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DECISION FORM 2.0
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Decision
Assessment decision
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Provisional views
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Final decision
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Case details
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Person(s) affected
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person affected is not
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Organisation(s)
complained about
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Theme(s)
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guidance
Risk and mitigation plan
Assessing Risk Section 1 – Service Model General Guidance
1
Using the risk matrix as a guide explain: Casework risk assessment tool
Description of type of risk/s: explanation including if no risks identified:
Description of the impact: (delete as applicable) People/Financial/
Reputational/Political /Customer Service/Legal
Severity of the impact on risk:(delete as applicable)
- Minor/Moderate/Critical
Explanation:
Likelihood of risk occurring: (delete as applicable)
- Unlikely/Likely/Highly likely
Explanation:
What is the initial risk rating? (delete as applicable)
– Low/Medium/High
Mitigation plan: Explain if and what we can do to mitigate the risk and to what extent
this will reduce likelihood and impact.
Overall risk rating, in light of mitigation?
Low/Medium/High
Summary of complaint
2
Claimed failings:
Repeat for each organisation/named person
Impact the complainant claims flows from each claimed failing/category of claimed
failings: Repeat for each organisation/named person
Outcomes the complainant wants:
Repeat for each organisation/named person
Assessment planning and complaint background
3
Give details or delete where applicable.
Background/chronology:
Assessment planning considerations:
Key evidence required and impact on the assessment:
Named people:
Contract arrangements (for primary care):
Can we investigate the complaint?
4
Is the complaint in remit? Remit guidance
Is the organisation complained about in remit? Yes / No (give details then proceed to 19)
Is the subject matter complained about in remit? Yes / No (give details then proceed to 19)
If answer cannot be found in the service model guidance please contact:
5
Is this case joint working? Joint working guidance
No / Yes (If yes, give details and email
to obtain approval
from JWA decision makers to transfer the case)
6
Is the complainant suitable? Suitable complainant guidance
Yes (give details) / No (give details)
Representative used?
Consent confirmed?
7
Is the complaint premature? Premature guidance
No / Yes (If yes, give details and proceed to 19. If yes and also out of time, please
manage the complainant’s expectations)
8
Time consideration Time consideration guidance
Date of complaint to us (health):
Date of complaint to MP (parliamentary):
Date of events:
Date of knowledge: give details
By how long is the complaint out of time?
The complaint is: out of time (proceed to 9) / in time (proceed to 10)
9
If out of time, the caseworker should make these considerations according to the
circumstances of the case. Out of time guidance
Complainant's explanation for the delay:
Time taken for local resolution to be completed:
Scale of the injustice:
Wider public interest:
Is an investigation practical/how available is the evidence:
Any other factors to consider:
Conclusion:
We should: Put the time limit to one side / decline as out of time (proceed to 19)
10
Does, or did the complainant have an alternative legal remedy available to them?
ALR guidance Also See: Legal briefing note
No (give details and proceed to 12)
/ Yes (fully or partly?)
Explain ALR considerations, including whether it is available for all the issues complained
about or just some of them.
11
Is it reasonable for the complainant to pursue ALR?
ALR guidance Also See:
Legal briefing note
Factors you may wish to consider if relevant to the case:
- Is or was the legal route the only way to obtain outcome sought?
- Is the amount of financial remedy the person wants proportionate to legal costs?
- Would legal action achieve all of the outcomes sought?
- Can the complainant obtain the relevant funding for making the claim?
- How difficult would be for the complainant to make the claim due to the complexity
of the legal action required?
- Does the complainant not want to pursue legal action and is there is a good reason
why. (E.g. very intimidated or frightened of attending court)?
- The age and particular circumstances of the complainant.
- The time that the complainant would need to pursue legal action. For example, does
the complainant have a terminal illness and we can achieve the outcome they want?
Conclusion:(give details)
Decision: Not reasonable to pursue ALR / Decline as reasonable to pursue ALR (proceed
to 19)
Precedent check
Precedent checks guidance
12
Precedent check completed? Yes/No
Outcome:
Should we investigate the complaint?
13
Is there another dispute resolution forum that is reasonable for the complainant to
pursue? Another dispute resolution forum guidance
Forum available
GMC / NMC / ICO / Other (please specify) / None (proceed to 14)
Give details including whether this addresses all issues raised and provides full outcome
sought
Is it reasonable for the complainant to pursue it? Yes (explain why and proceed to 19) / No (explain why more suitable for us)
14
Are there any indications of maladministration or service failure? Indications of maladministration guidance
Yes / No (proceed to 19)
Address each head of complaint
15a Indications of injustice? Indications of injustice guidance
Is there an indication of the claimed impact? Give details. Include consideration for each claimed impact.
Does or might it flow from an indicated failing? Give details. Include consideration for each claimed impact.
Are there any indications of an injustice flowing from the maladministration or
service failure? Yes / No (proceed to 19)
15b Is the injustice still unremedied? Unremedied injustice guidance
Has the organisation already acknowledged the claimed injustice?
What has the organisation done to put right the claimed injustice?
Is this enough?
16
Have you agreed a resolution? Resolution guidance
Yes (give details and proceed to 19) / No (give details)
17
Are there any other reasons to decline to investigate? E.g. cannot achieve outcome
sought: Any other reason to decline to investigate guidance
Yes (give details & proceed to 19) / No (give details)
Material evidence for assessment decision
Material evidence (Assessment) guidance
Please speak with our DP Team for any advice you may need on sharing material evidence
externall
y: xxxxxxxxxxxxxxxxx@xxxxxxxxx.xxx.xx
Documents
Activities
Assessment
Case discussion notes
18
Complex/Senior/Caseworkers: (Where applicable) Record key points of discussion with
OM/AD and rationale for assessment decision.
