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ANNUAL REPORT ON PUBLIC APPRECIATION, FEEDBACK & COMPLAINTS MANAGEMENT 2016/17

Page No.

INTRODUCTION 1

Section I The HA Complaints System

A. Two Levels of Complaints Handling 2

B. Structure and Mode of Operation 2-3

Section II HA’s Complaints & Feedback Management

A. Complaint Handling at the First Level 4

B. Corporate Level of Handling 4-5

C. Statistics: Appreciation, Complaints & Feedback 5

D. Patient Experience and Satisfaction Surveys 5-7

E. Enhancing Capacity & Staff Competencies in Conflict Resolution 7-8

F. System Improvement: Progress 9

G. External Relations and Communication 9

Section III Work of the Public Complaints Committee (PCC)

A. Appeal Cases Handled by the PCC 10

B. Observations 10-11

C. Initiatives to Improve Handling of Appeal Cases 11-12

D. Recommendations 12

E. Case Illustrations 12-15

APPENDICES

INTRODUCTION Obtaining feedback from service users is one of the effective ways to enable HA and its hospitals to achieve the objective of providing quality patient-centred healthcare services to meet the needs of the community. Complaints, as well as appreciations, serve as useful indicators of patient satisfaction. Rather than treating them in a negative perspective, complaints and feedback are regarded as an opportunity to improve public hospital services. As a further step forward, the Hospital Authority (HA) has followed the international trend of employing Patient Experience and Satisfaction Survey (PESS) to proactively engage patients for feedback. Complaints may arise from a diverse number of causes. These include: unmet expectations (dissatisfaction with services provided or treatment outcome), miscommunications and attitude problem that required clarification, lack of understanding of the nature of medicine (complications may be misconstrued as medical incidents), the grief of relatives of deceased patients, and allegations of wrongdoing of healthcare professionals and/or teams. The aim of the HA complaint handling system is therefore to provide an easily accessible, efficient and effective avenue for addressing complaints fairly, impartially and effectively, both for the complainants and those complained against. In complaint handling, it is essential to be just and fair to both the complainant and staff in the review of matter(s) under complaint, and HA has adopted the following approaches:

− Both the complainant’s and staff’s versions of the incident are given due consideration.

− All the concerns and allegations of the complainant are addressed

and the decision reached is clearly explained.

− Suitable acknowledgement is given if a complaint is justified. Where a complaint is not justified, the complainant should be informed accordingly and that the staff must be fairly treated.

− To provide appropriate assistance to patients and complainants as

far as possible.

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Section I The HA Complaints System A. Two Levels of Complaints Handling

Since its inception, HA has established a two-level complaints system to handle public complaints. As complaints are in general most effectively handled at the point of service delivery, all complaints are handled by the respective hospitals/clinics in the first instance. Complainants who are dissatisfied with the outcome of their complaints can appeal to the Public Complaints Committee (PCC) of the HA Board for a review of their cases. B. Structure and Mode of Operation (a) The First Level

At the hospital level, the Hospital Chief Executive is ultimately responsible for the proper handling of complaints against the hospital, and the target response time is 6 weeks from receipt of the complaint/feedback. (b) The Second Level

PCC was established under the HA Board to independently

consider and decide on all appeal cases. The Committee is the final appeal body within HA in respect of complaints.

Membership

PCC comprises the Chairperson, 4 Panel Convenors and 23 members. Of all the 28 members, 4 are HA Board Members while 24 are from the community. None of the members is a HA employee and the majority are outside the medical/healthcare field with diverse backgrounds. The PCC membership list is in Appendix 1.

Terms of Reference

PCC’s terms of reference and complaints handling guidelines are in Appendix 2.

For efficient handling of complaint cases, PCC has established 4

Case Panels, an Interview Panel and a Fast-track mechanism on handling repeated appeals:

The Case Panels

Four Case Panels have been established to deal with individual appeal cases. Recommendations to HA/hospitals for improvement

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are made by the Panels where deficiencies in service delivery are discovered in the course of handling complaints.

