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A panel has blasted conduct within the Health Department as "unjust" and "improperly discriminatory" after finding that healthcare given to an islander was impacted after she lodged a complaint.
The patient – referred to only as Ms X – had her complaints referenced during the course of a medical appointment.
A States of Jersey Complaints Board upheld the complaint against the Health Minister on the grounds that Mrs X had been treated in a manner which was contrary to the generally accepted principles of natural justice, and had been unjust, oppressive or improperly discriminatory.
Geoffrey Crill, Chair of the Complaints Panel, said: “The Board was particularly concerned about the Department’s complaints process, which was not followed and the fact that once Mrs X had been categorised as a ‘complainant’ this appeared to have had a material effect on her clinical care.
"It is just unthinkable that a patient’s care could be impacted because they have filed a complaint.”
Pictured: "It is just unthinkable that a patient’s care could be impacted because they have filed a complaint.”
The findings of a hearing held on 25 January were today made public.
Mrs X's complaint was centred around access to tertiary care, communication from health care providers, and the Health Department's complaints process.
The case followed on from a previous complaint against the Health Minister, which had been upheld five years ago.
The Board found that Mrs X's case "identified significant weaknesses and inefficiencies" within the Health Department – including a "failure to place the patient at the heart of its processes".
Pictured: Mrs X's case "identified significant weaknesses and inefficiencies" within the Health Department.
The report said: "The Department must maintain a constant awareness of the fact that a patient is, by definition, unwell and this will have an emotional impact.
"It is essential for patients to have confidence in the oversight and management of cases.
"In practice, this means that a clear clinical plan with a timetable should be formulated and, most importantly, a dedicated point of contact should be established at the outset."
The Board criticised the "unfulfilled undertakings, the cancellation of meetings at short notice, inadequately briefed clinicians or Departmental officers, and somewhat patronising unsigned correspondence".
They said that this "did nothing to suggest practical progress in respect of ongoing care or treatment, and were not positive indicators of the proper management and surveillance of a patient’s case".
The Board was also "particularly concerned" about the Health Department’s complaints process.
At the outset, Mrs X appeared to have no desire to make a formal complaint, but contacted the Health Minister to highlight inefficiencies and shortcomings in respect of her own care.
The Board found that the Health Department "did not follow its own complaints process".
Pictured: The Board found that the Health Department "did not follow its own complaints process".
Mrs X’s complaint was escalated to Stage 2 which, according to the Health Department, should involve "assessment and investigation of the complaint".
The Board found that "no meaningful assessment or investigation of the complaint at this stage took place".
The Stage 2 procedure also states that where a person making a complaint is dissatisfied with the outcome of a Stage 2 review, they may seek escalation to the Chief Officer – which is Stage 3.
The escalation of the complaint to Stage 3 is therefore entirely at the discretion of the complainant.
However, the Board found that "Mrs X was not aware that the complaint had been moved on to Stage 3", which they said "demonstrates further a clear failure on the part of the [Health] Department to follow its own procedure".
The Board also criticised the fact that once Mrs X had been categorised as a ‘complainant’, it "appeared to have a material effect on her clinical care".
It was noted that complaints submitted by Mrs X had been referenced during a medical appointment, and the manager of the Patient Experience Team apologised for this during the hearing.
The Health Department said that no further steps could be taken in Mrs X's clinical care until the complaints process had been completed which the Board described as "indefensible".
Pictured: Complaints submitted by Mrs X were referenced during a medical appointment.
The Board said that this "would require a full explanation as to what bearing the outcome of its consideration of the Department’s complaint handling could possibly have in the context of the patient’s clinical care".
"All patients were entitled to receive the best clinical care reasonably possible in a timely manner," the Board found.
During the hearing, the Manager of the Patient Experience Team, Mr Evans, noted that complaints submitted by Mrs X had been referenced during a medical appointment and apologised for this.
In its recommendations, the Board said that "Mr Evans (whom the Board understands has now left the Department after less than three months in post) tacitly acknowledged that complainants might be regarded somewhat differently in the context of the provision of clinical care.
"This would appear to be undeniable in this particular case, and reinforced by allegations that the publication of this Board’s findings would likewise delay clinical care decisions."
The Board described this as "unacceptable".
In concluding, the Chief Nurse extended an apology to Mrs X on behalf of the Health Department for the "trauma and inconvenience" she had experienced.
The Board has made several recommendations for improvements, including a review of communications to ensure that these focus on patient care and are in an appropriate tone.
Pictured: "The [Health] Department should also take patients’ personal circumstances and health into consideration when communicating with them."
The Board suggested that the Health Department "review the nature and relevance of all communications to ensure that these focus on patient care and do not inadvertently adopt an unnecessary tone which could be misconstrued as patronising or condescending".
"The Department should also take patients’ personal circumstances and health into consideration when communicating with them."
The Board also recommended that patients should be allocated a dedicated liaison officer to "ensure ongoing and clear communication between the Department and the patient, both in respect of the complaints process and the clinical care plan".
"This would ensure that clinical care was not adversely affected or disrupted by the complaints process."
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