Complex Caseworkers: If proposing to investigate, use this discussion to agree the scope
and focus of the investigation with OM/AD.
Assessment decision summary
19
(DELETE AS NECESSARY)
Approved by OM/AD:
Date:
Adjudicated at assessment
Reason for closure: (one of the grounds above 1-17)
Action to be taken: (delete as necessary) proceed to
Resolution agreed
investigation / transfer to …. team / close with
explanation
Proposal to investigate
Proposed scope
Proposed scope guidance
20a Record the proposed scope with the exact wording:
Consideration of comments on proposed scope
Comments on proposed scope guidance
20b Comments received on the proposed scope? Please provide further details.
20c Does your consideration of the comments indicate we should amend the scope or we
should not investigate the complaint for any other reason? Please provide further
details.
Proposed revised scope (where applicable)
20d This should take account of any preliminary discussions you have had with a clinical
adviser about the organisation’s/individual’s response to the complaint, as well as your
discussion with the complainant about their key concerns.
Agreed scope
Confirming the investigation/agreed scope guidance
21
Include claimed failings, injustice and outcomes agreed with all parties.
Risk assessment
Confirm the investigation
22
A risk assessment is required when we confirm the investigation
Casework risk assessment tool
Refer to the considerations recorded at the initial risk assessment and provide details
of any changes to the risk rating:
Risk rating:
Impact
Likelihood
Overall rating
(delete as
applicable)
Minor/Moderate/Critical
Unlikely/Likely/Highly likely
L/M/H
Investigation plan
Investigation planning guidance
23
Use the Work Plan at section 31 to record target completion dates for key milestones
throughout the investigation
Agreed communication plan with the complainant:
Agreed communication plan with the organisation:
Senior/caseworkers: Use the following sections where applicable.
Complex caseworkers: Use the following sections as the basis for discussion with your
operations manager/AD.
Particular issues to be aware of Diversity (complaint):
Diversity (complainant/aggrieved):
Human rights:
Precedent information: Include any relevant precedent information (previous
investigations into the organisation(s), whether the complaints were upheld, any
recommendations made for systemic redress and information about recent action by the
organisation/organisations following those recommendations)
Section 6 – Service Model Main Guidance
Evidence needed to address the complaint:
Interviewing Interviewing guidance
Say whether or not you propose to interview the complainant and/or clinical staff and
give reasons for your proposal. (E.g. whether it is necessary to offer a face to face
meeting on Skype or in person). Your proposal should take account of whether an
interview will add value to the investigation, and the risks associated with not
conducting interviews.
Clinical advice (including proposed questions to the adviser)
Any other advice? (e.g. legal advice)
Specific proposal for discussion at planning meeting Any other specific proposals for
discussion at the meeting beyond those issues already considered
Investigation
Case discussion and planning notes
24
Senior/caseworkers: (Where applicable) Record key points of discussion with OM/AD.
Complex caseworkers: Use this discussion to agree next steps in the investigation with
your OM/AD and record the key points.
Manager/director agreement to the record of the outcome of the planning meeting
25
Approved by OM/AD:
Date:
Analysis of evidence and advice
Section 7 Service Model Main Guidance
26
Provide analysis of the evidence and advice you have received (where applicable)
that you will use in the provisional views report
Consider weighting of evidence: (Clearly evidencing how clinical and/or legal advice has
had a bearing on reasoning).
Include any evidence you have not relied on and why.
Include any clinical/legal advice that you have challenged and why.
Risk assessment
Provisional Views
27
A risk assessment is required when before we send the provisional views
Casework risk assessment tool
Refer to the considerations recorded at the initial risk assessment and provide details
of any changes to the risk rating:
Risk rating:
Impact
Likelihood
Overall rating
(delete as
applicable)
Minor/Moderate/Critical
Unlikely/Likely/Highly likely
L/M/H
Please confirm you are satisfied with the provisional views
28
Provisional views:
(Delete as applicable) Upheld / Partly upheld / Not upheld
Approved by OM/AD:
Date:
Comments on provisional views
Comments on provisional views guidance
29a Comments received from organisation / named persons
Give details and consideration of comments
29b Comments received from complainant
Give details and consideration comments
Material evidence for investigation decision
Material evidence (Investigation) guidance
Please speak with our DPA Team for any advice you may need on sharing material evidence
externall
y: xxxxxxxxxxxxxxxxx@xxxxxxxxx.xxx.xx
Documents
Activities
Please confirm you are satisfied with the final decision
30
Final decision
(Delete As applicable) Upheld / Partly upheld / Not upheld
Approved by OM/AD:
Date:
31
Work plan
Remember to take account of leave, existing workload and other factors which will
affect the speed of the investigation. Your manager and director will expect you to
adhere to the work plan unless stated otherwise.
Target for confirming scope of investigation to organisation
DD/MM/YYYY
Target for confirming scope of investigation to complainant
Target for interviewing complainant
Target for requesting advice
Target for receipt of advice
Target for case conference (if needed)
Target for clinical interviews (if needed)
Target for sharing provisional views with OM
Target for sharing provisional views with Director (if needed)
Target for sharing provision views with organisation
Target for sharing provisional view with complainant
Target for receiving comments/additional evidence on provisional views
Target for issuing final report
Plan agreed on:
Updates to the work plan
Provide an explanation for any substantive changes to the work plan here.