1. Patients have the right to appeal against
- Being immediately removed from a practice as a result of an incident that was reported to the police
- being placed on the scheme
- remaining on the scheme
2. Appeal should be in writing unless the patient is unable to do so, in which case they should be supported to provide their appeal by alternative means.
3. The contact details for any appeal will have been provided in the patient communication informing them of their removal and allocation to a SAS
4. An appeal by the patient should be made within
- 14 days if appealing against being placed on the scheme
- 28 days if appealing against remaining on the scheme
5. Appeals will be received by the South East London Commissioning Alliance (South East London Primary Care Team) and acknowledged, preferably by email or by post and an email address will be requested (although not mandatory), within 7 working days.
Patient Appealing against removal and allocation to the Special Allocation Scheme
6. The South East London Primary Care Team will send an “Appeals Pro forma” to the patient within 7 working days of receipt of notification of appeal. The patient should complete and return within 14 days to South East London Primary Care Team.
7. The South East London Primary Care Team will send by email the “SAS Panel Practice Incident Form” to the practice that removed the patient. This form must be returned within 7 days.
8. The South East London Primary Care Team will populate the appeal panel summary paper which summarises the issues, and includes the potential recommendations for the Panel to consider
9. An Appeal Panel will be convened within 28 days of receiving both the patient’s pro forma and the practice incident form.
10. Papers should be made available to the Panel at least 5 days before the Panel convenes.
To note: The appeal process does not delay the immediate removal of a patient following an incident that has been reported the police and the commissioner (via PCSE)
11. On reviewing the papers submitted the Panel may decide to get further information or request that the SAS Provider undertakes a risk assessment of the patient and provide statement in relation to the patient. This would normally involve the patient presenting to the Provider for an assessment.
12. The main issue for the Panel to address is to ensure that the criteria listed in Annex B has been met.
13. The Panel will consider the evidence submitted and can decide to either:
- Reject the patient’s appeal. The patient then stays on the scheme and will be reviewed by the provider in line with the service specification.
- To uphold the patient’s appeal.
- Depending on the reason for upholding an appeal, the commissioner may engage the removing practice to ascertain if they are willing to re-register the patient, or;
- The patient will be provided a list of practices in their area where they may register without restriction. The commissioner will inform PCSE to remove the flag from the patient’s medical record to allow them to register freely.
- Should the patient have difficulty registering the normal process to support registration by NHS England will be implemented.
14. Patient will be informed with 14 days of Panel decision detailing the reasons for the panel’s decision.
15. Referring practice will also be informed of the Panel’s decision.
Patient Appealing against remaining on Special Allocation Scheme
16. A patient on the scheme will normally stay on the scheme for a minimum of 12 months and must have undergone at least 2 reviews. Where the provider thinks appropriate to consider discharge before the minimum 12 months has elapsed, at least 3 reviews must have carried out in the previous 6 months.
17. After carrying out the reviews, if the provider considers that the patient should remain on the scheme, the patient may appeal.
18. The patient should appeal in writing unless the patient is unable to do so, in which case they should be supported to provide their appeal by alternative means.
19. The Scheme provider will be required to submit a report to the panel to explain why the provider has assessed that the patient should remain on the scheme. This report will include:
- reviews conducted within the previous 12 months, or 3 reviews where the patient has been on the scheme for less than 12 months
- the risk assessments carried out for this patient within the previous 12 months
- any other issues that the provider deems relevant, which may include treatments that are currently on going or planned for the patient
- any other relevant information from other providers NHS services
20. An Appeal Panel will be convened within 28 days of receiving both the patient’s pro forma and the Scheme provider’s report.
21. Papers should be made available to the Panel at least 5 days before the Panel convenes.
22. On reviewing the papers submitted the Panel may decide to get further information or request that the Scheme provider undertakes a further review and risk assessment of the patient.
23. The Panel will consider the evidence submitted and can decide to either:
- To uphold the patient’s appeal. The patient will then be “discharged” from the scheme and given a list of practices in their area where they may register without restriction. South East London Primary Care Team will also inform PCSE to remove the VPS flag from the patient’s medical record. Should the patient have difficulty registering the normal process to support registration by NHS England will be implemented.
- To confirm the report from the Scheme provider and refuse the patient’s appeal. The patient then stays on the scheme and will be subject to review by the provider in line with the service specification.
24. Patient and the scheme provider will be informed within 14 days of Panel decision detailing the reasons for the panel’s decision.
Appeals can be sent to:
Post:
South East London CCG – Head Office
160 Tooley Street
London
SE1 2TZ