The Interview Panel

The Interview Panel comprises a convenor and at least 2 regular members of the relevant Case Panel. It conducts separate interview sessions with the complainant/patient, staff under complaint and witnesses, if any. The aim of an interview session is to seek a fuller picture of the issue at hand to assist the Panel in making a decision. Fast-track mechanism on repeated appeals

From time to time, PCC received requests for re-opening of appeal cases which had already been concluded. A fast-track handling mechanism was established to expedite the processing of these repeated cases. Upon review and confirmation that there is no ground for re-opening a case, PCC would inform the complainant that PCC had responded fully to the complaint and the case would be closed. When an appeal in respect of a complaint is received, one of the

Case Panels will undertake a thorough review of all available evidence including the patient’s medical records, reports from staff and statements from witnesses, if any. It will also seek expert opinions whenever necessary. Separate interviews by the Interview Panel with the complainant, staff under complaint and witnesses may be arranged as deemed necessary by the Case Panel.

(c) Liaison with the Coroner’s Court

In accordance with the Coroner’s Ordinance, HA and its hospitals

are required to report certain death cases. It is not uncommon to find that relatives of a deceased patient have lodged a complaint with HA, while the death case is simultaneously reported to the Coroner. In such circumstances, PCC will suspend its deliberation on the case until the Coroner has taken a decision on whether or not a death inquest is required. The Coroner’s Court has made an arrangement with HA whereby PCC is informed of the progress of a case under the Coroner’s consideration. This helps ensure timely reactivation of the case handling by PCC once the Coroner has made a decision. (d) Performance Target

PCC’s target response time to complaints is 6 months. Complex cases would take longer.

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Section II HA’s Complaints & Feedback Management A. Complaint Handling at the First Level (a) Local Resolution

Very often complaints have arisen from queries or unmet expectations on certain aspects of medical treatment or administrative procedures. As such, the “complainants” in these situations may be seeking clarifications or assistance to navigate in the public hospital system. To promote a positive complaint management culture, front-line workers are encouraged to take ownership, proactively communicate and provide assistance to patients. Local resolution is therefore the main emphasis in the first-level case handling, with appropriate assistance to be provided to patients and complainants as far as possible. (b) Patient Relations Office

The Patient Relations Office, a distinct functional entity of the hospital administration, is the contact point to help early communication and alignment of viewpoints among all concerned parties (both complainants and healthcare providers) should a case be formally taken up as a feedback or complaint. Patient Relations Officers (PROs) serve as an effective channel of communication between complainants and staff complained against.

Both at the level of clinical units and the PRO, early and effective communication is crucial in addressing the grievance and complaints. B. Corporate Level of Handling (a) HA Head Office

At the Corporate level, the Director of the Quality & Safety Division (Q&SD), HA Head Office, is overall in charge of the corporate function in complaints & feedback management. He is supported by the Patient Relations & Engagement Department (PRED) of Q&SD, to oversee the corporate complaints & feedback management work. PRED is also the executive arm of the Public Complaints Committee, which is the second level and final appeal body within HA.

(b) Central Committee (Complaints Management and Patient Engagement)

The Central Committee (Complaints Management and Patient Engagement) (CC(CM&PE)), comprising clinical leaders and management from 7 hospital clusters, was established to enhance the overall management of patient relations. The terms of reference of CC(CM&PE) are at Appendix 3. CC(CM&PE), -----

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together with its three Sub-committees on “Complaints System Review”, “Training and Development in Complaint Management” and “IT Systems on Complaints and Feedback Management”, is tasked to align the policies, standard and practices of various aspects of patient relations and complaint management of public hospitals. C. Statistics: Appreciation, Complaints and Feedback

HA’s 5-year statistics on complaints, feedback and appreciation are

presented in Appendix 4. The statistics for 2016/17 are summarised as follows:

Complaints1

Feedback2 Appreciation3

HA hospitals 3,106 11,539 46,518 General Outpatient Clinics ( GOPCs )

187 920 5,038

Total 3,293 12,459 51,556

HA and its hospitals provide a substantial volume of healthcare services each year. Given the large number of appreciation received, the majority of patients appears satisfied with the HA services they receive. To put the numbers of complaints in perspective, the volume of services HA provides is shown in the table below.

