30 August 2016
Robert Woolley
University Hospitals Bristol NHS Foundation Trust
Trust Headquarters
Marlborough Street
Bristol
BS1 3NU
Dear Mr. Woolley,
Healthwatch response to independent reports
I write to you on behalf of Healthwatch Bristol and Healthwatch South Gloucestershire regarding the recently-published independent reports relating to children’s cardiac services, complaints handling and associated support for patients, carers and families. I write to you to discharge the statutory duty of local Healthwatch as follows:
Promoting, and supporting, the involvement of people in the commissioning, provision and scrutiny of local care services
And;
Enabling local people to monitor the standard of provision of local care services and whether and how local care services could and ought to be improved;
I will ensure that responses to our questions and ongoing requests for updates and communication are shared widely with patients and the public in order to discharge these statutory duties. A copy of this letter will also be provided to local health overview and scrutiny committees for information.
1. Complaints
Summary
Healthwatch notes that significant improvements have been pledged by UHB relating to your treatment of complaints.
Although we are pleased that UHB have committed to improving approaches to complaints, Healthwatch is concerned that UHB failed to deliver an effective complaints support package to the parents of Ben. We are concerned that lessons learned in previous years on a national level regarding complaints do not appear to have adequately informed complaints processes in this instance. Our concerns reflect particularly the findings and recommendations of Clywd-Hart (October 2013), including:
‘When action is delayed or mishandled it can cause great distress and a breakdown in the trust between the patient, their family or friends and the hospital’ (page 34).
And;
‘We (Clywd-Hart) agree with the Francis Report, which recommended that hospitals should always use an independent investigator in circumstances, where… a complaint raises substantive issues of professional misconduct’ (page 36).
Requests
1.1 We request that regular updates on the overall progress made to improve the quality of your complaints processes are communicated regularly to us, and we will in turn publicise throughout our networks. Please respond with a timeframe for this
1.2 Please provide an update regarding how UHB is going to ensure that the importance of complaints is embedded within your organisation, including at the most senior levels
1.3 Please provide an update regarding how UHB is going to ensure that roles and responsibilities for complaints, including serious complaints, are clearly defined. Please also outline your approach to identifying when to bring in an independent investigator
1.4 Please provide an update as to whether the Trust will commit to naming a senior individual who will take overall responsibility for ensuring that all complaints are handled properly and effectively
1.5 Please provide an update regarding how UHB intends to develop an ‘integrated process for the management of complaints’
1.6 Please provide us with an explanation as to how you will ensure that complaints are dealt with in a timely manner in future. Please also provide us with a written update in August 2017 to demonstrate whether you are complying with this commitment
1.7 We would like to remind UHB that the Patients’ Trust identified 12 good practice standards following the mid-Staffordshire scandal. Please update us on whether UHB is taking steps to learn from the good practice standards. Healthwatch would be willing to provide lay support to explore this proposal with UHB if required.
2. Openness and transparency
Healthwatch notes that the report prepared by Verita did not find evidence of a cover up at UHB. It is, however, clear that a lack of openness and transparency has contributed to a suspicion held by Ben’s parents of a cover up. We note with some concern that inaccurate information was provided, that many of your complaints processes took an unacceptable length of time, and that UHB staff actions during the recess of the Child Death Review Feedback Meeting of 22 July 2015 - and the subsequent media coverage – can be reasonably assumed to have damaged public confidence.
Actions:
2.1 Please advise us as to how you will ensure that you effectively recognise and implement ‘guidance and training for clinical staff as regards liaising with families and enabling effective dialogue’.
2.2 Please provide us with an update regarding steps that the Trust will take to re-build patient and public confidence following the incident during the recess of the Child Death Review Feedback Meeting of the 22 July 2015.
3. Involving patients, carers and families
We note that the Trust has committed to improving information provision and involvement for patients, carers and families. Some of the proposed improvements have already been shared with Healthwatch, and we would like to thank your staff for this. We also recognise the positive efforts made by PPI staff at UHB to engage with local Healthwatch over the last several years.
Actions:
3.1 Please provide us with an update on the overall success of your measures to improve the involvement of patients, carers and families within the next 12 months.
3.2 Please outline how you intend to measure the effectiveness of your involvement of patients, carers and families
3.3 Healthwatch has previously recommended improvements to discharge processes to UHB, including within our report of July/August 2014 which contributed to the Healthwatch England report ‘Safely Home’ of July 2015. We note that it has been recommended that UHB takes steps towards ‘Ensuring that advice from all professionals involved with individual children is included in discharge planning to ensure that all needs are addressed’. Please provide an update to Healthwatch within 12 months regarding the implementation of this recommendation.
Morgan Daly
Director for Community Services