AHPI PATIENT’S GRIEVANCE REDRESSAL FORUM (APGRF)

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Association of Healthcare Providers (India) represents the vast majority of healthcare providers in India. It is registered under Society Registration ACT- 1860 as “not for profit” organization. It educates to its members and at the same time, advocates with the government, regulatory bodies and other stake holders on issues, which have bearing on enabling its member organizations in delivering of Universal Health Coverage to the community at large. AHPI has been working on building capacity in Indian health systems with focus on patient safety and affordability of healthcare services.

Motto of AHPI is: ‘Educating and Advocating for Well Being of Common Man’

In line with the motto, AHPI has established ‘AHPI Patient’s Grievance Redressal Forum’, with a view to educate as well as listen to the grievances of patient as consumer, while availing services from private healthcare providers. APGRF is made up of a number of member organizations related to healthcare consumer groups such as national level pensioner associations, state health consumer organizations, health consumer organizations and networks dedicated to particular health conditions with a general interest in healthcare consumer affairs. APGRF networking partners will help in coordinating and reaching out to large percentage of patients/ health consumers across country. In our efforts to ensure consumer and community-centered care is a priority for decision makers.

APGRF Objectives:

  • To provide opportunities to patients/ consumers & community groups in influencing national policies which affect the health services to the population
  • To educate about promotive and preventive aspects of health with focus on; safe drinking water, sanitation and nutrition.
  • To promote patient centered/ patient driven health services by private sector so as to have active participation by patients in understanding and choosing particular care plan.
  • To promote rights and responsibilities of patients among communities and providers.
  • To listen to the grievances of patients and help in their redressal through dialogue with healthcare providers.
  • To reduce the number of negative publicities regarding treatment charging patterns in Mainstream Public Media thus improving the healthcare repute

Constitution of AHPI Patient’s Grievance Redressal Forum:

The FORUM will function as independent entity under governing board of AHPI. The FORUM will have its charter and governance structure. The FORUM will have following structure;

  • CHAIRPERSON: Person of eminence, with legal credentials
  • CONVENER: Head of AHPI MEDIA Engagement Committee
  • MEMBERS: All State Presidents or their nominees
  • Co-opted Members: Presidents/ Secretaries of networking organizations, including pensioners associations etc.
  • Media Representatives

The Chairperson may constitute ‘Core Group’ to deal with routine cases. The Core Group will be working under the CONVENER and will have members drawn from Media engagement committee representing North, Southern, East and Western regions. AHPI State President from where complaint is filed will be co-opted for that particular case. Findings of Core Group will be put up to the Chairperson of the FORUM for his final approval and disposal.

The patient’s rights as a consumer are as follows*

Patients have the right to be told about their illness; to have their medical records explained? Patients should be explained about whatever treatment/medicines are prescribed to them. They should be made aware of the risks and side effects, if any. They have the right to ask questions and clarify their doubts about the treatment? Patients have the right to know a doctors qualifications? Patients have the right to be handled with consideration and due regard for their modesty when being physically examined by the doctor? Patients have the right to maintain confidentiality regarding their illness and can expect the same from the doctors? Patients have the right to a second opinion if they are doubtful about the medicines or treatment suggested? Patients have the right to know what a suggested operation/surgery is for and the possible risks involved. If he/she is unconscious or unable to make the decision due to other reasons, informed consent needs to be taken from their nearest relatives? Patients have the right to get their medical records / case papers on request from the doctor / hospital? If the patient needs to be moved to another hospital, he / she has the right to know the reason for it and also has the right to make his or her own choice in consultation with the doctor.? Patients have the right to get details of the bills they have paid for

Is informed consent required*

Informed Consent from the patient is required in serious ailments and surgical treatment. In case the patient is unable to give consent, the same needs to be taken from the immediate family or attendant. However, medical treatment cannot be delayed in case there is no one available to sign the consent and the patient is unable to sign the same due to medical conditions.

What is medical negligence*

Negligence is simply the failure to exercise due care. It occurs when a doctor fails to perform to the standards of his or her profession. The three ingredients of negligence are as follows:

  • The defendant owes a duty of care to the plaintiff.
  • The defendant has breached this duty of care.
  • The plaintiff has suffered an injury due to this breach.

