Watchdog warns top NHS managers too scared of complaints

A CULTURE of fear of litigation in the NHS has seen more than half of complaints unfairly rejected and left patients and staff feeling ignored, according to a public service watchdog.

Scottish Public Services Ombudsman (SPSO) Jim Martin upheld more than half (56 per cent) of the complaints he received about the NHS last year.

Some were “extremely distressing”, he told Holyrood’s health and sport committee yesterday. They included “horrific” bedsores, an elderly patient being treated in a gynaecology ward and persistent complaints about poor communication and attitudes of staff.

Some complaints where an error was obvious, such as those that contained clear X-ray evidence, were only accepted by the NHS following investigation by the SPSO, he said.

Mr Martin has called for greater use of “no-fault compensation” for patients and improved procedures for issuing apologies, adding: “There is still a culture in some senior areas of some health boards where there is a real fear of litigation, that to admit that something has gone wrong will leave the board open to being taken to court.”

He told the committee: “We spend a lot of time talking about this but what we really need to start thinking about is what the hell we are going to do about it.

“We are seeing repetition of incidents of failure to care adequately for people with pre-existing conditions in acute settings, and some of the cases that we see are extremely distressing.

“I heard about an elderly person who attended accident and emergency and ended up in a gynaecology ward.”

Managers needed to listen more to front-line staff, Mr Martin said. “We have, very often, top-down wisdom when what is happening on the ground is being impeded by management processes where the last people listened to are the people who deliver the service. We must be careful the health service does not become over-managed, with too many people directing. I heard of an interchange where a consultant was asked not to refer to his place of work as ‘my ward’, and told ‘it’s not your ward’.

“If there is that kind of petty level, it is on the one hand almost laughable. But what does it say about the culture under which healthcare is being delivered in our hospitals?”

Committee member Dr Richard Simpson, a Labour MSP and former GP, quoted figures which found that 16 per cent of staff (one in six) reported bullying and only 48 per cent felt their concerns were being listened to, meaning more than half felt their concerns went unheeded.

Many workers felt subjected to “petty” reprimands by managers, the committee also heard.

SPSO nursing adviser Dorothy Armstrong said that “the way people are spoken to, body language and written communication” featured in almost every complaint the SPSO received.