Appeals Process

1. Patients have the right to appeal against
   • being placed on the scheme
   • remaining on the scheme

2. Patients are advised that in the first instance they are to contact theComplaints Team within NHS England

3. All appeals must be in writing to:
   By email: [email protected]
   or by post:
   SAS Appeal Panel
   North East London Primary Care Area Team
   Kenworthy Road Health Centre
   10 Kenworthy Road London
   E9 5DT

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 North East London Primary Care Team (NEL team) and acknowledged, preferably by email or by post and an email address will berequested (although not mandatory), within 7 working days.

Patient Appealing against being placed on Special Allocation Scheme

6. The NEL 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 NEL team.

7. The NEL team will send by email the “SAS Panel Practice Incident Form” to the practice that removed the patient. This form should be returned within 14 days.

8. An Appeal Panel will be convened within 28 days of receiving both the patient’spro forma and the practice incident form.

9. Papers should be made available to the Panel at least 5 days before the Panelconvenes.

To note:
The appeal process does not delay the immediate removal of a patient following anincident that has been reported the police and the commissioner (via PCSE)

10. On reviewing the papers submitted the Panel may decide to get further information or request that the SAS Provider under takes a risk assessment of the patient and provide statement in relation to the patient. This would normally involve the patientpresenting to the Provider for an assessment.

11. The main issue for the Panel to address is to ensure that the criteria listed in Annex Bhas been met.

12. The Panel will consider the evidence submitted and can decide to either –
    • To confirm the referral to the scheme and refuse 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. The patient will then be given a list of practices in their area where they may register without restriction. NEL 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.

13. Patient will be informed with 3 working days of Panel decision detailing the reasonsfor the panel’s decision.

14. Referring practice will also be informed of the Panel’s decision.

Patient Appealing against remaining on Special Allocation Scheme

15. 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, atleast 3 reviews must have carried out in the previous 6 months.

16. After carrying out the reviews, if the provider considers that the patient should remainon the scheme, the patient may appeal.

17. The patient will be required to appeal in writing to the address as quoted above. The NEL team will send the “Appeal Pro forma” [tbc] to the patient within 7 working days of receipt of notification of appeal, outlining in detail the reasons why they disagree with the provider’s assessment and review. The patient should complete and returnwithin 14 days to NEL team.

18. 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 reportwill include:
    1. reviews conducted within the previous 12 months, or 3 reviews where thepatient has been on the scheme for less than 12 months
    2. the risk assessments carried out for this patient within the previous 12months
    3. any other issues that the provider deems relevant, which may includetreatments that are currently on going or planned for the patient
    4. any other relevant information from other providers NHS services

19. An Appeal Panel will be convened within 28 days of receiving both the patient’spro forma and the Scheme provider’s report.

20. Papers should be made available to the Panel at least 5 days before the Panelconvenes.

21. On reviewing the papers submitted the Panel may decide to get further information or request that the Scheme provider under takes a further review and risk assessment of the patient.

22. 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. NEL team will also inform PCSE to remove the VPS flag from thepatient’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.

23. Patient and the scheme provider will be informed with 3 working days of Paneldecision detailing the reasons for the panel’s decision.