life care, delayed diagnosis or poor record keeping,' she says.

People have a right to go to the PHSO if they have complained to the practice first, or if the complaint has not been resolved after six months.

The NHS Constitution says: 'You have the right to take your complaint to the independent PHSO or the Local Government Ombudsman if you are not satisfied with the way your complaint has been dealt with by the NHS.'

Complaints are initially assigned to lay case workers, who involve GPs like Dr Qureshi if necessary.

The PHSO employs five GPs. It also hires another 40 GPs on a freelance basis, as and when it needs them or if it needs a GP with a specific specialty which it does not have in-house.

Dr Qureshi says: 'I think it's very important to involve a GP who works within the NHS, because we understand the day-to-day pressures of a busy surgery and of limitations within NHS resources.

'Our role is to help the complainant and the clinician to understand what was done, why it was done and why the outcome may not be what was expected.'

What lessons could GPs learn from the work that she has done?

'Complaints from our patients will raise anxieties, but should be viewed as a learning opportunity. Things can go wrong with clinical care, but where improvements need to be made, there should be a willingness to put things right. I would like people to look at these things with an open mind,' Dr Qureshi says.

The PHSO has received some 2,200 complaints about GP practices since the beginning of 2014/15 and is currently investigating about 300.

The number of complaints looks set to be similar to the previous year. However, in 2013/14, the number of complaints the PHSO received about GPs did increase from previous years (2,951 in 2011/12, 3,319 in 2012/13 and 3,996 in 2013/14).

Dr Qureshi points out that just because a GP is the subject of a PHSO investigation, that does not mean a complaint will be upheld. Between April and November 2014, it carried out more than 2,500 investigations, upholding just 38%.

The pressures on the complaints system for children’s care services are being highlighted in a new report by the Local Government Ombudsman (LGO).

In a number of case studies the LGO shows some of the common issues it sees in children’s social care complaints, including:

• failure to recognise a children’s service complaint
• long delays in the process
• refusal to go through all stages of the process
• choosing the wrong complaints procedure

The LGO report adds to an ongoing debate in local government, about whether the current statutory procedure for children’s services complaints is the best way to ensure effective outcomes for children and young people.

In addition to complaints it receives, the LGO surveyed councils to understand experiences at a local level. Councils say that at its best the process is independent, has strict time limits for acting and has clear guidelines on who can complain.

However, they also say the interests of children are often not central to a complaint because only a small proportion are actually from the young people affected. The process can be process driven rather than outcome focused.

Additionally it can cost thousands of pounds per investigation to recruit independent investigators and panel members, with some councils suggesting this is diverting funds from providing vital services.

Dr Jane Martin, Local Government Ombudsman, said:

“The cases from people who complain to us and what we hear from councils, points to a children’s social care complaints system that is creaking under the strain.

“Councils provide crucial support to thousands of young people at difficult and often traumatic times so it essential that if things go wrong, problems are sorted out quickly and openly.

“While we are clear that councils have a statutory duty to follow this process, in this report we are asking whether the process is impacting on the best interests of children and young people.”

Councillor David Simmonds, chair of the Local Government Association’s (LGA) Children and Young People Board, said:

"Councils are committed to listening to the concerns of children and young people, either directly or through their advocates, and will want to reflect on the learning in this report to encourage them to share their views. We recognise there are always areas that can be improved and we will work hard to make the complaints system easier for young people to navigate and ensure that issues are resolved quickly and fairly."

On receipt of complaints by, or concerning, children and young people, councils must follow a statutory complaints procedure. This comprises three stages. Stage one is a local resolution, stage two is an independent investigation to which the complainant can request a report containing the council’s response.  Stage three is an independent review panel.

Each stage has set timescales and the complainant has the right to progress through each stage of the process if they wish. There is limited scope to refer the complaint to the LGO, either at the request of the council or the complainant, before the statutory procedure is complete.

A number of years ago there was a similar debate about the complaints process for adult social care. The policy was changed from being a statutory process to one handled through a council’s normal complaints procedure.

En el BOJA de 9 de Marzo de 2015, nº 46, se ha publicado la Orden de 3 de marzo, de la Consejería de Fomento y Vivienda, por la que se aprueban las bases reguladoras para la concesión de ayudas para el alquiler de viviendas a personas con ingresos limitados en la Comunidad Autónoma de Andalucía y se efectúa su convocatoria para el ejercicio 2015.

Se trata de las ayudas al alquiler de viviendas libres previstas en el Plan Estatal de fomento del alquiler, la rehabilitación edificatoria, y la regeneración y renovación urbanas 2013-2016, regulado por el Real Decreto 233/2012, de 5 de abril.

Se efectúa la convocatoria para la concesión de ayudas el alquiler de vivienda habitual a personas con ingresos limitados para año 2015.

- Plazo de presentación: DEL 10 DE MARZO HASTA EL 30 DE ABRIL DE 2015

- Personas beneficiarias:

* Las personas titulares de contratos de arrendamiento de vivienda destinada a residencia habitual y permanente, ubicadas en Andalucía.

* Las personas que tengan intención de alquilar una vivienda, siempre que presenten un contrato de alquiler que condicione sus efectos a la obtención de la ayuda en el plazo de un mes desde la resolución de la misma.

Los requisitos habrán de cumplirlos todos los miembros de la unidad de convivencia a la que se destina la vivienda.

Se entiende por unidad de convivencia a todas las personas que convivan y estén empadronadas en una misma vivienda, existan o no lazos familiares. Una misma persona no podrá formar parte de dos unidades familiares distintas.

- Cuantía de las ayudas: Consistirá en el 40% de la renta anual que deba satisfacerse por el alquiler de la vivienda habitual y permanente, con un límite máximo de 2.400 euros anuales por vivienda. Estos límites se prorratearán sobre los meses subvencionables que correspondan.

- Pago: El pago de la ayuda se fraccionará abonándose al inicio de cada mes en curso y en caso de existir meses ya vencidos, se incluirán estos en un pago único.

- Solicitudes: Según el formulario aprobado que se podrá obtener en la dirección web http://www.juntadeandalucia.es/export/drupaljda/002252-A00-V00-00_0.pdf

- Lugar de presentación: Preferentemente en las Delegaciones Territoriales de la Consejería de Fomento y Vivienda de la Junta de Andalucía http://www.juntadeandalucia.es/fomentoyvivienda/portal-web/web/directorio de la provincia en la que esté ubicada la vivienda, o en el registro Telemático Único de la Administración de la Junta de Andalucía, en la dirección web http://www.andaluciajunta.es, en cuyo caso se requerirá firma electrónica reconocida.

INFORMACIÓN: http://www.juntadeandalucia.es/servicios/ayudas/detalle/77700.html

Conservación de solares, espacios en inacabado proceso de urbanización y edificaciones no terminadas. Control municipal y actuaciones de fomento en interés general. Incumplimiento municipal de la obligación de información al Justicia. Ayuntamiento de Teruel.