Thursday, 31 August 2023

Appeals, Complaints & Other Issues (Ireland only)











Are you unhappy about a welfare payment you received, or were you denied a payment you think you were entitled to?

If you are unhappy about a payment you have received, or if you feel that you have been unfairly treated when claiming your entitlements, you can make an appeal. 
You can get help to make an appeal from your local Citizens Information, just click on the link and choose your county to view the centres in your area Citizens Information Centre. You can also call the Citizens Information Phone Service on 0818 07 4000, Monday to Friday, 9am-8pm.




Appeals


Welfare Appeals


If you think you have been wrongly refused a social welfare payment or receive a lower payment than expected you can appeal this decision to The Social Welfare Appeals Office. 
You can also appeal if you are unhappy about any decision of a social welfare Deciding Officer or Designated Person (in the case of the Supplementary Welfare Allowance Scheme). You must appeal within 21 days of getting the decision on your claim.




Appeals re Illness Benefit


If you think you have been wrongly refused Illness Benefit, you can appeal the decision to the Social Welfare Appeals Office. You should appeal within 21 days of getting the decision.
 
Where to appeal

Illness Benefit
Department of Employment Affairs & Social Protection
P.O. Box 1650
Dublin 1
Ireland
 
Tel: (01) 704 3300 or 0818 928 400

Homepage:

Email: illnessbenefit@welfare.ie

 


 

Appeals re Invalidity Pension/Disability Allowance/other payments


If you think you have been wrongly refused Invalidity Pension/Disability Allowance/other payment or you are unhappy about a decision of a Deciding Officer, you can appeal this decision, more here.








Are you unhappy with a public service you received or were you denied a service you think you were entitled to?

If you are unhappy about a service you have received, or if you feel that you have been unfairly treated when claiming your entitlements, you can make a complaint or an appeal. If you would like to make a complaint, here are some suggestions that may help:
  • tell the public service provider you are unhappy with the service and explain why
  • tell them what happened and what you think should have happened instead



Making a complaint if you are unhappy with the public service provider’s response


You could: 
  • ask the service provider how you can make a complaint about that response
  • ask for the name of the person you should complain to
  • be very clear in describing what you think has gone wrong
  • tell them what you want them to do to make things right
  • ask for help to make your complaint if you have a disability or if you have a difficulty with writing





Complaints about Public Health Services (HSE)


For complaints about public health services you can use the HSE complaints process. 

There is a HSE complaints system for anyone using:
  • Public health or social care services provided by the HSE
  • Service providers who provide health or social care services on behalf of the HSE



HSE Your Service Your Say (YSYS)


Use the HSE's Your Service Your Say (YSYS) feedback and complaint service if you wish to make a complaint or bring an issue to the attention of the HSE. 

The YSYS process is a legal one, set in law which the HSE ‘has’ to follow, though practice is mixed across the country.

The HSE YSYS process is the HSE's process to listen and respond to your feedback about their services. 
Your feedback might be a comment, compliment or complaint.

There are many ways you can tell the HSE about your experience, please see your choices below:




- Fill in the online form below that applies to you: 
 

 


- Send an email to HSE at yoursay@hse.ie




- Fill out the paper feedback form and put it in the feedback box at at one of the HSE service locations or give it to a member of staff.




- Send a letter to the service or a completed feedback form to the HSE service you want to give feedback on, e.g.,  a hospital, or primary care centre. An HSE staff member can give you the contact details.  
 

To send your letter or form:

    • use the feedback box at one of the HSE service locations or
    • give it to a member of staff or
    • ask a staff member for the right postal address for that service or
    • post it to HSE Your Service Your Say, Oak House, Limetree Avenue, Millennium Park, Naas, Co. Kildare, W91 KDCT



 - By Phone
    • Call HSE on 1890 424 555 from 9am to 5pm Monday to Friday. Call 045 880 429 from a mobile.
    • Freephone HSELive on 1800 700 700 from 8am to 8pm Monday to Friday and 9am to 5pm on Saturday.
    • From outside of Ireland, phone +353 1 240 8787.


- Through a Complaints Officer
There are complaints officers across the HSE. A member of staff at one of the HSE service locations can give you the contact details of the complaints officer for the service you want to complain about. 
If you are unable to contact the Complaints Officer listed for your area or you are unsure who to speak to about your feedback, please contact the office of the general manager for the service you are using and a staff member will tell you who you may discuss your concerns with, see list below:

 











If you're not able to give feedback yourself, ask a relative, carer or advocate to do this for you. As mentioned before you can get help to make a complaint or an appeal from your local Citizens Information office, just click on the link and choose your county to view the centres in your area Citizens Information Centre 

You can also call the Citizens Information Phone Service on 0818 07 4000, Monday to Friday, 9am-8pm.








