Concerns raised over NHS Fife’s move to suspend investigating patients’ complaints

Concerns have been raised over a decision by NHS Fife ​to suspend investigating patients’ complaints due to the impact of the Covid-19 pandemic and staff shortages.

​The health board announced last week that complaints by the public will continue to be acknowledged and registered but that “investigation and formal responses” would be suspended. NHS Fife received 1302 complaints in 2019/20. 

In a letter sent to staff the health board said healthcare services have come under increasing strain due to a “sustained and significant rise” in the number of patients suffering “both Covid-related and non-Covid related conditions”.

A number of measures were being introduced to try and “reduce unprecedented pressure” on healthcare services, NHS Fife added, including a hold on complaints being investigated.

Those commenting on that decision included Dorothy-Grace Elder, secretary of the Scottish Parliament cross party group on chronic pain, who said that a “lack of investigation can put lives at risk”. The Patients Association warned that delays with investigations can be “very distressing” for those concerned. 

This is very serious – Covid is still a problem but it is also being used in some places as an everlasting excuse not to act on almost anything. Lack of investigation can put lives at risk.

Dorothy-Grace Elder, secretary of the Scottish Parliament

NHS Fife said it had been forced to take “incredibly difficult decisions” due to current pressures. Announcing the new measures last week, Margo McGurk, director of finance and deputy chief executive of NHS Fife, said the demand on healthcare services “has been relentless” adding that “many of our staff are exhausted, having worked through the most challenging of circumstances for the last 18 months”. 

The new measures to try and reduce pressures on NHS Fife included the postponement of all non-urgent surgical procedures and a staff redeployment programme. On patient complaints, NHS Fife said they “will continue to be acknowledged and registered, however compliant investigation and formal responses will be paused at this time”. 

The Patient Rights (Scotland) Act 2011 provides a specific right for people to make complaints, raise concerns, make comments and give feedback and also places a duty on NHS Boards to thoroughly investigate and respond to any concerns raised.

Dorothy-Grace Elder voiced concern over the suspension of investigations. She told The Ferret: “This is very serious – Covid is still a problem but it is also being used in some places as an everlasting excuse not to act on almost anything. Lack of investigation can put lives at risk. They must be able to find people – perhaps retired professionals – to investigate. Investigations internally are often poor – use outsiders.”

Sometimes an action we’d usually think of as unacceptable may need to be taken

Lucy Watson, chair of the Patients Association

Lucy Watson, chair of the Patients Association, said that despite the success of the vaccines the pandemic is not over and the organisation recognised that “sometimes an action we’d usually think of as unacceptable may need to be taken”. 

She explained that English trusts were allowed to pause their complaints investigations last year, which was “preferable to the wholesale shutdown of complaints processes that we saw in the first wave”.

However, she added: “If Scottish boards are now going to pause investigations they need to be clear about the reasons why they are doing this and to be mindful of people who have lodged a complaint and are affected by delays in any investigation, which can be very distressing. Patient complaints and feedback are essential ways for NHS organisations to understand their own performance.”

In reply, NHS Fife director of nursing, Janette Owens, said that with rates of Covid transmission in Fife “likely to lead to a further increase the number of hospitalisations” over coming weeks, the trust had taken a number of “incredibly difficult decisions to help safeguard urgent care, trauma and cancer services”.   

She added: “The measures we have taken are designed to help reduce the unprecedented pressures on our services, and indeed on healthcare staff, and are vital in ensuring we can continue to provide good quality care for those who are most acutely unwell. We are hopeful that the postponement of all affected services will be brief, with the measures remaining under continual review to ensure full services can be recommenced as it is safe to do so.”

The Scottish Government said it expected NHS boards to comply with their legal duty under the Patient Rights (Scotland) Act 2011, but added that the NHS complaints handling procedure makes provision for “timescales of responses to complaints to be extended where appropriate”.

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A spokesperson said: “We have been supportive of boards taking this approach since the start of the pandemic which has been the most significant challenge the NHS has faced in its 73-year history. We know that the pandemic is not over, and that Covid-19 and other pressures will continue to impact the NHS for some time and we are working proactively with health boards to manage pressures.”

Over the past week other Scots health boards have warned of rising Covid cases putting severe pressure on their services.

NHS Highland said staff numbers had been hit by illness or workers having to self-isolate and that it was having to return to prioritising vital care and treatment, such as emergency admissions and cancer care.

NHS Grampian said Covid patients were up more than 40 per cent in a week and NHS Highland some patients would have to wait longer for operations.

The Scottish Government has been asked to comment.

Photo Credit: iStock/megaflopp

Correction: This story was amended on 17/9/2021 to remove references to Scottish NHS trusts. There are no NHS trusts in Scotland, only health boards.