NHS Shetland Summary of General Feedback received in 2016/17

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1 1 Patient not notified of appointment cancellation (St Olaf Street) 2 Patient unable to get appointment within the next month 3 Patient rec d as DNA, but had not received appt letter. He had not understood follow-up procedure as noone had told him Dental Misunderstanding Appointment postponed and new date given Patient thought this appointment was in addition to, not instead of LHC Patient had not advised LHC that this was too long to wait Explanation that call could have been triaged by duty doctor OP/DS Director of Nursing and Acute Services replied directly 4 Out of Area Treatment (OAT) Out of Area Treatment Issue thought to be decision made by external Board Consent required to investigate further (not forthcoming) 5 Treatment offered in Aberdeen; patient would prefer Glasgow to be nearer Out of Area Treatment Explanation of how OAT worked and the existing SLA with NHS Grampian family Offer to pay w/e travel between Aberdeen and Glasgow 6 Patient escort not approved Patient Escort Clinical decision by GP, cannot be changed by NHS admin intervention 7 Apparent delay to ARI transfer for cancer patient GBH Investigation showed referral on track SCN at GBH to ensure patient and family kept informed 8 Letter of thanks A&E, X-ray, Theatre and Ward One Acknowledged and shared with staff 9 Poor care CMHS CMHS Suggest 1:1 discussion of concerns direct with clinicians as way forward 10 Patient escort not approved Patient Escort Advised to speak direct to different GP at practice (with permission of patient) to discuss concerns for future travel

2 11 CAMHS referral CAMHS Meet with Director of Nursing and Acute Services and Child Health Manager Letter sent from DNAS through Corporate Services 12 Unhappy with not getting information requested regarding son CMHS Explanation that member of staff not at liberty to disclose information about son (who was an adult) Matter referred to CPN who made a judgment and resolved the issue Concerns noted about the way the member of staff was spoken to 13 Request for adult autism assessment for son; mandate sent CMHS Letter from family to request written confirmation that ASD assessment is planned to take place Signed mandate received Unhappy with timescale of CAMHS referral for daughter Appointment of clinical psychologist expected to resolve CAMHS Ongoing concerns June/July 2016 Meeting with service representatives to discuss concerns and notes agreed for inclusion in records 15 Seeking appointment with CMHS CMHS Referred to GP in first instance 16 Challenging OAT decision (see PF 2016_17 05) 17 Unhappy with GP decision re Patient Escort Out of Area Treatment Explained reason for decision and that patient had accepted treatment in Aberdeen with offer of travel costs for w/e visits between Aberdeen and Glasgow reimbursed See PF 2016_17 05 Patient Escort Discussed with GP Patient Travel working on updated guidelines for GPs regarding escort criteria 18 Patient wanted to see GP, not ANP LHC Explanation of ANP role, and capacity to refer to GP Passed comments on to LHC 19 Family unclear about forward treatment plan for son and seek reassurance that his needs will be addressed CAMHS Assurance from KDC and team to contact parent direct

3 20 Contacted LHC as family member s nebuliser broken; annoyed at how LHC dealt with his concerns 21 Patient confused about appointments in dental and surgery 22 Carer angry about patient re-referral process via GP 23 Lack of dental cover in the north of Shetland 24 Family unhappy with medical rehousing points allocation 25 Availability of specialist neurology rehab services on NHS 26 Poor communication between NHS Grampian and patient s GP 27 Unacceptable waiting time for treatment 28 Lack of dental cover in north of Shetland 29 Lack of dental cover in north of Shetland LHC reception Community Nursing able to replace nebuliser LHC reception staff reminded on procedure for replacing nebulisers Appointments Meeting arranged between patient and GP to facilitate ongoing arrangements Re-referral Misunderstanding; explanation of re-referral for DNAs given Copy letters provided Explanation that patient weight is taken into consideration in relation to surgical procedures, so correct clinical decision had been made Dental Apology offered and explanation provided Medical re-housing points No material change to medical condition to warrant increase in points allocated No further review this year unless significant change to medical condition Out of Area Treatment Reply sent including advice of meeting with family, NHS and SIC to discuss onward management Onward plan to be organised to be organised by SIC Follow up with Medical Director Wasted trip to Aberdeen Forwarded to NHS Grampian Waiting time; Aberdeen Formal complaint forwarded to NHS Grampian Appointment brought forward to early August Dental Dental to respond direct to Unst Community Council Apology offered and explanation provided Dental Dental responded directly to individual Apology offered and explanation provided