Information about Making a Complaint


What should happen when making a complaint through any complaint process option mentioned above i.e., the Your Service Your Say process 


You may have had a poor experience and told a member of staff or the person providing your home care, for example, by phone or in person.

If they cannot help within 48 hours they should ask you if you want to have your complaint looked at by a complaints officer. They can send your complaint to them for you. 
To express concern about your experience a complaint is best put in to yoursay@hse.ie and it will be sent to the relevant hospital or service.

The Your Service Your Say process is a legal one, set in law which the HSE ‘has’ to follow, though practice is mixed across the country.


(Stage 1) When sending a complaint via the Your Service Your Say process, whether by email or letter, or any of the other options listed above -
 
(a) Include facts, facts are more important than opinions, so stick to the facts  
 
(b) Describe what happened and when it happened, if it made you feel uncomfortable, what made it feel ‘not ok’ to you. 
 
(c) Describe who was involved. 
 
(d) Explain what your concerns are. 
 
(e) Mention if you have done anything to resolve this matter, if you have already tried to sort it out, describe what you have done so far. 
 
(f) Explain why you are unhappy and what you would like done to fix the problem. 
  
(g) Include any evidence you have, for example, reference numbers, copies of correspondence or relevant documents and anything that helps explain what happened. 
 
 
 (i) Give them your contact details and a mobile number if possible. If you have a carer or an advocate you could give their number and a consent note to say that you are happy for them to represent you in all matters relating to your complaint.

 

  • NB:  
  • Never make offensive remarks about the people you have been dealing with
  • Don’t include any personal views unless you have evidence to support them

 


If it is a letter you are writing you should begin with your own name, address and date. It should be at the top of the page and could be to the top right, top left or in the middle, depending on what style you prefer.
The name of the person you are writing to
Their job title
The name and address of the public service provider [where the person works]



Sample Letter

Dear [name of the person you are writing to],

I would like to complain about…

In this part of your letter,

  • explain clearly what happened, when it happened and what you have done to try to sort things out
  • explain why you are unhappy with the service and what you would like done to fix the problem
  • provide enough background information to explain the situation
  • include information and details such as reference numbers, photographs and copies of letters or emails you have sent
  • ask them to contact you by a reasonable, specific date – tell them if you would prefer to be contacted by phone, email or letter – and make sure you include your contact details or those of your carer or advocate (if you are unable to write yourself or unable to deal with any communications regarding the complaint and have a carer or advocate)
  • if the person you are writing to is not someone who can sort out the problem, ask them to explain why they can’t help and whether there is someone else you can complain to
Yours sincerely,
Put your name and phone or email contact details here or those of your carer or advocate


(Stage 2) The Your Service Your Say system should forward your complaint to the relevant area and a complaint officer should be assigned to your complaint.

(Stage 3) If you made a written complaint, Your Service Your Say will let you know that they have received your complaint within 5 working days. The Complaint Officer may contact you within five working days or you ‘should’ receive a formal communication by email or letter within five working days telling you the name of the complaint officer, the issues you have raised and the completion date.

(Stage 4) Then Your Service Your Say will look into your complaint and respond to you within 30 working days.
They may contact you to ask for more time, if needed and keep you updated every 20 working days after that.
They might call or ask to meet you to hear more about your complaint.

Within thirty days of the report, the ‘accountable officer’, that’s the person responsible for the service should write and tell you that they have accepted the recommendations and if they’re not accepting them, why not.
They should also offer ‘redress’ - an apology, reassurance that this will be put right - for you and others.

(Stage 5) The response should have findings and recommendations. When you get the response, it should tell you about your right to have a Review or to go to the Ombudsman.


(Stage 6) If you are not happy with the outcome of your complaint, you can ask for an internal review by the HSE. You can also ask for an external review from the Ombudsman or the Ombudsman for Children. These are the options if you think:

- they haven’t addressed all the issues you raised in your complaint
- you think they haven’t looked at all the evidence or have ‘got it wrong’
- they haven’t followed the process as described above from 1 to 5 and didn’t give you a chance to ‘tell your story’


(Stage 7) Internal or External Review


Internal Review

If you are not happy with the recommendations in the report following your complaint process, you can ask for an internal review. You will find out how to do this in the letter you get with your report. In an internal review HSE look back over the recommendations they made. They will do this within 20 working days or let you know if they need more time. 



External Review (public bodies & disability services)

If writing to complain does not work you can ask for an external independent review through the Ombudsman. 

The Ombudsman can investigate complaints about public bodies. 
Under the Disability Act 2005, the Ombudsman also has a role in investigating complaints about accessibility to public services. 

The Ombudsman can examine complaints about most public service providers including government departments, local authorities, the HSE and public hospitals, and publicly funded third-level education bodies. 

The Ombudsman cannot handle complaints about organisations such as An Garda Síochána, the ESB and financial services or pensions providers.
If you are not sure whether they can help, please contact them.

You can also visit their website for information on service providers within and outside their remit.

 
Please see more information via one of the links below:









Assessment of Need

There is a separate complaints process if you wish to make a complaint about an Assessment of Need








Quality & Patient Safety (QPS) 

(when there’s a clinical element to your complaint) 

A complaint with a clinical element will be dealt with by the Quality and Patient Safety (QPS) staff.

You can include the effect of that Consultant/Dr on you, their attitude, did they give you the information you needed to give informed consent, did the Dr appear to have the knowledge of the illness, did you feel there was care, compassion and that you could trust them, did you feel respected, were you treated with dignity can all go under a complaint.

The HSE YSYS complaints system is a legal one, set in law which the HSE ‘has’ to follow, though practice is mixed across the country. The clinical judgement piece relies on the Open Disclosure policy and the Incident Management Framework, but the QPS staff should engage and listen to you and address any concerns about clinical judgement.







Further Supports


Patient Advocacy Service (PAS)


If you want to make a complaint about your experience in a public hospital or nursing home, the Patient Advocacy Service (PAS) can provide you with information and support. 

The Patient Advocacy Service providers are an independent, free and confidential service that can help you make a complaint about the care you received in a public acute hospital, HSE-operated nursing home or private nursing home.

Please see more about PAS here


Contact PAS

Monday to Friday, 10am - 4pm
Phone: 0818 293003 
Address: Level 3 Rear Unit, Marshalsea Court, Merchant's Quay, Dublin D08 AEY8
Email: info@patientadvocacyservice.ie 








National Advocacy Service (NAS)


The National Advocacy Service (NAS) is an organisation which helps adults with disabilities. If you have a disability, like a physical or intellectual disability, one of the NAS staff could help you with an issue you are having.

NAS provides a free and confidential advocacy service to adults with a disability, aged 18 years and over.

NAS has a particular remit to work with people with disabilities who are in vulnerable situations, such as people who are isolated from their community of choice or mainstream society, may communicate differently and who have limited formal or natural supports.

Please see more about NAS here


Contact NAS

Phone:  01 5200863 
 
Address: National Office, Level 3 Rear Unit,Marshalsea Court, Merchant's Quay, Dublin 8, D08 AEY8 
 

 








SAGE Advocacy


Sage Advocacy acts on behalf of older people who need support in fulfilling their wish to remain living in their own homes and communities. 

You can get in touch with SAGE if you are having difficulty in securing the care and support needed to remain at home/return home from another place of care; 

or if there are hard-to-resolve issues with your housing that affect your ability to stay there; 

or if conflict or controlling behaviour is pushing you out or making life at home miserable. 


Sage Advocacy supports people who are having difficulty with the process of obtaining nursing home care; people who are having issues with their nursing home or for whom there is a safeguarding concern; and people who have decided to leave their nursing home to move home (or to another place of care). 

Sage Advocacy can also provide information and guidance if you are having difficulty with your personal affairs or in dealing with the systems of public provision.

Sage Advocacy ensures that a person’s voice is heard, that their wishes are taken into account and that they are assisted, in whatever ways necessary, to be involved in decisions that affect them. Sage’s work is independent of family members, service providers and systems interests. They are publicly funded and while they collaborate where possible, they challenge where necessary.

Please see more about Sage Advocacy here



Contact Sage Advocacy

 Address: 24-26 Upper Ormond Quay, Dublin D07 DAV9









The Confidential Recipient


You can report a concern to the Office of the Confidential Recipient.
The confidential recipient is a person appointed by the HSE, however, they are independent of the HSE.
This means they can act as a voice for vulnerable older people and people with a disability when a complaint is made.
You can report a concern to the Office of the Confidential Recipient if you are:
  • a person who uses these services and you need confidential help and advice
  • a neighbour, family member, friend
  • any member of the public
  • working at a HSE-funded service


Types of Concern
The Office of the Confidential Recipient deals with concerns about:
  • abuse
  • negligence
  • mistreatment
  • low quality of care
For example, if a person is physically abused, threatened, not fed enough of the right foods, is kept to their room or not allowed to move around (being confined).
Concerns may also be about denial of dignity, or someone not having control over their daily life or choices. You can also report concerns about abuse of power or a culture of oppression.

