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Health / Target for responding to stage two complaints remains ‘very challenging’ for NHS

IT IS “harder than ever” for NHS Shetland to meet targets for responding to complaints that need a formal investigation, a meeting of the health board has heard.

Corporate services manager Carolyn Hand told Tuesday’s meeting of the NHS Shetland board that this was due to staff capacity.

Health boards have a target of responding to 80 per cent of stage two complaints within 20 working days, with stage ones needing to be dealt with in five days.

Only 11 per cent of stage two complaints in 2023/24 were dealt with in the 20 day target – three out of 27.

Hand said stage two complaints can be “complex and span a number of departments and staff groups”.

“The 20 working day timeline has always been a challenge to us,” she said, adding that it feels “harder than ever” to get them out on time.

In 2023/24 the service handled 183 pieces of feedback, which included 29 stage two complaints.

There were 54 stage one complaints, 72 concerns, ten comments and 18 thank you contacts.

Some recurring themes included access to treatment, including dental services, while staff attitude and communication also featured.

Hand said feedback is particularly important for the NHS as it can result in better outcomes for patients and improved services.

But members of the health board were reminded that the number of complains only form a very small part of the “thousands and thousands” of healthcare interactions in Shetland.

Hand also said there is a lot more positive feedback for staff that can go unrecorded – with “huge sackfuls” of thank you cards and gifts being given to employees for example.

The capacity pressure in dealing with complaints appears to echoe difficulties the health board has had in responding to an increased number of freedom of information requests.

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Meanwhile the health board heard that there has been a “quite remarkable” increase in incidents reported through the duty of candour scheme.

Duty of candour is a legal requirement which means that when unintended or unexpected events happen that result in death or harm, people affected understand what has happened, receive an apology, and that organisations learn how to improve for the future.

In 2023/23 a total of 267 adverse events/complaints were reviewed, which was up from 106 the previous year.

Only four required “organisational duty of candour” to be applied, which is the same as the previous year.

This included a fracture being missed on an X-ray, and a GP changing the dose of medicine without informing the patient, which resulted in hospital admission.

Medical director Kirsty Brightwell suggested she believed the increase in incidents put through the duty of candour scheme was partly down to increased awareness.

But she said there were also occasions where incidents experienced by Shetland patients when on the mainland were also reported.

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