4 30 Lack of dental cover in north of Shetland 31 Thanks for standard of care from all clinical staff 32 Patient felt they had been stonewalled by reception staff; non-availability of appointments 33 Difficulty in making annual dental checks for children 34 Local SAS transport to hospital appointment; agreed in Lerwick but denied by Inverness 35 Patient symptoms worsening; advised needed MRI waiting for date Dental Explanation provided to MSP Apology offered and explanation provided Ward One & OT Individual thanked for feedback Positive comments passed to staff involved LHC reception Director and GP on Radio Shetland to explain issues July 2016 Child Dental Difference explained between PDS and independent dentists providing NHS service and the impact on PDS service of impact on waiting times/lists and ability to respond SAS Suggest patient contact RVS transport to see if possible to arrange transport at short notice Check Patient Travel re Inverness SAS Referral pathway GP requested to contact patient re symptoms and then contact ARI consultant to discuss pathway going forward 36 Waiting time for BP monitor BP monitor Seven BP monitors ordered for LHC 37 Exceeded 12 weeks RTT Referral for second opinion LHC looking into delay; GP contacted patient to apologise and progress 38 Cancellation of visits to care home for denture replacement affecting elderly patient 39 Lost in A&E handover; A&E prescribing/lhc re prescription deficit make up 40 Query re medication / diagnosis Medication (Consultant Physician) Dental Full explanation of dental process and timetable given Apology given A&E/LHC/prescribing Full explanation including prescribing process and apology for delay and inconvenience Medical Director agreed phased reintroduction of medication Consultant Physician to take forward and contact patient directly

5 41 Waiting for wheelchair adaptations MARS MARS suggested they would contact family directly Family to revert to Corporate Services if this did not happen 42 Patient unhappy that GP referral Consultants Advised route through GP downgraded from urgent to routine Noted as feedback concern 43 Patient unhappy at GP pain relief advice; consultant referral cancelled in error, but reinstated by GP practice 44 Possible missing items following emergency admission and transfer 45 Making follow-up appointments for dental/sc; GP appointments 46 Thanks for kindness and professionalism of Day Surgery staff 47 Thanks for professionalism of A&E staff for holiday maker Yell Health Centre / Medical Secretary Medical Director to follow up with YHC and Pharmacy GBH / A&E / Ward 3 Followed up through hospital management PC/SC appointments Full explanation given for not giving automatic follow-up dates and local arrangements for GP appointments Day Surgery Staff advised and thank you sent A&E Staff advised and thank you sent 48 GP attitude LHC No further action taken GP noted patient dissatisfaction 49 Re closure of Ronas Ward Ronas Ward DNAS to respond directly 50 Definitive diagnosis / 2 nd opinion / onward care and management 51 Attitude of on-call GP re pain relief available for elderly patient LHC Medical Director discussed with LHC; GP contacted husband and wife to discuss options Further correspondence Feb 17 to request mtg note GP Medical Director to discuss with GP to understand circumstances

6 52 Waiting time for YAG surgery ARI Acknowledged and forwarded to ARI for response 53 Social work intervention raised by Ward staff not acceptable to patient 54 Availability of smear tests out with GP surgery; access to GP notes and other general issues relating to women s healthcare provision 55 No consultation prior to change to appointment made direct with GP 56 1) Physio waiting times 2) GP allegedly recommending private physio 57 Query information given by NHS 24 re OOH dental cover in Shetland 58 No response from staff in dietetics re appointment for son; concerned not to miss 14 day deadline for response 59 Why does patient have to travel to Glasgow to see consultant? 60 Concern about cover for planned absence 61 Concerns about aspects of Yell GP practice 62 Technical error with appointments system Ward Three Acknowledged by Chairman; passed on to Director of Service for further investigation and following response GP services Service Manager for Primary Care corresponded with patient direct; query originally forwarded from generic information inbox and developed into other issues (see also responses to annual review questions) LHC GP had not put note on patient record; now resolved, patient happy to have seen named GP Physio/GP comment Referral triaged as not urgent but did miss 4 week referral time due to increase in demand for appointments rather than staffing levels being pressured NHS 24 / Dental OOH Information given was correct; misunderstood by patient Dietetics Dietetics rang (independently) and mother advised that she has sorted the appointment for her son GJNH appointment Explanation of service given and reasons for Glasgow appointment; date included Community Nursing - Foula Staffing issues to be addressed: NHD staff reduced from 8 to 5; difficulty in providing cover Yell HC Comments noted; advised that GP has now left Yell HC and NHS Shetland LHC Not a technical error; suggest LHC calls be recorded for training purposes (would entail a new system?)

