Why do we need a Patient Rights Act?
Patients' rights are very important. Putting patients' rights into law sends out a strong signal that the NHS exists to serve and care for patients and they should be at the heart of the NHS in Scotland.
The treatment time guarantee is a legal guarantee to give certainty to eligible patients about their wait for treatment.
Patients will be provided with more support and advice to help them to use the health service.
What happens if my rights are not met?
If you think your rights have not been met, you can make a complaint to the Health Board. The Patient Advice and Support Service will be able to help you to do this. If you are not satisfied with the Health Board response, you will be able to take your complaint to the Scottish Public Services Ombudsman.
The Patient Advice and Support Service (PASS) will also be able to help and support you to give feedback:
What happens if my treatment doesn't start within 12 weeks and the Treatment Time Guarantee applies to me?
There could be good reasons for this. For example, your doctor might have agreed with you that it would be better to treat another condition before your elective treatment started or you might have asked the Health Board not to start your treatment because you needed to go on holiday first. Generally, though, your Health Board should make sure your treatment starts within 12 weeks. If it doesn't, there are steps that the Board must take, including making sure you are treated at the next available opportunity and that your availability is considered, alongside the clinical need of others:
Isn't this just a charter for lawyers? Won't there be a lawyer at every bedside?
No. To avoid this, the Patient Rights (Scotland) Act 2011 contains a section that excludes liability for damages. This means that the Act does not give you additional rights to take legal action or to claim compensation if you think that your rights in the Act have not been met.
This does not affect your rights to claim damages for breaches of other legal rights, for example damages for personal injury.
If your rights have not been met, you can make a complaint to the Health Board or to the NHS healthcare provider (such as the GP, dentist or pharmacist). The Patient Advice and Support Service (PASS) can help you to do this, if necessary.
The Act puts a duty on Health Boards to monitor the complaints they receive in order to improve the services they provide.
What are my responsibilities as a patient?
Patients have responsibilities as well as rights. Examples of some patient responsibilities are:
- to treat staff with dignity and respect
- to attend appointments or to cancel in advance if you can't attend, to avoid wasting time and resources
- to take medicine that has been prescribed to you.
These responsibilities are not set out in the Act. Instead, these will be included in the Charter of Patient Rights and Responsibilities, and the Patient Advice and Support Service (PASS) will help to explain what patients' responsibilities are. Health Boards will also promote patients' responsibilities.
This is about making the health service work for all of us as best it can, and about us looking after our own health. It's not about denying people treatment.
What services will the Act apply to?
It applies to hospital services and to NHS services like your GP, dentist, and pharmacist.
It doesn't apply to local authority services, such as social work services.
Who does this Act apply to?
The rights in the Act apply to all NHS Scotland patients, including children and young people.
The treatment time guarantee will apply if you are having a treatment that is planned or elective, and carried out on an inpatient or day-case basis.
What treatments are included in the treatment time guarantee?
We aren't listing treatments that will be included because it would be a very long list. Instead, we want people to assume that if they are having a planned or elective procedure, such as a hip or knee replacement, or cataracts removed, and they will be a day-case patient or an inpatient, then the guarantee will cover them. There will be a short list of exclusions.
Are mental health services excluded from the treatment time guarantee?
No, they are not. The treatment time guarantee will apply to mental health services where they are delivered as planned and elective care on an inpatient or day-case basis.
This is likely to have the biggest impact on child and adolescent mental health services, because they make more use of planned admissions than other mental health services, which are often used because of a crisis or emergency, where it would not be appropriate for patients to wait for treatment.
Does this Act give me the right to access a certain treatment or medicine?
No. This Act is about how services are delivered, not which services are delivered.
One part of this Act is about considering your needs as an individual and balancing that against the needs of others; the NHS in Scotland's resources (such as staff capacity and money); and what treatments or medicines are recommended for use in Scotland.
It deals with general principles about how healthcare should be delivered, and what all patients have a right to expect. It does not give rights to specific treatments or medicines, or specific rights for people with particular conditions.
This is because the Act is about the way that you should be treated when you receive healthcare, rather than the type of healthcare or treatment you should receive.
Since 2002, the Scottish Medicines Consortium (SMC) has provided advice to NHS Boards across Scotland about newly licensed medicines or treatments and makes recommendations for their use in the NHS in Scotland.
NHS Boards are required to make Scottish Medicines Consortium-recommended medicines or treatments (or their equivalents) available on an equal basis across Scotland. In the planning and provision of NHS services, NHS Boards ensure that patients have access to medicines or treatments in line with their clinical needs.
The decisions of individual clinicians (for example, the doctor or nurse) in relation to patient care are a matter of professional judgement. However, all NHS staff operate within the management framework of their employing organisations. All Boards have arrangements in place to consider individual cases where there are exceptional circumstances and can consider a request for a medicine not recommended by the Scottish Medicines Consortium: