NHS Scotland - elective surgeries, patient concerns, elderly care: FOI release

Information requested

 

You asked for the Scottish Government to provide you with answers to the following questions:

1. The process which the Scottish Government uses to ensure that policy with relation to the pre-requisites for elective surgeries is consistent across all NHS Boards in Scotland.

2. The process which is in place should there be inconsistencies in the way elective surgeries in specific areas are handled across NHS Scotland boards to ensure that patients are not discriminated against based on locality.

3. The process under which a patient can seek remedial action to change policy when there is an identified inconsistency in approach which unfairly discriminates against them based on locality.

4. The process under which a patient or group of patients may seek a public inquiry into matters of concern with relation to inconsistent treatment across NHS boards in specific fields.

5. The processes under which the Scottish Government monitor the delivery of elderly in-patient care across NHS Scotland boards.

6. Any reports into the delivery of elderly in-patient care in local health boards over the past 5 years by NHS Scotland or by the Scottish Government,

 

Response

 

I enclose a copy of the information you requested.

Some of the information you have requested is available from http://www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/nhs_hospitals_and_services/care_of_older_people/all_reports.aspx Under section 25(1) of FOISA, we do not have to give you information which is already reasonably accessible to you. If, however, you do not have internet access to obtain this information from the website(s) listed, then please contact me again and I will send you a paper copy.

 

1. The process which the Scottish Government uses to ensure that policy with relation to the pre-requisites for elective surgeries is consistent across all NHS Boards in Scotland.

The Scottish Government ensures consistency across NHS Boards by using a performance management approach. The Scottish Government have a team of performance managers who work closely with the local teams to ensure best practice is instilled across all hospital sites.

In addition, to share best practice and innovation across NHSScotland the Scottish Government use learning workshops, improvement network meetings and case studies.

There are a number of government improvement programmes already in place that support the spread and sustainability of person centred, safe and effective health care for every patient, every time in Scotland, and aim to reduce variation in service provision.

 

2. The process which is in place should there be inconsistencies in the way elective surgeries in specific areas are handled across NHS Scotland boards to ensure that patients are not discriminated against based on locality.

Please see answer above (1)

 

3. The process under which a patient can seek remedial action to change policy when there is an identified inconsistency in approach which unfairly discriminates against them based on locality.

The Patient Rights (Scotland) Act 2011 and supporting legislation, provides a specific right for people to make complaints, raise concerns, make comments and give feedback. The Act also places a duty on NHS Boards to thoroughly investigate and respond to any concerns raised, to take improvement actions where appropriate and to share learning from the views they receive. When a person has concerns about their treatment or care, this should be addressed at a local level through the NHS complaints procedure. When that is not possible the Scottish Public Services Ombudsman (SPSO) is the second and final stage in the complaints process.

 

4. The process under which a patient or group of patients may seek a public inquiry into matters of concern with relation to inconsistent treatment across NHS boards in specific fields.

Under section 1 of the Inquiries Act 2005, Ministers may cause an inquiry to be held in relation to a case where it appears that—

(a) particular events have caused, or are capable of causing, public concern, or
(b) there is public concern that particular events may have occurred.

A full public inquiry is relatively rare. There are two full public inquiries being held in Scotland at present, the Edinburgh Trams Inquiry and the Child Abuse Inquiry.

One of the reasons why full public inquiries are so rare is that they tend to be very expensive and they can last for a number of years.

A full public inquiry may not be appropriate for the reason you describe above. If a patient or group of patients are concerned about inconsistent treatment across NHS boards in specific fields then a review by the Scottish Public Service Ombudsman (SPSO) may be more appropriate. They will investigate and make recommendations in a shorter timescale and at less cost.

The SPSO is independent from the provider of healthcare and Ministers and looks into complaints about most organisations providing public services in Scotland. Their role is to give an independent and impartial decision on complaints and it also has a statutory role in improving complaints handling by organisations. Once the SPSO have completed an investigation and made a decision, they will write to the person who brought the complaint, as well as the organisation involved, and give details of that decision. This will include details of any recommendations the SPSO have made to put things right, and the deadlines by which the organisation must carry out these recommendations. There is a rigorous review process in place to ensure that recommendations have been implemented by that time.

 

5. The processes under which the Scottish Government monitor the delivery of elderly in-patient care across NHS Scotland boards.

In June 2011, the then Cabinet Secretary for Health, Wellbeing and Cities Strategy announced that Healthcare Improvement Scotland (HIS) would carry out a new programme of inspections to provide assurance that the care of older people in acute hospitals is of a high standard.

HIS monitor NHS Boards’ compliance against a range of standards that have been developed to ensure older people get the best care possible. They inspect against best practice statements and other national documents relevant to the care of older people in acute hospitals, including the Care of Older People in Hospital Standards (Healthcare Improvement Scotland, June 2015). The process includes a planned NHS Board visit that allows them to highlight areas of good practice and also areas where improvements could be made. The NHS Board visits are followed up with an unannounced inspection to each acute hospital in the NHS Board area.

NHS Boards must prioritise those areas where improvement is required to meet a national standard. Boards must develop an improvement action plan, which are published and available to view on the Healthcare Improvement Scotland website http://www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/nhs_hospitals_and_services/care_of_older_people/all_reports.aspx. HIS supports Boards and monitors the implementation of the improvement action plan.

6. Any reports into the delivery of elderly in-patient care in local health boards over the past 5 years by NHS Scotland or by the Scottish Government.

The Scottish Government do not hold individual reports on the delivery of elderly in-patient care in local NHS Boards. Older People in Acute Hospitals inspections reports are available on the Healthcare Improvement Scotland website and can be found at the following link: http://www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/nhs_hospitals_and_services/care_of_older_people/all_reports.aspx

Additionally, you may wish to visit the Mental Welfare Commission website and their publications page which you will be able to view reports from their national, themed visits to people with similar health issues or situations across Scotland, and Mental Welfare Commission monitoring visits https://www.mwcscot.org.uk/publications/visit-monitoring-reports/

 

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at http://www.gov.scot/foi-responses.