What is medical malpractice*

A medical malpractice is a claim of negligence committed by a professional health care provider - - such as a doctor, nurse, dentist, technician, hospital or hospital worker -- whose treatment of a patient departs from a standard of care met by those with similar training and experience, resulting in harm to a patient or patients.

Is medical negligence covered under Consumer Protection Act*

Yes in 1995, the Supreme Court brought the medical profession under the Consumer Protection Act 1986 and medical treatments were labeled as services?

Can someone not has satisfied with outcomes of surgery, file claim as medical negligence*

In general, there are no guarantees of medical results, and unexpected or unsuccessful results do not necessarily mean negligence has occurred. To succeed in a medical negligence case, a consumer has to show an injury or damages that resulted from the doctor's deviation from the standard of care applicable to the procedure.

Can doctor guarantee complete success for treatment?*

No. The Doctor cannot guarantee the complete success of any medical treatment as the same would differ in case to case, depending on the age and health of the patient, the stage of the Ailment and the body response of the patient

* Adopted from INGRAM, Copyright © Department of Consumer Affairs 2018

Procedure to file complaint for medical negligence case:

Patient or authorized family person, can send written complaint, citing details of grievance to the Medical Superintendent (M.S) of the concerned Hospital with copy to AHPI Help Line (E-Mail). If there is no reply or if you are not satisfied with the reply from the hospital, complaint may be sent to the State Medical Council (SMC), with copy to National Medical Commission. In case it is criminal category of case, the affected consumer can file a complaint with the local Police Station. However, expert opinion will be required to register any police complaint. You may also file a complaint with the Consumer Forum/ Commission, Civil Court and Criminal Court as the case may be, for seeking damages arising out of medical Negligence.

How AHPI can help?

  • Consumer at the time of filing initial complaint with concerned hospital, can mark copy to AHPI through E-mail, grievance@ahpi.in at AHPI Grievance Portal/ Consent to contact the patient must be taken before the call is made to the patient – through IVR or automated message, etc
  • Complainant can log in to AHPI website www.ahpi.in and file the complaint.
  • AHPI shall take up the case with the concerned hospital and will facilitate in connecting consumer with hospital leadership with an aim to resolve the redressal.
  • AHPI being ‘Not for Profit NGO’ and also the industry representative body of hospitals will help in redressal of issue in short period of time as appropriate.
  • AHPI to recruit and man 1 dedicated manpower for Grievance Redressal Process – Grievance Redressal Manager
  • The Email ID (grievance@ahpi.in) to be populated through Social/Traditional Media to encourage adoption amongst general public
  • The GRM will directly respond to the complainant through a call and collect any additional details as required
  • The GRM will contact the Hospital Management and share the complaint and attempt to negotiate
  • The GRM will take the support of the Regional Engagement Committee Member to resolve the same
  • In case the GRM is unable to make both parties reach an amicable solution they will be advised to continue their regular actions to resolve the matter, and AHPI will not be involved further into the same
  • The GRM will maintain an excel sheet and share weekly updates casewise to the engagement committee
  • A Feedback request message/call will be made to the complainant on a regular basis to take general feedback on the GRM process and person
  • Statistics can be covered by media to publish the success of the Initiative and address the challenges faced by general public

Creation of an individual webpage that can capure the grievance details and enable the PGRF to connect with them and liasion with the hospital operator to address the aggrieved family's concern

A Grievance redressal multilingual webpage at website can be created with following columns:

Identify the common grievances which usually arise in the hospitals and include them as pop-up bullets in website linked to our email.

  • Complainant name
  • Address, Contact details etc.
  • Patient's name, age, medical records number, address (if complainant is not himself a patient)
  • Name of the hospital/doctor against which the complaint is being lodged with address
  • Type of Complaint (here we can give various bulleted common grievance points, which can be selected)
  • Description (of complaint)
  • Relevant documents uploading option (this will be allowed with consent only)
  • Submit

Patient gets an acknowledgement email and content details of the GRM and a turn around time.

It will be user friendly and easy to use page, as soon as the complaint is filed an email will come to us for further actions and a complaint ticket will be issued to the complainant for tracking purposes.

The webpage could later be integrated with a database to auto forward such details to the hospital management directly through building and integrating a national database and uniting the hospital industry.