Types of HA Services

Volume ( 2015 – 16 )

Inpatient and Day patient discharges Over 1.66 million Patient days ( including day patient discharges ) Over 8.34 million Accident & emergency attendances Over 2.23 million Specialist outpatient attendances Over 7.31 million General outpatient attendances Over 5.98 million

( Source: HA Annual Report 2015-16)

Analysis of the GOPC statistics and content of complaints and feedback revealed that the issues were mainly related to appointment booking and queuing systems, and the overwhelming service demand.

D. Patient Experience and Satisfaction Surveys Against the background of rising community expectation for better care and higher accountability, HA has followed the international trend of employing experience/satisfaction survey to measure and monitor patients’ experience. The first Inpatient Survey in 2010 using a validated tool was the first

1 Complaint - an expression of dissatisfaction 2 Feedback - an expression of opinion 3 Appreciation - an expression of gratitude

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of its kind in any Chinese community in Asia.

Over the years, Patient Experience and Satisfaction Survey (PESS) has become an integral part of the governance framework to engage patients to improve quality for patient-centred care. Significant progress has been made for systematic planning, development of validated instruments (questionnaires) and follow-up on PESS. (a) Publication of the Results of the Inpatient PESS for 25 hospitals

Following the Corporate PESS Service Plan, the third Inpatient PESS was conducted in 2015. Public reporting on the findings was conducted in September 2016. The survey results were positive and encouraging. The overall score on inpatient service was 7.8 out of 10, with high degree of confidence and trust in the doctors (9.3 out of 10) and nurses (9.4 out of 10). Areas for service improvement identified included information giving on (1) medication side effects to watch after discharge; (2) danger signals to watch for after discharge; and (3) patient care and recovery for the patient’s caregiver. The survey results have suggested sustained momentum with a high degree of engagement for both staff and patients towards PESS and patient-centred care. Appropriate follow-up actions are in progress. The Full Report is available on the HA website. (b) Future Corporate Survey Plan

Re-naming: Patient Experience Survey Over the years, PESS has been very well received and proven to be an effective means to engage patients, staff and the public for quality improvement. At the international level, researches have shown that patients’ satisfaction are influenced by a myriad of factors (individual health conditions or other socio-economic/-psychological factors) and might not directly relate to the quality of hospital service received. To better reflect the survey objectives and align with the practices of other developed countries such as the UK, the survey will be re-named as “Patient Experience Survey (PES)”. Survey Plan To facilitate systematic planning and development of PES, and to ensure a structured longitudinal monitoring of patients’ view, HA will continue to conduct corporate-wide Inpatient Survey at regular intervals. In between, there will be Surveys on Specialist Outpatient Service or Specialty-based service to address specific areas or issues.

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PESS on Accident & Emergency (A&E) Service The PESS on A&E Service was launched in August 2016, covering more than 9,000 patients attending the A&E Department of 17 public hospitals. Survey aspects include patients’ experience on the registration process and waiting time; environment and facilities; and hospital staff. The data collected are being analysed and the results is scheduled for public reporting in late 2017.

(c) Enhanced Follow–up Mechanism Based on the consistent survey results over the last five years, it is noted that patients’ experience was generally very positive. HA received high ratings on “overall patient experience”, as well as “confidence & trust” in doctors, nurses and other healthcare workers. However, there are two specific domains which have consistently recorded relatively low scores and/or wide variations among the Clusters/Hospitals. Consistent patient feedback indicated their need for (a) “Better communication with healthcare workers”; and (b) more information on “Medications and their side effects”, “Post-discharge self-care” and “Danger signs to watch out for” after discharge. At both the Cluster/Hospital and Head Office levels, structured mechanisms are in place to follow up through quality improvement programmes vide the HA’s annual planning exercise. To ensure proper follow up and to enhance robustness of the follow-up mechanism, the Head Office Central Committee (Complaints Management & Patient Engagement) (CC(CM&PE)), comprising representatives of 7 Clusters, has recently set up two Work Groups tasked to drive improvement action plans on two specific targeted domains identified, i.e. Compassionate Communication and Information Giving upon Discharge. Progress of implementation would be reported in due course. E. Enhancing Capacity & Staff Competencies in Conflict Resolution

