Appendix 6 - Lessons learned log

Complaint Reference Number & Service Area:

Date of Complaint:

Date of Complaint Conclusion:

Outcome of Complaint:  

Upheld

Not upheld

Partially upheld

(circle as appropriate)

Investigating Officer:

Brief Complaint Outline:

Do we need something saying who is responsible for implementing actions – who is probably not investigating officer?

Action

Action Number:

Action Detail:

Responsible Agency/Professional:

By Which Date:

Complete? (Y/N)

Outstanding and Unresolved Action(s):

Action Number:

Action Detail:

Why Outstanding/Unresolved:

Action to be Reviewed? (Y/N)

Responsible Agency:

What We Did Well:

What Could We Have Done Better:

Follow Up:

Is a Follow-Up required:

Yes / No

Required Follow Up

Person Undertaking the Follow-Up

Date

Name:

Title:

Organisation:

Contact details:

Name:

Title:

Organisation:

Contact details:

Name:

Title:

Organisation:

Contact details:

Final Outcome Identified to Ensure Learning:

☐ policy change

☐ procedure review

☐ staff training

☐ team meetings/agenda items

☐ other

Brief overview:

Decision maker:

Sign Off / Complaint Closes

Have All the Actions Identified Been Actioned:

Yes / No

If no, please provide a summary of why not and any intended future action

Date Closed (following discussion at Practice Board)

Signed off by (name and role)