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In March 2024, the Time2Talk team received 256 contacts which included of 22 complaints, 107 concerns, 105 queries, and 22 were noted for information only. The top themes were around clinical treatment, staff attitude, and access to treatment or drugs.

Example of concern

The Time2Talk team received contact from Mr F who explained that due to his living situation(s) he has no fixed address and moves every two weeks. Mr F was currently residing outside of the Black Country area having recently discovered a lump, he attended an out of area GP practice where he was advised he would require an urgent scan. The GP advised they were unable to refer him to the local hospital as he was not on their clinical system and directed him back to his registered GP in the Black Country.

Mr F contacted his registered GP practice and was told he would need to register with a GP in the area he was residing in as they could only refer to hospitals that they have a contract with. Mr F felt he was going around in circles and was concerned that he would not be able to have the urgent scan. He enquired if his registered GP could refer him to a hospital local to his current location under the ‘Right to Choose’ framework.

The Time2Talk team liaised with the ICB's Primary Care team who confirmed the right to choose guidance and sought advice to enable a response to Mr F. The Time2Talk team contacted Mr F and explained that the practice in his current area of residence should still be able to contact the service provider directly for the referral.  Alternatively, they could contact his registered GP practice to highlight that the ICB have advised under the ‘Right to Choose’ guidance, patients can choose to be referred to their preferred provider, this is not restricted to the West Midlands only. Mr F was very happy with the advice provided and for the help of the Time2Talk team stating that he felt extremely relieved that he would be able to have the urgent scan he needed. Learning of this case study has been shared with colleagues within the provider, and Primary Care networks.

In February 2024, the Time2Talk team received 293 contacts including 40 complaints, 101 concerns, 112 queries, and 40 information queries.

Concern example

The Time2Talk team received contact from Mrs H who advised her husband had been on the waiting list for ADHD and Autism services since October 2021. She explained that he had two assessments with his GP and a referral was made, however, he was advised that the waiting lists for the service were extremely long. The patient had requested through the right-to-choose framework that he would be seen by a private provider and was advised by the provider that the funding request was declined. Mrs H contacted Time2talk as she wanted to understand why this was the case as her husband was struggling to cope day to day and has had to reduce his hours at work. She explained that this was causing the family a lot of distress as she is unable to work due to being a full-time carer for their child and they rely on the husband's income.

The Time2Talk team contacted the ICB’s senior commissioner for mental health services and a colleague in the contracting team who discussed this with NHS England. The Time2Talk team received confirmation that the ICB would fund the patient’s assessment with the patient’s requested provider under the right-to-choose framework and that the provider had been informed of this.

The Time2Talk team contacted Mrs H and advised that the funding had been approved and directed the patient to his GP practice to follow up on the original referral to ensure it has now been accepted and is in progress. Mrs H was very happy with the outcome and was very thankful that the Time2talk team had not only listened to her concerns but had assisted in gaining a resolution that both she and her husband were very happy with.

In January 2024, we received 161 contacts which consisted of 45 complaints and 116 concerns and queries. The top theme in Dudley was patient care, for Sandwell it was access to treatment/drugs and for Walsall and Wolverhampton, it was around communication.

Example of a concern

The Time2Talk team were contacted by Mrs S who wanted to raise a formal complaint regarding her GP practice as they did not offer travel vaccinations. Mrs S explained that she approached the practice to request the necessary travel vaccines required for her to travel abroad. The practice advised that they did not offer this service and Mrs S was directed to Boots. She paid £94 for the vaccinations and subsequently found out that the GP practice should have offered the vaccinations needed.

The complaint response from the practice outlined their reasoning for not providing the service and declined to reimburse Mrs S based on that reasoning. The Time2Talk team sought advice from the Primary Care Contracting team with regards to the contractual obligations of the practice. The Primary Care Team agreed that the practice should reimburse Mrs S and following further discussions the practice agreed to contact Mrs S and offer reimbursement.

In December 2023, we received 202 contacts which included a mixture of formal complaints, concerns, and queries. The top theme in Dudley was appointments, for both Sandwell and Walsall it was clinical treatment and for Wolverhampton it was access to treatment and drugs.

NHS England estimated that we would receive 17 new contacts per week relating to primary care services and pharmacy, optometry, and dentistry across all four places, however, this month we experienced 25 contacts on average every week.

Example of a concern

We received an email from Mr. A who wanted to raise a formal complaint as he was unhappy that despite contacting his GP practice on multiple occasions in relation to a form he had handed in four weeks prior for completion, he had not received any contact or had the form returned. Mr. A explained that the form was required to progress an offer of employment and that he was very anxious that the offer of employment may be withdrawn, which was having an effect on his mental health.

