Jean Turner: Patients are at heart of health service – so listen to what they are saying

Hopefully this report will allow management to start afresh by involving patients and staff to improve their service to patients.

Health boards need to listen to all feedback from staff and patients as an essential foundation in changing their culture to a more “do-as-you-would-be-done-by” model, remembering that they may well be patients one day and suffer from the unintended consequences of their actions.

I agree with Nicola Sturgeon there is no place for “an inappropriate management culture originating from top management”. Management should lead by example, thus gaining the respect of their staff and encouraging best practice.

In general, if a health board has problems meeting targets, we would expect it to have internal meetings with all NHS parties concerned and patients, in an attempt to find solutions. But if the problems are too difficult to solve, then it is the health board’s job to inform the health secretary – urgently.

Patients on waiting lists should be included in finding solutions, as ideally they should be working in partnership with all health professionals. Patients have often said to us they would be prepared to wait a little longer on a waiting list if it meant they could be treated close to their home and by the specialist known to them and in whom they had confidence. They would be pleased to let someone go ahead of them if their condition deteriorated, but rarely are patients involved in this process, sadly.

Patients expect to be treated by other health boards if the expertise for their treatment cannot be found in their area, but of course they would be pleased to be referred by the NHS within the UK or, failing that, Europe, if the expertise cannot be found in Scotland; there is no shame in this, as Scotland is a small country and cannot provide specialists for all rare treatments. Patients understand this.

When patients formally complain about the NHS, it is usually due to failures in communication between health professionals and between them and the patients, often coupled with the problem of poor staff attitudes. It does seem that some NHS Lothian management suffered from a degree of both.

Targets are good if they are for the patient’s benefit and not manipulated by health boards to pretend to the health secretary that all is well when it is not. Honesty is usually the best policy.

• Jean Turner is chief executive of Scotland Patients’ Association.