PART A: General comments

“One Click” principles of use
The below points outline the code of practice for using the “One Click” system. They are:

· “One Click” has been provided to identify patterns and trends that may necessitate management intervention. The responsibility for the resolution of any identified issue rests with the relevant health professional.

· The EMIS number may now be used as a patient of reference.  This will allow the trust to contact you directly should they require further information. Please note: any use of the patient NHS number or any other patient identifiable information will breach information governance legislation and will be reportable to the Information Commissioner and is therefore forbidden.

· This system must not be used for the report of significant events/ serious incidents, patient safety incidents or complaints as there are separate and established processes for dealing with these issues.  The “One Click” remains a soft intelligence information gathering tool only with the aim of collecting emerging themes for resolution at scale and must not be used as a mechanism to resolve individual issues.

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* 1. What is your name?

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* 2. Which practice do you represent? 

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* 3. Please state the healthcare provider / service that is involved in the issue

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* 4. Regarding what aspect of care are you complaining / expressing a concern?

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* 5. What department(s) / service(s) was involved?

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* 6. Which speciality was involved?

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* 7. Which (if any) staff group was involved?

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* 8. Further details

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