For healthcare workers, complaints management is challenging as it requires competencies other than clinical skills. These competencies include awareness and acumen of the current political and societal trends, investigation skills, mediation/counselling skills, empathy and tact, verbal and written communication and public relations skills. Training programmes and activities in 2016/17 were as follows: (a) Enhanced Communication Training

Through collaborations with the HR Training & Development Department, hot scenes and cases of educational value were employed to develop the curriculum of the new Patient-centred Communication Programme

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launched since October 2013. So far, around 4,700 front-line healthcare workers have attended the training. (b) Complaint Management and Conflict Resolution Training

In support of the Government’s advocacy of mediation to build harmony, continuous efforts have been made by CC(CM&PE) to promote applied mediation skills in communication and conflict resolution. The following specific programmes were implemented:

Sponsorship programme on accredited mediation courses

Since 2011, HA has been sponsoring staff to attend accredited mediation course. In 2016-17, 89 front-line doctors, managers with patient care duties and staff of the Patient Relations Offices attended accredited mediation courses organised by universities or tertiary institutes. The objective of the training is to empower and sharpen the skills of front-line staff in conflict resolution at source (point of care). So far, over 550 HA front-line healthcare staff have received this 40-hour formal mediation skills training.

Programme-based applied mediation skills training for conflict resolution

With a view to ensuring effectiveness of the training courses, clinical leaders of 7 hospital clusters participated in the course review to enable co-design and co-production of the course content and format of training to meet the practical needs of front-line workers. Over 560 front-line workers attended programme-based workshops on conflict resolution through case sharing and role-plays on difficult clinical interactions at the front-line.

(c) Patient Engagement Forum in HA Convention 2016

A patient engagement forum with participation of 350 attendees was held in the HA Convention in May 2016. Fruitful exchange and sharing with patient group representatives were conducted on the following topics:

- Insights from HA’s Patient Satisfaction/Experience Surveys

and the Current Worldwide Movement to Enhance Patient’s Experience

- What Matters? — Perspectives and Challenges for Better Patient and Staff Experience

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F. System Improvement: Progress Complaints and Feedback Management

The key objective of the system is to enable monitoring of complaints and feedback received for quality and risk management purposes. Through concerted efforts of the CC(CM&PE) and complaint management personnel of 7 clusters, construction of an on-line Complaints & Feedback Management System (CFMS) was started in 2011.

This uniform electronic platform for reporting complaints and

feedback across clusters has enabled online reporting and monitoring of complaint and feedback handling by Patient Relations Officers of all public hospitals. The CFMS was rolled out to all Cluster Patient Relations Offices in the second quarter of 2017. Complaint Management Audit A Group Internal Audit was conducted in the fourth quarter of 2016 on HA’s complaint handling. The Audit findings would provide an independent assurance of the HA Complaints System, and identify areas for improvement. G. External Relations and Communication

Through regular liaison with local and overseas complaint redress organisations and various stakeholders, HA is kept abreast of good practices, latest research, trends and development of both local and overseas complaints redress mechanisms. The following is a summary of the activities held in 2016/17:

− Sharing at TV Programme: The Pearl Report on the Patient Experience & Satisfaction Survey as well as insights from healthcare complaints management

− Sharing with the People’s Daily on the HA Complaints System and the related training for hospital staff

− Poster Presentation on the Patient Experience and Satisfaction

Survey at the Conference of International Society for Quality in Healthcare in Japan

− Presentation of HA’s work on Patient Experience and Satisfaction

Survey at the Conference of the International Healthcare Federation in Durban, South Africa

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Section III Work of the Public Complaints Committee (PCC) A. Appeal Cases Handled by the PCC

During the reporting period, PCC held 19 meetings. The total

number of appeal cases taken to PCC in 2016-17 was 349. Of these cases, 302 cases (87%) were concluded while 47 cases are still under investigation. The performance target of PCC is to conclude an appeal case within 6 months. During the reporting period, PCC’s performance on the 302 concluded cases was as follows:

176 cases (58% ) Concluded within 6 months 92 cases (31% ) Concluded within 9 months 34 cases (11% ) Taken more than 9 months to

conclude Cases which took a longer processing time to conclude were highly

complex requiring detailed investigation, repeated clarifications with hospitals and commissioning of independent medical expert reviews.

