Welsh Redress and Putting Things Right – You’re Not On Your Own.

Clinical complaints in Wales are sometimes suitable for consideration under the NHS redress scheme, known as the Putting Things Right (“PTR”) scheme. The PTR scheme was introduced in 2011 and is a method of investigating and dealing with complaints about the NHS in Wales, providing the opportunity for redress by way of an apology and a financial award up to the value of £25,000.

The guidance applies to all health boards or NHS Trusts in Wales and the term “concern” means any complaint, claim or reported patient safety incident.

So, what happens with your complaint under the PTR scheme?

How to raise a concern?

In the first instance, a concern should be raised to the health board about which you are complaining. This can be by way of letter, email or verbally, and the person raising the concern does not necessarily need to be the person who received the treatment. The scheme does identify that a concern should be raised no later than;

i) 12 months from the date of the treatment, or
ii) 12 months from the date the person raising the claim realised they had a potential concern

The complaint should set out the extent of any concern(s) and a list of any potential questions you may have about the treatment that you would like answers to. We would advise setting the complaint out in a letter/email is the best way to ensure your all relevant information is included.

Investigation period

Once a concern has been raised, the health board has to investigate and provide a letter of response containing their position and setting out the next steps.

In order to successfully obtain redress for your complaint, the health board will need to establish a “qualifying liability”. This is a two stage test where, much like the legal tests for clinical negligence in civil litigation, you have to establish;

a) A breach of duty – i.e. that the care or treatment provided fell below a reasonable standard.
b) Causation – i.e. that harm has been caused to the patient due to the breach of duty.

There are a number of potential responses that you could receive;

1. A qualifying liability exists

The health board could accept that there is a qualifying liability in your case and clarify the extent of this. They will often offer redress in their response which can be an offer of financial compensation up to £25,000, an apology, offer for rehabilitation/future treatment and details outlining how they have taken steps to prevent future incidents of the same nature, or a combination of all of these.

2. A qualifying liability may exist

Here, the health board may establish a breach of duty but they need to undertake further investigation as to the extent of causation. This may include jointly instructing a medico legal expert to provide a report dealing with this.

3. A qualifying liability doesn’t exist

If the health board are of the view that, following their investigation, no qualifying liability exists, they will set out their reasoning as to why. This does not necessarily or immediately mean you have no alternative options. They will often set out alternative avenues for you being contacting the ombudsman or pursing a civil claim for clinical negligence.

4. The value exceeds the redress threshold

In this scenario, the health board may well be able to identify that there is a qualifying liability, but they believe that the potential value would exceed the £25,000 limit. They will typically not identify in their response their position on liability, and instead set out that you should seek legal advice on pursuing a civil clinical negligence claim.

Limitation

Clinical negligence claims have a general limitation period of three years, which will run from either the date of negligence or your date of knowledge of the potential negligence. For concerns considered by the redress scheme, limitation will be paused from the date of the health board’s acknowledgement of your complaint if a qualifying liability is found or if it may exist.

It is always best to bring a claim as soon as you can, or as soon as you are aware of a potential concern to avoid any issues with limitation. It will also be important to establish with the health board that limitation has been paused, over just assuming it will be without specific confirmation.

How can we help?

The health board have a duty to fund the costs of legal advice where a qualifying liability does or may exist. Lanyon Bowdler are recognised by the health boards as being able to offer advice under the redress scheme if a qualifying liability exists, and therefore the health board can pay the costs of us providing that advice to you. We are experts in clinical negligence claims and have significant experience in advising on redress concerns. It is important that you seek legal advice to ensure any offer of redress made is suitable, and all aspects of any potential claim have been considered.

Additionally, If you think you may have suffered medical negligence and would like more information about making a civil claim, please do get in touch via the contact us link on this page or by calling 0800 652 3371.