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Poor hospital care: are systems improving for patients?


    The Government is bringing in further changes to the service culture for NHS patients by providing an updated NHS Constitution, which is intended to give enhanced commitment to patients, particularly if there has been negligent hospital treatment. In addition to the completed consultation on strengthening the NHS constitution the Prime Minister has also requested a review of the system for NHS hospital complaints

    By Kerstin Kubiak

The current NHS constitution (which applies to England only) is dated 8 March 2012; this document has established for the first time a set of written principles and values for the NHS, with a view to confirming the rights of patients and staff. A consultation was undertaken to review the principles laid down in the constitution which ran from 28 November 2012 to 28 January 2013; the Department of Health (DoH) has accepted all of the recommendations which came out of the consultation process and will produce the updated constitution by April 2013.

One of the key principles of the constitution is that: “The NHS aspires to the highest standards of excellence and professionalism – in the provision of high-quality care that is safe, effective and focused on patient experience…”. Many patients and relatives will have not have experienced this high level of service however and may wish to seek an explanation from the NHS or consider suing the NHS for compensation after poor hospital care.

Quite often the first step is to make a complaint; under the constitution a patient is entitled to make a complaint and to have any complaint “dealt with efficiently and to have it properly investigated.” In addition there is a duty on NHS staff when mistakes happen to “acknowledge them, apologise, explain what went wrong and put things right quickly and effectively.” This is related to the campaign by AvMA (Action against Medical Accidents) that there should be a compulsory duty of candour on NHS staff when mistakes are made in patient care.

Each hospital will have its own internal complaints procedures and in the event that you are unhappy with NHS care the Trust should provide you with details of their NHS complaints procedure and to then support you through the process.

I have heard a lot of patients complain that the NHS complaints process was simply too lengthy and complicated to deal with, particularly when they are very ill and stressed in any event. This has recently been brought to light following publicity raised by Welsh MP Ann Clwyd. MP Clwyd’s husband, Owen Roberts, died from hospital-acquired pneumonia in October 2012; she stated that nurses treated her husband with “coldness, resentment, indifference and even contempt”. She stated that: “when something does go wrong, it must be easy for patients and their carers to speak up, without fear.”

Many of my clients have been too afraid to make a complaint to the NHS about poor care or negligent hospital treatment because they are worried that the NHS staff will be angry or resentful of them and that it will affect their ongoing care; this is an appalling position for a patient with legitimate concerns to be in and must be addressed with measures to reassure patients that their care will not be affected if they make a complaint.

Jeremy Hunt, Health Secretary, agreed with MP Clwyd, stating: “Complaints can be the earliest symptom of a problem within an organisation and the NHS should use them to learn from and improve their service.” For many medical negligence lawyers, to date the complaints process seems to have focused primarily on resolving the dispute, but not to my mind the further step required to actually learn from mistakes to prevent recurrences going forward. There is little point in making a complaint about the hospital treatment if the hospital fails to take action from learning points.

Sometimes a complaint is not enough to put things right, particularly where a patient has suffered a significant injury as a result of negligence. The constitution also states that a patient has a “right to compensation where you have been harmed by negligent treatment.” If you are still not satisfied after having made a complaint it is important to consult with a specialist medical negligence solicitor. Although the changes to the complaints culture in the NHS is a positive step forward it will not go to redressing the effects of a significant injury, if one has been suffered. A specialist clinical negligence lawyer can advise you of your options if you think you may wish to sue the NHS or sue a Doctor.

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