The categories and trends of all PCC cases were monitored. The data of cases handled by PCC over the past 5 years are shown in Appendix 5.

B. Observations

Out of the concluded cases, 2 cases were found to be substantiated

and 17 cases partially substantiated. A detailed analysis of the unsubstantiated cases showed that these complaints arose mainly because of:

− Lack of understanding regarding medical care (34%) − Unmet expectations regarding HA services (18%) − Misunderstanding in hospital practice (16%) − Breakdown in communication (28%) − Inappropriate use of HA’s complaints system (4%)

PCC’s observation is in line with the results of international research which indicates that adverse outcome in medical care arises from the following two major sources:

Limitations of medicine

Many of the allegations of delayed diagnosis, misdiagnosis, or inadequate/incompetent care arose because of lack of understanding of the limitations of medicine. Certain diseases are difficult to diagnose in the early stages. Some are known to

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deteriorate rapidly and many are without cure. Surgery is associated with risks, and the outcome may not be as expected. Substandard practice arising from system errors or incompetence of individuals _ As modern medical care involves many parties and often complex procedures, medical errors do occur from time to time. HA and its hospitals should make consistent efforts to identify and rectify system errors (that might lead to mishaps). Structured and continuous training of doctors, nurses, and other hospital staff to enhance their competencies would further increase the effectiveness of the public hospital system.

To foster a healthy relationship between the healthcare workers

and patients, PCC advocates more public education, especially on the nature and limitations of medical care, and promotion of a positive and just complaints culture to enhance communication and prevent misunderstanding.

C. Initiatives to Improve Handling of Appeal Cases

PCC’s objective is to provide an independent, accountable and effective complaints system with the ultimate goal of improving service quality. PCC had the following initiatives and activities in 2016/17:

Membership review Four new members were appointed onto the Committee to replace three retiring members including the PCC Chairman. There was also membership rotation amongst the Case Panels to ensure a balance of expertise and experience in complaint assessment. Self-assessment of the Committee’s work As an annual exercise, the Committee conducted a self-assessment on its work in June 2016 to further improve its efficiency and effectiveness.

Transparency and credibility of the PCC To enhance transparency and credibility, this Annual Report covering the work of PCC would be posted on the HA website for easy access by the public.

Analysis of the unsubstantiated cases

The unsubstantiated cases would also be analysed so as to gain a better understanding of the reasons for complaints, address the

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concerns of the complainants and help HA prevent their recurrence. Sharing of observations and mutual exchange with medical experts To ensure fair and objective assessments of cases, PCC regularly consults medical experts for advice on its case assessment. A panel of medical experts was established to support the PCC on a rotating basis. PCC is pleased with the impartial and fair approach of the independent experts in supporting its work.

D. Recommendations

Where appropriate, PCC’s recommendations arising from complaints management on clinical and administrative issues were referred to HA’s respective committees and departments for consideration and follow-up actions.

E. Case Illustration

The following are examples of PCC’s recommendations for more public/patient education arising from a few cases: (a) Tagging of patients as Vancomycin Resistant Enterococcus (VRE) contact

cases Case Background A patient was tagged as a VRE contact case in the Clinical Management System (CMS) after discharge. A few years later, he attended the Accident and Emergency Department (AED) for right ankle fracture. Feeling puzzled by AED staff in full protective gear when treating him, the patient asked the staff for the reason but in vain.

The patient was subsequently transferred to another hospital for further management on the same day. Similarly, the staff handled him in a very cautious manner with personal protective equipment (PPE). He was required to have rectal swab collected for further examination. Not until the patient’s query on the purpose of the examination was he eventually told that he was labelled as “VRE contact” for the hospital admission a few years ago. The patient was dissatisfied with the hospital’s tagging of him as VRE contact without his consent or advance notice.