We provided assurances that we would follow this up for him with the practice manager of the GP practice. The Time2Talk team liaised with the practice manager, who advised the form was returned directly to the DVLA via a secure email eight days prior. The practice manager offered apologies that she had not been able to return Mr. A's calls due to being on annual leave over the Christmas period. She advised she would contact Mr. A immediately to explain what had happened.

Mr. A contacted the Time2Talk Team following discussions with the practice manager and the DVLA to advise that the email had been located, however, this was still waiting to be actioned due to staff annual leave. Mr. A received a holding email from the DVLA which he then shared with his new employer to explain the delay. Mr. A was very happy with our input and support.

In November, we received 246 contacts with the top theme in Dudley around appointments, for both Sandwell and Walsall it was access to treatment, and for Wolverhampton it was clinical treatment.

NHS England estimated that we would receive 17 new contacts per week relating to primary care services and pharmacy, optometry, and dentistry across all four places, however, this month we are experiencing 31 contacts on average every week.

An example of a concern

The Time2Talk team were contacted by Mr G who was unhappy that a pharmacy in the Sandwell area was repeatedly taking his prescriptions from the spine without his consent. The team had received similar concerns about this pharmacy so it was escalated to the Head of Community Pharmacy and the Quality Directorate for the ICB. This resulted in a letter being shared with the pharmacy reminding them of their contractual obligations and the professional standards expected by the General Pharmaceutical Council (GPhC). The ICB also decided to inform the GPhC of this inappropriate activity.

The Time2Talk team sent a letter to Mr G thanking him for raising his concerns, offering assurances that his concerns have been taken seriously, and informing him of the follow-up actions that took place. Mr G sent a letter of thanks to the team for their help and support.

In October we received 209 contacts, an increase of 24 contacts from last month. The contacts consisted of complaints, concerns and queries with the top theme in Wolverhampton and Dudley about appointments and in Sandwell and Walsall it was about communication.

Example of complaint

The Time2Talk team received contact from Mrs S who wished to raise a formal complaint about advice given by the NHS 111 service when seeking to obtain a prescription.

Mrs S explained that her GP had not issued her prescription and as it was the weekend, she contacted NHS 111. Following contact with a doctor from the NHS 111 service Mrs S was informed due to the medication she required being a controlled drug they were unable to issue a prescription and arranged an appointment for Mrs S at the Urgent Treatment Centre at 10.30pm. At 10pm that evening, Mrs S was contacted by the Urgent Treatment Centre to say that due to the medication being a controlled drug Mrs S had not been previously prescribed they were unable to see her and cancelled the appointment. Mrs S was left feeling angry and if she had been better informed by NHS 111 she would not have spent the time chasing her prescription.

The Time2Talk team liaised with the NHS 111 complaints team on behalf of Mrs S. She was offered the opportunity to speak with the NHS 111 complaints manager directly to attempt to reach a faster resolution. Mrs S accepted the offer and was very happy following her discussion with the complaints manager. Learning was identified for staff within the NHS 111 service and the manager arranged an urgent prescription for Mrs S by liaising with her GP. Overall, Mrs S was  happy with the outcome and the quick resolution.

In September, we received 185 contacts - this was an increase of 23  contacts compared to August 2023. The top theme of contacts was access to treatment and drugs, and patient care.

Example of informal concern

The team were contacted by Mr A who had previously submitted a request for in vitro fertilisation (IVF) funding via his GP.  He was unhappy that his previous referral had been declined by the ICB and he felt that he met the criteria due to his ongoing health conditions and felt that the GP did not include enough information when the referral was made for the ICB to consider.

The Time2Talk Team liaised with the Individual Funding Request Team (IFR) on behalf of Mr A and shared further information provided by Mr A. Following further investigation and further clinical information received from Mr A’s GP, the IFR Team approved Mr. A's IFR application. Mr A was very thankful for the support offered during his application.

In August, Time2Talk received 162 contacts which was 31 fewer contacts than the previous month. These contacts were made up of formal complaints, informal concerns, and general health-related queries from members of the public. The top themes across all four boroughs were access to treatment and drugs and in addition, Sandwell patients had issues relating to admissions and discharges from the Trust.

Time2Talk holds the statutory responsibility for complaint handling on behalf of the Black Country ICB, the team also offers a range of additional customer services, which includes, managing informal concerns to achieve local resolution where possible, responding to queries, signposting patients, and providing information to local patients.

