We agree!

Update from Care Opinion Scotland

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About: NHS Scotland

picture of Gina Alexander

We received this story from “Support the NHS” the other day giving us some feedback and we were pleased they felt able to do that. 

The story raises a number of concerns which it felt it would be good to open up to wider debate, hence the blog where anyone can respond.

We agree with much of what “Support the NHS” has to say, including their screen name!

We agree that NHS staff should feel valued.   We hope that staff do feel appreciated and encouraged and judging by the fact that around half the stories shared on Patient Opinion are good news stories: of heartfelt thanks, appreciation, encouragement and praise, so do many, many others.    As the author says, “praise where praise is due” and we are delighted that people use Patient Opinion to do just that. 

The remaining stories are not just “complaint”, in fact some people tell us that they use Patient Opinion because they don’t want to complain, they want to make a comment, give some feedback, share an idea or how they felt.  Others can feel frustrated by having to share their concerns within the complaints framework provided by the NHS. 

Through their stories people share experiences not just facts and how they felt or how they were made to feel: investigation of feelings is difficult.  Health services can invite the person sharing their experience to contact named individuals, and people do.   Sometimes we actively discourage investigation because it can negate experiences and feelings and become a sterile fact finding mission. 

In Scotland, many health services, encouraged by the Patients’ Rights Act  are   working towards streamlining their procedures so that all kinds of feedback:  comments, concerns, complaints and compliments, are viewed as opportunities to listen, learn and improve.  Far from being a tool of division, we want Patient Opinion to be used as a tool to support those opportunities.  We see increasing evidence of this across many Scottish health boards as we continue to work in partnership with them.

We agree, too, that staff confidentiality should be prioritised!  We moderate all stories shared with us before we publish and share them.  You can read our moderation policy here.  We believe it’s important to protect the identities of staff and not initiate a witch hunt, instead, encouraging everyone in the team to reflect on the implications of any story, good or bad, for their professional practice.    

We agree that the NHS is a great service.  We believe that what we do gives people a voice and enables busy health service staff to hear that voice which can help to keep the NHS great and make it even better.  

We also recognise the challenges these new ways of sharing experiences bring.    Technology enables the citizen voice like never before: anyone can be in the driving seat of comment, without having to wait to be asked for their view.   It demands a new, more equal relationship.

We want Patient Opinion to help people to share experiences honestly, openly and constructively.   We want the NHS to encourage and support staff to use these experiences to improve and learn to.   We want people using health services and those delivering health services (often the same people!) to use Patient Opinion to work together to make a difference.  We want Patient Opinion to enable all that to happen in an open and transparent way.   Those are our goals.

We appreciate “Support the NHS” for taking the time to share their concerns with us.    It is helpful for us to hear how people feel and it genuinely challenges us to keep thinking about what we do and how we do it.

Response from Audson on

There is no bigger fan than me of the NHS nor greater supporter of the many excellent staff but I have learned in life that nonetheless we can all improve. And we can only do that through feedback. Patient opinion is an excellent and moderated mechanism to give feedback to the service. All efforts are made not to identify individuals and much of the feedback is positive. Openness and trust are the corner stones here and we need to encourage engagement and not be fearful of it. So the norm becomes feedback not complaint. I believe this is one way to achieve this but we must be open to learning because that's the motivation for all concerned.

Response from Lundin Links on

I can see the concerns however having used Patient Opinion for feedback. Posting of the story isn't immediate and having used a name which would have identified a relative it was thankfully taken out. The replies that I have seen to feedback, negative or positive, are structured and give the impression that it's done with investigation by relevant individuals. It offers a method of feedback that is transparent in many ways and for the public and professionals to see. 

Response from Ken Donaldson, Associate Medical Director, NHS Dumfries & Galloway on

I welcome the feedback from 'Support the NHS' as staff support through the complaint/feedback process can often fall short of the support offered to the complainant. I would like to think that the feedback supplied through Patient Opinion would be channelled through the appropriate complaints officer by each board and therefore undergo investigation. As you say social media offers unprecedented access to a platform for everyone to comment so we all have to act responsibly when we use it. Patient opinion is an excellent website. Keep up the good work.

Response from Dougie Brownlie, Patient Advice and Support Service (PASS) Marketing Officer, Citizens Advice Scotland on

Gina has explained how Patient Opinion do an extremely professional job in ensuring confidentiality from their end and ‘Support the NHS’ has alluded to the NHS complaints procedure. I thought I would add a bit more about that procedure and the different routes available.

Each Scottish health board has their own individual teams who deal with feedback, comments, concerns and complaints and whilst it may be obvious to say that individuals should send any feedback direct to these teams, the recent joint Healthcare Improvement Scotland/Scottish Health Council report, “Listening and Learning”  recognised that, “The main barriers to giving feedback or making a complaint were identified by respondents as:

•a fear of repercussions for their own or relatives’ treatment

•not knowing how to make contact or who to make contact with, and

•a lack of confidence that anything will be done

This report may prove to be a watershed moment for the NHS in Scotland. The Patient Rights (Scotland) Act 2011 made it a statutory right for people in Scotland “to give feedback (both positive and negative) or comments, or raise concerns or complaints about the health care they have received.”

