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Sorry seems to be the hardest word: clinical negligence clients and communication with the NHS

Complaints against NHS have soared, often because of careless communication

9 January 2013

Clinical negligence solicitor Gemma Castrofilippo comments on poor communication in the health service.

A recent report by the Health Service Ombudsman, Dame Julie Mellor, has revealed that complaints against the NHS in England have risen by 50% due to “careless communication”, “unclear explanations” and “insincere apologies” when things go wrong.

This is reflected in our clients’ experiences of trying to discuss with NHS staff what went wrong with their treatment.  Our clients have met with an unwillingness to discuss what happened, felt fobbed off and sadly felt information was forthcoming only when it served the NHS’s own interests.

One of the most upsetting aspects of the NHS’s behaviour towards complaints and patients’ questions about treatment is its failure to hold its hands up and apologise when mistakes are made.  A large number of our injured clients have yet to receive an apology from the NHS, despite negligence having been admitted in full during the course of legal proceedings – in fact, one client’s response to being asked whether an apology had been received from the NHS was “Wow! An apology from Never Hardly Supplied”.

Below three families we represented have set out their experiences of trying to get answers from the NHS, all of whom have yet to receive an apology from the NHS for the negligent treatment received:

NHS unwilling to discuss what happened

One of our clients, a parent whose child’s genetic condition was not picked up antenatally due to the treating NHS hospital’s negligence, says of trying to discuss her concerns with NHS staff:

“Generally, I feel that no one actually listened to what I was saying - at times I felt like I was banging my head against a brick wall!  There was pity and sympathy, but that quickly turned into irritation and outright annoyance when it became clear that I wasn’t content with deliberately evasive answers. I believe that most of the health professionals viewed me as a neurotic, grieving mother who was simply looking for any old person to blame for her child's impairment - they were too arrogant to consider that I had valid questions that needed answering”.  With the help of the family’s GP, who “informally supported my desire to investigate the matter further and went as far as suggesting that I get some very specialised legal advice”, our client decided to investigate the hospital’s care resulting in a full admission of liability.  Despite this admission over two years ago, our client has yet to receive an apology from the Trust which, as she says, “is disgraceful”.

Fobbed off by staff

The parents of a child injured during birth felt left in the dark about what had happened due to their questions being fobbed off by staff: “When your experience in hospital is quantified by the words “it was just one of those things”, every alarm bell in your soul should ring.  Clearly you know in your heart that something has gone wrong, but trying to obtain information from those involved is too often greeted politely with “blank stares” and “quiet silences”.  Extracting your own tooth would be easier.  Information supplied by staff is designed to reverberate around you with medical jargon and technicalities.  The simple fact that the hospital made a complete “Horlicks” is never likely to be spoken by those involved.  The sad fact is that only after gruelling legal representation are you likely to receive the “Holy Grail” of apologies. And too often lessons will not have been learnt”.  It was only when legal proceedings were instigated and the NHS was forced to disclose key medical records and other information that the events during the child’s delivery began being pieced together.

Information forthcoming only when it serves NHS’s own interests

The parents of one of our young brain injured clients have expressed their disappointment at the NHS’s reluctance to be forthcoming about mistakes:

“There were a number of points at which the NHS should have been forthcoming with respect to our son's treatment at and just after his birth - but they simply weren't.  In fact we were only told of any issues when the NHS/Nursing and Midwifery Council (NMC) wanted our permission to pursue a disciplinary case against one of its staff to which our son's treatment by the individual might be of help to them - i.e. to serve their own interests”. The parents requested a meeting with the NHS consultant but this provided no reassurance in relation to their son’s care, in fact it raised further concerns due to the parents’ online research contradicting the consultant’s view that the care had been “sub-optimal but not contributory” to their son’s brain injury.  By this point the parents “had lost faith in the information we were being fed by the NHS”.  They realised the NHS would not be any more forthcoming with details of their failures, and so decided to seek legal advice.  Again, no apology has been made by the NHS despite liability having admitted for the son’s injuries over three years ago. 

A major ramification of the NHS’s current behaviour when dealing with complaints and questions about treatment, is the loss in trust patients then feel.  The Ombudsman’s report states “each complaint that is not fully addressed or investigated is a missed opportunity for the NHS to continue to improve, to pick up on possible systemic problems, and to reinforce the trust that we all place in the NHS to get our care and treatment right”.  The NHS cannot expect patients to remain trusting of its staff when explanations of and apologies in relation to wrong-doing are not forthcoming.  The parents of a child whose mismanaged care resulted in a brain injury say “There has never been a clear apology coming back from the hospital/NHS.  We obviously still deal with the hospital and other parts of the NHS in the local area but I personally find it difficult to put my trust in the organisation and its decision making. An apology might go some way to help build my confidence that they are putting patients’ interests before protecting their own”.

Clinical negligence lawyers at Leigh Day hope that the Ombudsman’s report will ensure lessons are learned by the NHS and its practice of dealing with patients’ complaints and concerns will improve.  As the Ombudsman says “Quality of care is not just about getting the treatment and care of patients right.  It is also about putting things right when mistakes occur. This means handling complaints promptly and sensitively, and carrying out thorough investigations to establish the facts of the case. It also means giving complainants timely and evidence-based responses, ensuring that any failings in care are properly acknowledged and explained”.

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