Example of informal concern

The team were contacted by Mrs S who had a long-term condition and had previously been able to access her medication by prescription from her GP. Mrs S was informed by her practice that the medication was no-longer available on prescription. She tried to arrange an appointment with her GP to discuss this but had not been able to arrange an appointment.

Time2talk offered to look into the issue with a member of the ICB’s medicine management team and via the team, liaise with the GP practice to resolve her concern locally. The medicines management team reviewed the NHS formularies and identified that following recent changes Mrs S would be able to receive her medication on prescription. The GP practice was informed and an apology was shared with Mrs S. The GP also arranged an appointment arranged the following day to discuss this directly.

The patient commented, “You don’t know how happy and grateful I am! Thank you so much for sorting this out so quickly for me”.

As of 1 July 2023, the Time2Talk team has taken on the responsibility for complaints, concerns, and compliments for primary care services such as dental, pharmacy, and optometry.

This month, we received 193 contacts, an increase of 52 contacts compared to June 2023. The top theme for these contacts was ‘clinical treatment’.

Example of informal concern

The team were contacted by Mrs C who was unhappy following her regular dental check-up. Mrs C explained that her dentist treats patients in both a private and NHS capacity. When she arrived for her appointment, she was advised that the dentist was unable to see her in an NHS capacity due to the number of patients on their books, and to continue with her appointment she would have to pay for her regular check-up as a private appointment.

Mrs C told us that she felt she had little choice but to pay for her regular check-up as she had taken time off work and travelled to the dental practice. Contact was made with the practice manager to look into Mrs C’s concerns. The practice manager advised that the dentist no longer had the capacity to see NHS patients and payment for a regular check-up was the correct process. However, on reflection, the practice manage agreed that Mrs C should have been contacted prior to her appointment to enable her to decide if she wished to continue on a private basis. Apologies were shared with Mrs C and a refund of the check-up was arranged because of the miscommunication. Mrs C was very happy with the outcome and thanked the Time2Talk team for the assistance and support in resolving her concerns.

In June, we received 141 contacts (54 more contacts compare to May 2023), which consisted of formal complaints, informal concerns, and queries from members of the public. The top themes were delays in appointments, administrative errors, and access to treatment and drugs.

Example of informal concern

The team were contacted by the ICB's Involvement Team to share feedback received from Miss V who attended a face-to-face event. She shared with the team that her GP was not supporting her needs with her confirmed diagnosis of autism and struggled to call the surgery at 8.00am to arrange an appointment if needed, due to her prescribed medication causing fatigue for her in the morning. Miss V had contacted the GP on several occasions however felt the receptionist would not listen and lacked empathy.

The Time2Talk Team contacted Miss V to discuss her concerns and to seek consent to contact the GP practice on her behalf. Miss V added that she was upset that reasonable adjustments were not considered for her. The team made contact with the practice manager to discuss the concerns raised and requested that reasonable adjustments were made with Miss V. The practice manager investigated the concerns raised and contacted Miss V to offer apologies and discuss what adjustments can be put in place. Miss V provided feedback that she felt listened to and was pleased with the outcome.

The Black Country ICB’s Complaints Policy is currently being revised to reflect the change in responsibility from 1 July 2023. All primary care concerns will be handled by the ICB's Time 2 Talk team including GP, dental, optometry, and pharmaceutical concerns and primary care formal complaints will be dealt with by Birmingham and Solihull ICB as the primary care hosts.  

In May, we received 87 contacts, a slight increase from the previous month, of which were concerns and queries and no formal complaints. The top theme of concern were delays in appointments, administrative errors, and access to treatment and drugs.

Concern example

As well as handling informal concerns, compliments, and signposting patients around the health service, Time2Talk is also responsible for handling complaints.

Miss K contacted the team to explain she was unhappy with her GP practice and felt there was a lack of care and support being offered to her whilst she was trying to obtain her medication for her mental health.

Miss K had been discharged from the hospital and had contacted her GP practice following a review of her medication. Her GP had not received the discharge paperwork from the hospital with the new medication listed and were unable to prescribe the additional medication.

The patient felt anxious and frustrated so contacted the team to look into the issue. It was identified that the member of staff who issued the discharge paperwork had taken an unplanned absence which caused a delay in the paperwork being issued to the GP. Miss K was signposted by her GP to the appropriate services to obtain her medication during the interim and apologies were given.

The investigation identified that the process needed to be reviewed to ensure that in the future discharge paperwork is issued in a timely manner.  As a result of this concern, a new pathway has been created to ensure that appropriate cover is put in place for staff sickness and annual leave.