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Observations PCC noted that HA had guidelines on control of VRE to prevent the outbreak of this multi-drug resistant organism in public hospitals. According to the guidelines, once a patient was confirmed with VRE, contact tracing would be performed to locate all patients who might have contact with the VRE patient. Inpatients identified as VRE contacts would be arranged for a screening for further identification of VRE carriers. As for discharged patients who were suspected with VRE contact during hospitalization, they would be tagged as “VRE contact” in CMS, so that preemptive infection control measures could be performed upon readmission. In essence, the use of PPE would be adopted in the care of VRE contacts so as to reduce the potential risk of dissemination of VRE to other vulnerable patients indirectly through the staff. Rectal swab specimen would also be required for VRE screening. The tagging could be removed only after the VRE screening showed a negative result.

The VRE guidelines did not require the hospital staff to notify a discharged patient or seek his consent before tagging him as a VRE contact. Unlike in the hospital setting where VRE would pose a threat to immunocompromised and severely ill patients who might undergo invasive procedures and under multiple anti-infective treatments, a discharged patient posed a very low risk of harm in the community setting even as a carrier of VRE because the bacteria rarely caused illness in healthy individuals. Hence, the VRE tagging only served to facilitate the implementation of preemptive infection control measures upon readmission of VRE contacts, so as to minimize the risk of VRE spread in public hospitals. Recommendations & follow-up actions Although the guidelines did not require the hospital to notify the patients or obtain their consent prior to tagging, PCC considered that enabling patient access to their own medical information was important. To avoid undue anxiety, reassurance should also be given to discharged VRE contacts that they had a very low risk for infection even as VRE carriers and would not pose a health risk to their family or the public. PCC is pleased to note that HA has followed up on the communication issue arising from the case. A clear and open communication with patients would be done to avoid misunderstanding.

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(b) Queue management and audio/video recording in hospital premises

Case Background

A patient attended a newly operated outpatient clinic where the queue display management system (QDMS) was still at its trial. After the attending doctor showed the patient’s number three times on the display panel within 15 minutes with nobody showing up, the patient’s name was put on the postpone list. The patient later approached the clinic nurse saying that he saw his number flashed for a few seconds on the display panel. The nurse then arranged him to be the next to see the doctor.

The patient demanded an apology from the attending doctor as well as a copy of the computer record of the QDMS. Despite explanation from the doctor, the patient became agitated and started taking audio record of the conversation using his mobile phone. Upon the patient’s refusal to stop taking audio recording, a clinic staff began taking video recording while waiting for the security guards to render assistance. The patient followed suit to take video recording and he also called the police. The patient was eventually seen by another doctor after leaving the consultation room at the requests of other patients.

Observations

PCC noted the frustration patients might have in missing their turns for the consultation. On the other hand, while the clinic staff might feel compelled, under the pressure of adversity posed by the patient’s agitated behavior, to document the incident through video recording, such action might create further tension and infringe on the patient’s privacy.

Recommendations & follow-up actions

PCC recommended that improvement on the QDMS should be made. It is also recommended that training to frontline staff should be enhanced to enable them to better cope with hot scenes and difficult situations.

PCC is pleased to know that the clinic has implemented enhancement to the QDMS, in which announcement of the patients’ ticket numbers over the PA system would be made in addition to the existing visual display. Clinic staff have been encouraged to proactively communicate and reassure the patients waiting for consultation.

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For protection of the patient’s privacy and per his request, the video recording taken by the staff was reviewed and then erased under the supervision of hospital senior management. Lessons learnt in the incident have been incorporated into regular training to enhance the staff’s skills in communication, handling of conflicts and awareness of privacy protection.

