Reform pledge as NHS Lothian complaints up by 20%

NHS Lothian is to overhaul the way that it deals with unhappy patients after new figures revealed that a record number of formal complaints was made last year.

In 2012, 3842 complaints were put to the health board for investigation – an increase of more than 20 per cent compared with 2011 levels.

Although it is understood that the number is rising across Scotland, and factors including higher patient numbers and taking on prison healthcare could partially account for the increase, Lothian NHS bosses have admitted any surge is a “matter of serious concern”, while MSPs also raised eyebrows at the “huge rise”.

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Health chiefs have vowed to delve deeper into the complaints to see what they can learn, while individual wards which see the highest levels of complaints are set to be subject to greater scrutiny.

Investigations sparked by high complaint levels are to be launched in orthopaedic wards 208 and 209 at the Royal Infirmary and the Balcarres ward at the Royal Edinburgh, after they were included in a list of the top 40 most complained-about departments for three years in a row.

NHS Lothian’s director of human resources, Alan Boyter, said: “The staff who deal with complaints have been under quite a lot of pressure recently in terms of the numbers. We are looking at how we can adopt a different mind-set in how we respond to complaints.

“If someone got in touch to say their operation had been cancelled three times, they don’t want people saying there was a shortage of staff or staff were off sick, they want someone to say: I’m very sorry, we let you down and we’ve made a new appointment’ to resolve it.”

Greater emphasis is to be placed on complaints as a way of gaining feedback on services.

Dr Charles Winstanley, NHS Lothian’s chairman, said: “Complaints should be part of the intelligence we receive. They should be used more
scientifically.”

Most patients who raised their concerns formally with NHS Lothian were unhappy with their medical treatment, accounting for 30 per cent of complaints, or the attitude and behaviour of staff – which make up 20 per cent.

The highest number of official complaints between April last year and March 2011 in a single area came from the region’s prisons, with 64 made about HMP Healthcare – temporary clinics run in Addiewell and Saughton Prisons. A further 47 were made over the permanent prison health centres run by the health board.

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The Royal Infirmary’s under-pressure A&E department received 56 formal grievances – up from 55 in the whole of 2011-12 and just 21 in 2010-11.

Patients or their families have formally raised issues 47 times about at the Western General’s main outpatients department this year in addition to 27 regarding the Royal Infirmary’s orthopaedics department.

Labour Lothians MSP Sarah Boyack said: “The challenge is not apologising to people more effectively, it’s focusing on improving the quality of services people receive.

“In my experience, most people don’t take the decision to complain lightly as they understand the pressure our health service is under – their motivation is generally to ensure that their poor experience prompts action to improve services for other patients.”

NHS Lothian said that an increased awareness of services and opening up the complaints process to social media websites were other factors behind the surge in complaints, from 3151 in 2011, in addition to a cultural shift that meant members of the public were more willing to challenge authority.

The Scottish Public Services Ombudsman, Jim Martin, said that details of scandal at the Mid Staffordshire NHS Trust may have made patients more likely to raise concerns formally.

The ombudsman received 1002 complaints about Scottish health boards in 2011-12 – a rise of 13 per cent on the previous year. The figure is set to rise again in 2012-13, although it is expected to be a smaller increase and well below the NHS Lothian hike of almost 22 per cent last year.

TWO-YEAR WAIT FOR VINDICATION

THE complaints department at NHS Lothian has also recorded a rise in complex issues being reported, which can require extensive investigations.

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It means patients or their families can wait be left with significant waits for cases to be resolved and has increased pressure on the department.

Maree and Stuart Notman lodged a formal complaint into the care their father, Thomas (pictured), received at the ERI in February and March 2011 before he died.

It touched on a series of issues, including the dignity their dad received, medical care, nursing and nutrition.

After writing to then-Health Secretary Nicola Sturgeon, the complaint was forwarded to NHS Lothian.

But after they were dissatisfied with the health board’s response, they went to the Scottish Government Ombudsman.

They were eventually vindicated when he ordered NHS Lothian to apologise and revealed that “serious failures” had been uncovered.

But the final decision was not taken until January – meaning they had faced a near-two year wait for the issue to be concluded.

Speaking after the ruling, Maree said: “We just wanted them to say sorry and we don’t want someone else or their family to go through what we went through.”

FORMAL COMPLAINTS BY AREA 1/4/12 - 11/3/13

HMP Healthcare 64

Royal Infirmary A&E 56

HMP Health Centre 47

Western main outpatients dept 47

Princess Alexandra Eye Pavillion 39

Royal Infirmary orthopaedics dept 27

Consultant/consultant secretary 24

St John’s Hospital day surgery centre 23

Admin & clerical office 22

St John’s Hospital A&E 20

Car Park 20

Waverley Gate 17

Sick Kids outpatients department 16

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Lauriston Building ear nose and throat outpatients department 15

Western General Hospital department of clinical neurosciences outpatients 15

Western General Hospital acute receiving assessment unit 14

Estates department 12

St John’s Hospital ward 18 - plastic surgery 11

Royal Infirmary ward 210 10

Lauriston Building switchboard 10

Royal Infirmary ward 104 9

Royal Infirmary ward 208 9

Royal Infirmary ward 209 9

Western General Hospital ward 57, 9

Lauriston Building dermatology outpatients department 9

Royal Infirmary dialysis department 9

St John’s Hospital outpatients department 2, 9

Western General Hospital day bed suite 9

Western General Hospital waiting list office 9

Royal Infirmary combined assessment unit 8

Royal Edinburgh Hospital - Balcarres 7

Royal Infirmary ward 108 7

St John’s Hospital ward 19A 7

Royal Infirmary labour suite 7

Royal Infirmary birth centre 7

Dental Institute orthodontics 7

Lauriston Building audiology 7

Royal Infirmary main radiology department 7

Royal Infirmary gynaecology 7

HMP Douglas - C wing 7