The act also created the Patient Advice and Support Service (PASS) which was launched in April 2012 and since then, the Scottish Government have also given funding to Patient Opinion. Both PASS and Patient Opinion can play a key role in improving the NHS across Scotland if health boards deliver some of the key recommendations contained within the Scottish Health Council report.

This is a blog on the Patient Opinion website so I’ll make an assumption that everybody on here knows, understands and supports the excellent work that Patient Opinion does. You may not have the same level of knowledge about PASS.

The Patient Advice and Support Service PASS is delivered by your local Citizens Advice Bureau (CAB) in Scotland and can be accessed by contacting your local CAB (the number is in the phone book) or visiting www.patientadvicescotland.org.uk

PASS has fully trained professional advisers that can provide confidential information, advice and support to help you:

•            give feedback or comments, raise concerns or make complaints about health care provided by the NHS in Scotland

•            understand your rights and responsibilities as a patient

•            write letters; attend meetings and make phone calls

Clients can also access information and advice on how to access health and community services that offer additional support with health care needs. PASS clients can also access other services provided by Citizens Advice such as housing, employment, benefits or money worries.

Scottish NHS patients deserve the best possible health service and to get this everybody involved has to listen and learn from previous experiences to ensure this and future generations get a health service they we can all be rightly proud of. Whether you use the health boards own services, PASS or Patient Opinion; your feedback will be most welcome.

Pam Whittle CBE, the chair of the Scottish Health Council said in the foreword of the “Listening and Learning” report, “People can’t exercise their right to give feedback or make complaints if they don’t know that this right exists”. Those rights do now exist.

Response from Faith in the NHS on

It's not so much about complaining but more of a suggestion.

All hospitals should have a department that looks into issues or queries before they get a chance to escalate into a complaint, a department or body that is totally independent from the hospital. This way they could be away ahead of what could be a resolvable issue turns into a validated complaint.  It's all well & good saying we have PAS & PALS but they seem to be there to shut the gate after the horse has bolted. These services seem to be under funded & understaffed at best. More time should be invested in preventing complaints. Most people do not want to complain but in most cases they would like to make things better before they get worse. I have a suggestion for the NHS, maybe they should hand everyone a number they could call instead of waiting for an issue to remain unaddressed then handing them a complaints form, sometimes all it takes is a friendly voice & a sympathetic ear to resolve a lot of problems

Response from Derek Barron, Associate Nurse Director, Mental Health Services, NHS Ayrshire and Arran on

I note the comments from 'Support the NHS' - I must admit their experience of PO is somewhat different from mine.  I am a supporter and advocate of PO, it offers the opportunity of direct feedback to clinical areas, services and staff.  I haven't found any instance of staff being named directly in relation to issues being highlighted, albeit identification may be possible in some circumstances.

PO gives people the opportunity to feedback without the need and perceived restrictions of a formal complaints process - that said we take both methods of feedback seriously.  Additionally, an apology is not an admission of wrongdoing or guilt - when I say sorry (as I have responder rights on the PO site) I am genuinely sorry that the experience someone encountered has left them dissatisfied.  My colleagues and I then investigate the circumstance and where possible and appropriate attempt to resolve the issue.

In my experience thus far we have as many, or potentially more, people who are feeding back about positive experiences, I always endeavour to ensure this is fed back to the teams/individuals involved.  Additionally I think that people in our local area are more likely to appreciate the openness and transparency that PO bring - many other forms of media do not offer the balance and direct honesty of feedback that PO provides.

There will always be a small group of people who find it difficult to take on board less than positive feedback, however I suspect that is the same whether this is via the complaints process or PO.

In my engagement with our staff to date the reception has been overwhelmingly supportive.

I shall continue to support PO as they continue support us in continuously developing our NHS where it needs developed and consolidating the many excellent examples that are regularly praised by PO contributors.

Derek 

Response from Eunice Goodwin, Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team, NHS Ayrshire and Arran on

I would like to add to the comments made by Derek Barron regarding 'Support the NHS' comments made on PO. I was recently asked to take over as the PO Coordinator in NHS Ayrshire and Arran (mid March 2014) and I admit I thought there would be 'poor use or abuse' of NHS Staff and services via the website.  In my experience so far, that has been unfounded.

The public nature of PO makes it extremely important and sometimes difficult to respond in a awy that everyone will understand the written word but great care is taken to respond in a possitive, caring and supportive nature.

I know that some posts have led to an official complaint and quite rightly so, some things do need to be thoroughly investigated and balanced outcomes within the official procecess for all concerned. However, I believe it has been very supportive of many people. I have several emails from staff, patients and relatives alike thanking me for the help they have had as a result of the posts, the responses and indeed the background work that may not be obviuos from the outside.

I am a convert to PO, I believe it can not only lead to improvements where and when they are needed but can give people a much needed way to express both their opinion and their feelings.  Capturing how people felt under specific circumstances can be difficult but immensely valuable.

If we truly believe in ‘Patient Centred Care’ we can only achieve this by listening, responding and acting appropriately to the information received.  Patient Opinion is a tool that can help us to achieve Patient Centred Care.

Eunice Goodwin (Patient Opinion Coordinator for NHS Ayrshire and Arran)

 

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