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Appendices

Public Complaints Committee Composition and Membership

Chairman Mr Ivan SZE Wing-hang, BBS, HA Board Member* Vice-Chairman Prof Raymond LIANG Hin-suen, SBS, JP, HA Board Member & Panel Convenor Members Dr Jane CHAN Chun-kwong Mr Raymond CHAN Kwan-tak*

Ms Christine Barbara CHAN So-han, BBS* Mr CHAN Wing-kai* Ms Peggy CHING Pui-ki* Mr CHOI Chi-sum* Rev Dr Andrew CHOI Chung-ho Mr HO Sau-him* Mr Herman HUI Chung-shing, SBS, MH, JP* Mr Samuel HUI Kwok-ting* Mr Joe KWOK Jing-keung, SBS, FSDSM* Mr KWOK Leung-ming, SBS, CSDSM* Mr Alex LAM Chi-yau* Ms Lisa LAU Man-man, BBS, MH, JP, HA Board Member* Dr Robert LAW Chi-lim, Panel Convenor Dr Agnes LAW Koon-chui, JP* Mr Peter LEE Shung-tak, BBS, JP* Ms Maggie LEUNG Yee-mei* Ms Manbo MAN Bo-lin, MH Mr Simon MOK Sai-man, MH* Mr TSE Man-shing, BBS, JP*

Mr Paul WU Wai-keung* Ms Lina YAN Hau-yee, MH, JP Panel Convenor* Ms Agnes Garman YEH* Ms Lisa YIP Sau-wah, JP, Panel Convenor* Mr Charlie YIP Wing-tong, HA Board Member*

Legend * Lay members outside the medical / healthcare field

Hospital Authority 15.12.16

Appendix 1

Public Complaints Committee

Terms of Reference

1. The Public Complaints Committee (PCC) is the final complaint redress and appeal body of the Hospital Authority (“HA”).

2. The PCC shall independently :

a) consider and decide upon complaints from members of the public who are dissatisfied with the response of the HA/hospital to which they have initially directed their complaints.

b) monitor HA’s handling of complaints. 3. Pursuant to Para 2 above, the PCC shall independently advise and

monitor the HA on the PCC’s recommendations and their implementation.

4. In handling complaint cases, the PCC shall follow the PCC Complaint Handling Guidelines (Annex) which may be amended from time to time.

5. The PCC shall from time to time and at least once a year, make

reports to the HA Board and public, including statistics or raising important issues where applicable.

[Term-Rev] 30.3.06

Appendix 2(a)

Guidelines on the handling of complaint cases in the Public Complaints Committee (“the PCC”)

1. The PCC is an appeal body within the Hospital Authority (“the HA”) to consider appeals made by the public relating to its services. Based on its Terms of Reference, the following are guidelines set by the PCC to facilitate the handling of complaints.

2. The PCC shall not normally handle a complaint:

(a) if the complaint relates to services provided by the HA more

than 2 years before the date of the lodging of the complaint, unless the PCC is satisfied that in the particular circumstances it is proper to conduct an investigation into such complaint not made within that period;

(b) if the complaint is made anonymously and/or the complainant

cannot be identified or traced;

(c) if the complainant has failed to obtain the proper consent of the patient, to whom the services were provided, in the lodging of the complaint (this restriction will not be applicable if the patient has died or is for any reason unable to act for himself or herself);

(d) if the subject matter of the complaint has been referred to or is

being considered by the coroner;

(e) if the complaint relates to a matter for which a specific statutory complaint procedure exists;

(f) if the complainant or the patient concerned has instituted legal proceedings, or has indicated that he/she will institute legal proceedings, against the HA, the hospital or any persons who provided the services (in any event, the Committee shall not entertain any request for compensation);

(g) if the complaint relates to dispute over the established policies of HA, for example fees charging policy of the HA in respect of its services;

Appendix 2(b)

(h) if the complaint relates to an assessment made by a medical staff pursuant to any statutory scheme whereas such scheme provides for a channel of appeal, for example, the granting of sick leave under the provisions of the Employees’ Compensation Ordinance, Cap. 282;

(i) if the complaint relates to personnel matters or contractual matters and commercial matters;

(j) if the PCC considers that the complaint is frivolous or vexatious or is not made in good faith; or

(k) if the complaint, or a complaint of a substantially similar nature, has previously been the subject matter of a complaint which had been decided upon by the PCC.

