Date posted: 01/02/2007

Audience:

  • HR officers
  • All those involved in referring cases to the Scheme Medical Adviser
  • Staff Welfare Officers

Action: For employers to implement the new procedures and review your HR processes and guidance as appropriate.

Timing: Immediate

Detail

  1. The Cabinet Office manages the medical advice contract which currently runs until 31 March 2009.
  2. This EPN introduces a new process using Med 09/05 Complaints Procedure form. You should provide this where a member wishes to make a formal complaint about the standard of service CHS have provided in their contracted role as medical adviser to the Principal Civil Service Pension Scheme (PCSPS) and Civil Service Injury Benefit Scheme (CSIBS) arrangements. This process does not replace the separate medical appeals procedure about CHS recommendations, described in the Medical Guidance Notes (EPN146), nor the Internal Dispute Resolution procedure in Section 9 of the EPG. You should explain this new process to members who wish to complain about the standard of service from CHS. You should also amend your staff communications material where appropriate. We are also issuing guidance to APACs.
  3. This new process does not apply to complaints about occupational health matters which means for this purpose you should not use the Med 09/05 – Complaints Procedure form. If you have a complaint about the service provided by your occupational health provider you should use your existing procedure under your contract.
  4. The purpose of the new process is to provide a structured approach to addressing complaints about the CHS service in dealing with pension and injury benefit referrals. Examples might include matters’ relating to the convenience of any appointment the member was offered or the way the medical consultation was carried out. Where a complaint is made, CHS will carry out an investigation and will take action where necessary.
  5. You should refer all complaints to CHS. If you or your APAC want to raise a complaint you can also use the Med 9/05 form to refer the case to CHS for investigation.
  6. In the past CHS have had difficulties identifying the problem which needs to be resolved where the complaint has not been set out clearly. It is therefore important that in all cases the issues are included on the Med 09/05. You must refer member complaints to CHS who will not accept them from members direct. You will find the Med 09/05 on our website via publications, rules and forms under the forms heading.
  7. The complaints procedure is a means of maintaining strong relationships between CHS, and departments and other bodies who use the contract.

Complaints Proforma

  1. Where a member raises a complaint, you must first decide whether it refers to CHS and you want them to investigate. You may be able to respond to the complaint yourselves, explaining any problems or delays. If you feel that it is appropriate to refer the complaint to CHS, you must ask the member to complete the Med 09/05 or you may complete the form on the member’s behalf.
  2. Whoever is making the complaint (you, your APAC or the member) must complete section 1 of Med 09/05. Section 2 is for you or your APAC only. This will help the complainant focus on the specific issues they want CHS to investigate.
  • The Med 09/05 provides:
  • personal and departmental details of the member
  • information about the original referral
  • a brief summary of the complaint
  • specific issues to be addressed
  • the opportunity to identify a desired outcome.
  1. On completion of section 2 you should send the completed Med 09/05 to the:

Administration Team
Capita Health Solutions
10 Queen Victoria Road
Coventry
CV1 3PJ
Email: pcsps.chs@capita.co.uk 

Process

  1. CHS will acknowledge receipt of the Med 09/05 form within 5 working days and provide a full reply within 4 weeks. If, exceptionally, this is not possible CHS will give an interim reply explaining what further action has been identified.
  2. CHS will investigate and give their reply to you. Where the case concerns a member complaint you must give them written details about the outcome.
  3. If the member is dissatisfied with the CHS response they should tell you. If you feel the matter has been resolved you must explain your reasons to the member. Any employer or APAC who agrees with the member that their complaint remains unresolved should refer the case to CSPD. It is envisaged that only serious or complex cases should be referred to CSPD at this stage, where it is felt that CHS have not provided a satisfactory reply.
  4. You should send unresolved complaints to:

Employer Helpdesk
Civil Service Pensions
8th Floor
Grosvenor House
Basingstoke
Hampshire
RG24 4HG

Or by email to: employerhelpdesk@cabinet-office.x.gsi.gov.uk

  1. CSPD will then take up the case with senior management at CHS and will reply to the employer/APAC with the outcome.

Reference

This document links to EPN146 and IDR EPN

Contacts:

Enquiries about content, distribution or to receive in a different format

employerhelpdesk@cabinet-office.x.gsi.gov.uk
01256 846414
Employer Helpdesk
Civil Service Pensions
Grosvenor House
Basing View
Basingstoke
RG21 4HG 

Published:
1 February 2007
Last updated:
25 January 2022