7 63 Accessing orthodontic appointments for daughter 64 Concern about ANP cover/replacement Orthodontics Became a formal complaint; FC2016_17_49 ANPs Detail of recruitment underway 65 Receptionist attitude / ANP attitude LHC Service Manager for Primary Care to pick up issue with blood results and also feedback re reception staff to new LHC Manager. Home visit by Service Manager for Primary Care and 66 Access to appointments, not dental care itself Complaints Officer Dental Acknowledged issues and that service was out of capacity 67 Given additional diagnosis from consultant; not sure of onward treatment plan 68 Unsatisfactory arrangements at HC in general. Patient had received letter to advise that she was not to speak to any staff without a third party present 69 Comparing prices at GBH to Islesburgh OP Advised to speak to GP in the first instance to discuss diagnosis and treatment plan Unst HC Agreed to pass on to service manager Positive feedback about some aspects GBH canteen Noted; to be discussed 70 Delay in forwarding CT scan results CT scan results Delay not with NHS Shetland. Chief Executive ed NHS Grampian consultant to make aware of the concern 71 Rude staff in A&E A&E Director of Nursing and Acute Services dealing with directly 72 Patient escort not approved; patient advised to appeal decision 73 Patient wished to withdraw from NHS physio service Patient Escort CAB to discuss with client; if agreed, CAB will pursue appeal direct with Medical Director Physio Information passed to physio who had already received it direct. Patient declined offer to pursue feedback

8 74 Consultant running late meant that elderly patient had to return to catch ferry before seeing a consultant Ophthalmology Patient Focussed booking to contact patient direct to rearrange appointment 75 Define criteria for OOH on-call x-rays A&E This action has now been completed 76 Case management and prescribing Dermatology/prescribing Pathway investigated by Medical Director, suggestion to family to contact Grampian direct 77 Inconsistency in approvals Patient Escorts Spoken with them and accepted discussion, however feedback to be noted 78 Neurology referral; letter from CMHS CMHS / refer to Neurology Edinburgh 79 Unhappy at delay to appointment for braces 1) VC arranged with Edinburgh Consultant 2) Primary Care to chase letter from CMHS to query local plan Dental Explained why braces not fitted immediately therefore no delay to treatment plan 80 Emergency dental service - thanks Dental Passed to Dental Management for onward circulation 81 Length of wait at OP OP/DS Director of Nursing and Acute Services to reply direct 82 Random information sent to patient GP LHC LHC Manager spoke to patient direct; software error apology given 83 Registered St Olaf Street patient unhappy at advice to register at Market Street for check-up 84 Excellence of service, GP / A&E / Ward 3 Dental Offered appointment at GBH with locum A&E / Ward 3 / HC Acknowledged and forwarded for sharing with staff 85 Wait for obs and gynae procedure Obs and Gynae Explained current challenges. Waiting to hear if planned clinic appointments possible No further contact from patient

9 86 Thanks for excellence care Physio Cc to staff for onward sharing 87 Thanks for care (Dr Fryer); query why scan not done when admitted in 2015 with TIA 88 Waiting for copy of child s physio report (CPIPS); phone call not returned; update on progress with child physio recruitment 89 Pre-arranged call from GP not received; no message left; patient angry when advised that GP had tried to call and failed 90 Waiting to hear about support following review meeting October Registered Montfield; unable to get appointment explanation sought GBH Acknowledged and forwarded to appropriate staff Explanation about why scan was not indicated at the time Physio Apology given - resolved LHC GP rang patient and arranged an appointment CMHS Phone call file noted and sent with copy of complaints procedure. Became a formal complaint (FC 2016_17 58) Dental Passed to Dental for comment/reply; children given appts; advised about future registration at LDP 92 Photo id s of staff in public areas GBH/Board Thanked and passed on comments to HoDs 93 Dissatisfied with north isles dental provision 94 Poor communication between NHS Grampian and patient s GP Dental Acknowledge and passed to Dental Director for response LHC/NHS Grampian Passed to NHS Grampian; phone call to confirm Grampian to log in DATIX 95 Waiting times for ENT referral ENT referral Demand high at national level as well as local; efforts being made to improve visiting consultant service 96 Patient concern at apparent reduced frequency of podiatry appointments Podiatry Podiatrist confirmed the patient s treatment plan complied with recommended outcomes from Diabetic screening plan

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