3. Taking into account the following:

(a) the disclosure of legal privileged documents in an open hearing;

(b) the disclosure of personal data in an open hearing;

(c) the PCC is not a judicial or quasi-judicial body;

(d) an aggrieved party has other channels to seek redress; and

(e) the PCC should not duplicate the functions of other

institutions such as the courts or the Medical Council;

the PCC considers that its meetings shall not be open to the public. 4. In considering the merits of a complaint, the PCC may from time to

time obtain expert opinion by medical professionals or other experts relating to the subject matter of the complaint. If the PCC considers appropriate, it may also invite the complainant, the patient, the medical staffs or any other relevant persons to attend an interview.

(The above Guidelines on the handling of complaint cases may be amended from time to time as appropriate.)

Central Committee on Complaints Management &

Patient Engagement [CC(CM&PE)]

Terms of Reference

(a) To advise on the strategic direction of complaints management of

HA (b) To follow up recommendations from Public Complaints Committee

on corporate complaints management matters

(c) To promote modernization/enhancement of the governance and structure of complaints management at hospital/cluster level

(d) To formulate implementation plans for enhancement of HA’s complaints management, including: (1) to monitor the trend of hospital complaints and feedback, and

recommend follow-up actions where appropriate; and (2) to promote specialist training, sharing and learning on

complaints management

(e) To provide advice on the following HA-wide projects: (1) Complaint & Feedback Management System; and (2) Patient Experience Survey (PES)

Appendix 3

2012-13 to 2016-17

I. Complaint Statistics of All HA Hospitals

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17

Medical Services 1,402 1,520 1,411 1,561 1,787

Staff Attitude 544 549 461 635 610

Administrative Procedures 444 397 355 390 482

Overall Performance 174 165 140 190 185

Others 77 22 32 32 42

Total 2,641 2,653 2,399 2,808 3,106

II. Feedback Statistics of All HA Hospitals

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17


Staff Attitude 2,693 2,568 2,651 2,634 2,525

Administrative Procedures 2,775 2,675 2,906 2,505 2,711

Overall Performance 2,276 1,825 1,773 1,844 1,794

Others 935 592 595 638 570

Total 12,775 11,642 12,075 11,150 11,539

III. Appreciation Statistics of All HA Hospitals

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17


Staff Attitude 8,187 9,302 11,979 14,041 12,068

Administrative Procedures 1,402 1,723 1,912 1,683 1,442

Others 11,423 13,220 12,659 10,284 7,886

Total 39,522 42,404 46,170 49,421 46,518

Appendix 4(a)

2012-13 to 2016-17

I. Complaints Statistics of All HA GOPCs

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17

Medical Services 73 83 68 91 85

Staff Attitude 94 72 63 97 49



Others 10 10 11 10 1

Total 235 219 177 236 187

II. Feedback Statistics of All HA GOPCs

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17


Staff Attitude 253 266 292 270 248



Others 32 30 38 14 6

Total 1,054 973 1,176 917 920

III. Appreciation Statistics of All HA GOPCs

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17


Staff Attitude 1,435 1,301 1,340 1,300 1,558


Others 541 828 812 613 796

Total 4,009 4,028 4,493 4,002 5,038

Appendix 4(b)

2012-13 to 2016-17

Cases handled by Public Complaints Committee

I. Nature of Complaint Cases

Year Case Nature

2012-13 2013-14 2014-15 2015-16 2016-17


Staff Attitude 32 38 28 43 39


Others 10 12 8 3 5

Total 219 289 281 320 302

II. Outcome of the Complaint Cases

Year Decision

2012-13 2013-14 2014-15 2015-16 2016-17

Substantiated 1 1 4 6 2

Partially Substantiated 12 22 11 15 17

Not Substantiated 176 241 233 276 253

Complaint case not pursued 1 1 2 1 1

Incapable of determination 0 0 1 4 2

Outside PCC’s Ambit 29 24 30 18 27

Total 219 289 281 320 302

Appendix 5

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