Communication complaints to NHS Ayrshire and Arran

A report to the Ayrshire and Arran health board showed that there were 1,798 complaints made between January 1, 2022, when a new ‘patient experience’ process was launched, and January 31, 2023.

Of these complaints, 719 were categorised as clinical treatment issues. The other main subjects of complaints were the attitudes and behaviour of staff, waiting times, and appointments.

Waiting time issues jumped from 145 to more than 400.

There were 123 stage one complaints around acute services, with 210 reaching stage two. Stage one complaints are those which are resolved and do not require escalation to a stage two investigation.

NHS Ayrshire & Arran said that it received 25 'stage one' complaints that an opportunity for a early diagnosis for new cancer was missed by medical staff.

The report to the health board also acknowledges the number of complaints from families that weren’t resolved at the first stage.

Concerns at poor communication from staff lay at the heart of half of all complaints made to NHS Ayrshire and Arran durign 2022

It states that this involved parents of patients or loved ones disagreeing with diagnoses made, and families unhappy that they were not involved in medical decisions, especially relating to end-of-life decisions and resuscitation.

Similar issues arose when it came to patient discharges. The report states that complaints included “failure to involve patient and family in discharge planning, disagreement with discharge decision, prolonged waits in discharge lounge, medication not being ready at time of discharge and discharging frail elderly patients out of hours without a family member present”.

Other complaints which were not resolved at the first stage were nursing care, including failures around hygiene, medication, poor care resulting in bed sores, poor response times and lack of assistance during meals.

Complaints around mental health services included issues with access to treatment, treatment plans, inpatient nursing care at Woodland View Hospital in Irvine and compulsory detention.

There were 12 complaints specifically around child and adolescent mental health services (CAMHS), with disagreements over diagnoses, poor communications and lack of support.

The report looked at the issue of communications in more detail, highlighting it appeared to be a problem in half of all complaints.

It stated: “Communication is a theme raised in a large proportion of complaints received. 50 per cent highlighted one or more issues relating to communication.”

Concerns at poor communication from staff lay at the heart of half of all complaints made to NHS Ayrshire and Arran durign 2022

The issues included a lack of updates or information on treatment plans; difficulties accessing complaint investigation results, with the majority of complainants waiting more than six weeks; failure to involve family, inaccurate information on written discharge instructions, failure to notify care homes of discharge and not providing families with the opportunity to raise and discuss concerns related to discharge; and end of life conversations, relating to treatment escalation plans or resuscitation decisions.

Around 200 complaints raised concerns with the “attitude and behaviour of staff”, a reduction from 254 in the previous year.

Of these, 80 per cent were concerns around verbal communication with medical and nursing staff, with complainers describing some as “abrupt, unhelpful, and uncaring”.

The NHS said that the massive increase in complaints around waiting times was “undoubtedly as a result of the impact of the pandemic on waiting times” and were classed as being resolved at the first stage.

The majority of waiting time complaints were for acute services, with more than 100 relating to waits for surgery, for outpatient appointments, results and medical imaging.

Some patients even received letters after the date of their appointment.

The report stated: “The real importance of being able to extract accurate themes from complaints received is to ensure we are proactive in our approaches to learning and improvement and seek to address the areas where we have evidence from service users that there is room for improvement.”