What the Office of the Confidential Recipient Does
They will:
  • listen to you and hear your concerns
  • keep your identity anonymous if you prefer
  • support you and send your concern to the right place
  • make sure a senior person looks into your concern within 15 working days

Contact the Confidential Recipient
There are 4 ways to contact the Office of the Confidential Recipient:
Online: Complete the enquiry form
Phone: Freephone: 1800 949 494  Office phone: 087 188 0523  Confidential recipient phone: 087 665 7269 Monday to Friday, 9am to 5pm
Email: General queries: cr.office@crhealth.ie  Confidential Recipient: grainne.cunningham@crhealth.ie
Post: Gráinne Cunningham O’Brien, Confidential Recipient, Office of the Confidential Recipient, Merlin Park University Hospital, Block B, Old Dublin Road, Galway, H91 N973


More re the Confidential Recipient here












Are you unhappy with another service you received or were you denied a service you think you were entitled to? 

Here is information about services that are not public or part of the HSE




If you want to make a complaint about a service that is not part of the HSE, contact the service directly.

This includes:

  • voluntary service providers
  • private service providers
  • services that get HSE funding

For example:

  • GPs
  • dentists
  • private nursing homes
  • voluntary hospitals
  • day services
  • other health and social care services

They will investigate your complaint, you can ask them about their complaints policy and process.





Private Health Services

If you are making a complaint about a private health service, you can complain directly to the private service provider or contact the regulating body. You usually can’t complain to the HSE or to the Ombudsman or the Ombudsman for Children about private health services.





Private Hospitals Complaint


Private hospitals also have complaint systems though only those funded by the HSE are subject to a complaint process based in law and can be taken to the Ombudsman.
Children’s Hospital Ireland receives funding from the HSE, so their complaint process is required to follow the YSYS process with access to the Ombudsman if needed.






Insurance Companies 

e.g., with regards to private salary protection

If you are a policy owner, or insured person, and are not satisfied in any way with your policy, or with any request to do an assessment that you are unable to do, or with the outcome of an assessment, you could contact the insurers customer services team or the broker if they are the ones communicating with you. They should send you a detailed response in writing.

If they are unable to satisfy your complaint, you may have recourse to the Financial Services and Pensions Ombudsman (FSPO). Details of the services provided by the FSPO here: 



Contact the FSPO
Financial Services and Pensions Ombudsman Lincoln House Lincoln Place Dublin 2 D02 VH29

Telephone: (01) 567 7000 
Email: info@fspo.ie 
Website: www.fspo.ie








Other Support We Have Come Across 


(but don’t have any feedback about)


The Disability Legal Information Clinic


The Disability Legal Information Clinic is run by the Centre for Disability Law and Policy in NUI Galway provides free, accessible, confidential legal information on disability related legal issues and is available right across Ireland for disabled people, their families and supporters. The clinic is staffed by law student volunteers who are supervised by a member of the CDLP team and a qualified legal practitioner. In the past the clinic has dealt with issues in relation to housing, education, employment, discrimination and access to supports or services. To find out more about the clinics work visit the website here. 

You can contact the Disability Legal Information Clinic if you have any questions or would like to arrange an appointment.



Contact the Disability Legal Information Clinic

Emai: dlic@nuigalway.ie





Most of the supports we have included above are free, others are free and independent advocacy services. 










Myalgic Encephalomyelitis (ME) is classified as a neurological illness since 1969 by the World Health Organisation (WHO) ICD G93.3



Myalgic Encephalomyelitis (ME) Classifications:

  • WHO Classification ICD 10 G93.3 classified as a Neurological disorder

  • WHO Classification ICD 11 8E49 classified as a Neurological disorder 

  • SNOMED Classification SCTID: 118940003 classified as a disorder of the nervous system 

  • NASS (HRB) G93.3







Your Feedback is Important to Us



We value your voice and always aim to include your thoughts and opinions in the conversations we have and the information we share, anonymously. If you would like to share any feedback about any of the complaints/appeals processes mentioned above that you have experienced with a view to supporting others and helping us to improve on or to add to the information we share please contact us with your feedback to:

 info@meadvocatesireland.com










Thank you for your support. 













Disclaimer: The information in this post is for general information purposes only. While we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the post or the information, products, services, etc contained in the post for any purpose. Any reliance you place on such information is therefore strictly at your own risk.The suitability of any solution is totally dependent on the individual. It is strongly recommended to seek professional advice and assistance through other avenues, depending on your query or need for support, for example, via Citizens Information, Your Local HSE Office, Revenue or other.

 





 
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