Publication - Correspondence

NHS Board complaint mechanisms

Published: 4 February 2019
Directorate: Healthcare Quality and Improvement Directorate
Topic: Health and social care, Public sector

Letters outlining health board procedures for reviewing complaints and assuring safety of surgical practices.

Following allegations that a former Head of Neurosurgery at NHS Tayside harmed patients for years with no systems in place to pick up his mistakes, the Cabinet Secretary for Health and Sport wrote to all chairs and chief executives of health boards in Scotland to:

seek assurance on the mechanisms in place for reviewing complaints of professional practice
ask how they are assured of the safety and quality of the surgical practices of its employees

The responses are attached below.

Information requested

Boards were asked to provide the following:

NHS complaints:

mechanisms for the Board to detect and respond to clusters of complaints about the same clinician – with details of the process and timescales for this
what arrangements are in place for ensuring timely decision making when the safety of practice of a Consultant is raising concern

Surgical safety and morbidity and mortality (M&M) reviews:

ensuring that there is reliable delivery of process for pre-operative marking
monitoring workloads, surgical list length and appropriately equipped theatres
processes to support clinicians in presenting cases and have time allocated to attend morbidity and mortality reviews
arrangements for reviewing the effectiveness of on-call rotas

Supervision of junior medical staff:

consultant oversight supervision of junior medical staff

Openness and transparency:

adescription of the processes in place to encourage open reporting and discussion of behaviours not consistent with NHSScotland values
how quality of outcomes are monitored and any deficiencies reviewed and necessary action taken

Follow up

The responses included several illustrative examples and also good practice examples in respect of arrangements in place to routinely consider and action similar issues to those that arose in NHS Tayside.

A workshop took place on 4 December 2018 which was facilitated by NHS Education for Scotland. Almost all territorial and special boards sent a representative.

The aim of the event was to consider the various examples of best practice that were reflected in the responses to the Cabinet Secretary for Health and Sport’s letter and explore opportunities to support learning, possible improvements derived from this learning and to be able to describe and evidence the effective implementation of this across the country.

We plan to build on this and to work with NHS Education for Scotland to identify how best to support the work of openness and learning, including an initial piece of research on what works and why.