Overall, Miss K was very happy with this outcome and thanked the Time2Talk Team for their help and support.

In April, we launched an interpreting service with more than 350 languages available. This means people, whose first language is not English, can contact the team to share concerns, complaints, and compliments about health services. Read more about the interpreting service.

As a first point of contact service, we received 75 contacts in April, which was fewer than those received in March (135). Despite the fewer number of contacts, they were more complex issues than in previous months. Of these contacts, we received three compliments and were thanked for “Listening and signposting [me] to services in the community”.

The top theme of concerns and complaints received were about access to treatment and drugs in Dudley, Sandwell, and Wolverhampton, and administration errors in Walsall.

Complaint example

As well as handling informal concerns, compliments and signposting patients around the health service, Time2Talk is also responsible for handling complaints.

Mrs. S wanted to raise a formal complaint about the Continuing Healthcare (CHC) Team. The complainant had attempted to organise a CHC Assessment for her husband who is a palliative care patient. Mrs. S was very unhappy at the length of time the teams were taking to respond to her concerns and queries.

The Time2Talk Team liaised with the Head of CHC on behalf of Mrs S, and an internal investigation was carried out. The outcome of this complaint was partially upheld, and learning had been identified, however. Mrs. S remained unhappy and had further queries.

Due to Mrs. S’ personal circumstances and her request to discuss her additional concerns face to face, a home visit was undertaken by the Deputy Chief Nursing Officer and the Customer Service Manager. Mrs.S was extremely grateful that staff had considered her difficult circumstances and for all the help and support the team had provided her with. She was very thankful for the team’s hard work.

We dealt with 135 contacts in March, compared with 196 recorded in February. The noticeable reduction is attributed to the fall in concerns raised regarding one Dudley GP practice, as detailed in the February update. As a result of this feedback, the ICB met with the practice representatives to discuss and support the team where possible. The number of concerns for this practice have since dropped significantly.

The most common theme for complaints across all four boroughs was ‘access to treatment and drugs’ and applications for NHS funded IVF treatment.

We also received five compliments - an example is included below.

Example compliment

A patient from Broadway Medical Centre, Mrs A, had contacted her GP practice and was offered a telephone consultation for her 5-year-old child. Based upon this consultation the GP felt that a face-to-face appointment was needed and although there were no available slots at Broadway Medical Centre on that day, an appointment was arranged through ‘Our Net’ for the child to be seen at Darlaston Health Centre. Mrs A advised that her son was very anxious to see a new GP, however, the GP at Darlaston Health Centre “picked up on this and was brilliant, kind, caring and made her son feel very relaxed”.  Mrs A stated she felt it was important to provide feedback particular as she felt her own GP had gone above and beyond.

The team thanked Mrs. A for her feedback and ensured her compliments were fed back to the appropriate teams/staff.

We received 208 contacts in February 2023, a significant increase from 105 contacts received in January. The top theme from patients/carers was ‘Access to Treatment and Drugs’. Examples of this were excessive telephone waiting times, online appointments unavailable in advance, and unable to see a doctor to obtain a repeat prescription.

This increase was the rest of a surge of contacts from patients registered with a Dudley GP practice. 116 patients shared their experiences within 48 hours - this information is valuable insight that allows the ICB to review contracts, service demand, and the general quality of services.

Case study of an informal concern

A parent of a patient registered with a Dudley GP, was extremely concerned about their child’s worsening behaviour and felt that no one was listening. The patient’s GP suspected ADHD, Autism, or Tourette’s syndrome and referred the child twice to the Child and Adolescent Mental Health Services (CAMHS) service. The referrals were rejected based on an earlier clinical report produced by the paediatric Team at Dudley Group NHS Foundation Trust.  Time2Talk raised this with the appropriate provider (Black Country Healthcare NHS Foundation Trust) who have since agreed that the CAMHS ADHD clinic will review the evidence provided by paediatrics and provide a second opinion on the child. The parent was very relieved and said: "Thank you for responding so quickly and supporting me with my concerns”.

We attended a number of People Panel gatherings across the four boroughs to promote the service and gain useful patient experiences. We received positive feedback from a patient at the event who shared with us that he had always had a good experience with the NHS and empathised with the pressures that the NHS were facing. We also heard this compliment from an attendee: “Thanks for taking the time to listen to me and signposting me to warm spaces”.

We received 105 contacts in January, a slight increase from the 98 contacts we received in December 2022. The top theme from patients/carers was ‘Access to Treatment and Drugs’ – this can range from anything from cough medicine no longer being available on prescription, to funding for cancer medicines.