External review of LUH complaint handling underway

An Ombudsman-ordered external review of Letterkenny University Hospital's complaint handling process is currently taking place, Donegal Live can exclusively reveal.

In a statement to Donegal Live, the HSE confirmed the Office of the Chief Operations Officer and Integrated Operations was undertaking a review of Letterkenny University Hospital's complaint handling processes, with the cooperation of the Saolta University Health Care Group.

According to the HSE, the Office of the Chief Operations Officer will issue a report on the review to the Ombudsman on or before the deadline of April 1, 2022 and publication of the review will be at the discretion of the Office of the Ombudsman.

The review of Letterkenny University Hospital's complaint handling processes was one of the actions ordered by the Ombudsman in response to a complaint made to his office by Moville man Enda Craig.

Mr Craig's complaint to the Ombudsman against Letterkenny University Hospital (LUH) centred on the manner in which he was treated by a staff member in the early morning of May 11, 2019, while he was a patient in a cubicle in the emergency department.

Mr Craig had told the Ombudsman the cubicle curtain had been pulled back by the clinical nurse manager, who, in his words, shouted aggressively at him from the entrance of the cubicle: “You have to get out of here. I need this bed to examine another patient”.

In his reply to Mr Craig, the Ombudsman apologised for the delay in finalising the examination of his case, which he said was due to a number of factors, including “consistently high volumes of complaints about health matters – many of which are complex in nature”.

The Ombudsman also disclosed he had found it necessary to issue a Section 7 Notice to Letterkenny University Hospital, in the course of his investigation into Mr Craig's complaint.

The Ombudsman explained: “These notices confer very significant powers on the Ombudsman in terms of acquiring documents and information necessary for the examination of complaints.”

He added: “During our examination of the complaint, we sought and received a number of reports on the matter from the hospital. We also received a copy of the hospital’s complaint examination file and a copy of your medical and nursing notes, including a copy of the relevant clinical incident report. We also reviewed the CCTV footage in detail and discussed the matter with hospital management.

“Having done so, we were not entirely convinced that some of the key comments in the hospital’s initial complaint response to you could be supported by the relevant recorded CCTV footage.

“In addition, in response to a number of questions, the hospital informed us that it is unclear as to which witnesses were consulted and on what basis they were chosen.

“Furthermore, it emerged that a number of key witnesses were not consulted about the complaint. Accordingly, the Ombudsman asked the Hospital to reflect on how it handled your complaint,” said the Ombudsman.

In his reply to Enda Craig, the Ombudsman confirmed he had asked Sean Murphy, the general manager, of Letterkenny University Hospital, to write to him; apologise to him, acknowledge that his complaint had been poorly handled and retract the initial complaint examination report.

The Ombudsman concluded: “However, given our experience with this particular complaint, the Ombudsman has also asked the National Director of the HSE’s Quality Assurance and Verification Division to undertake a review of the hospital’s overall complaint handling processes, with a view to ensuring that the recommendations in the Ombudsman’s Learning to Get Better Report 1 – particularly Recommendations 13 to 26 – are being actively implemented at all levels in the hospital.”

Donegal Live understands the consultant and the clinical nurse manager involved in Mr Craig's complaint are no longer working at LUH.

The HSE press office said the HSE Saolta Group and Letterkenny University Hospital (LUH) were committed to improving existing compliance levels with the recommendations contained in the Ombudsman's Report Learning to Get Better.

It added: “Complaints at LUH are managed using the HSE Policy Your Service Your Say and every effort is made to ensure that staff are trained and updated on the provisions therein.

“The HSE is fully committed to implementing the recommendations set out in the Ombudsman’s Learning to Get report which sets out best practice in the areas of Access, Process, Response, Leadership and Learning. The HSE continues to monitor progress and reports annually to the Ombudsman.

“In response to Learning to Get Better, the HSE revised the Your Service Your Say policy to encourage and support those using our services to share their experience with us. Training, guidance and supports have been developed to enhance the capacity and confidence of staff to be open and welcoming of feedback and to respond in a way that is reassuring and supportive.

“In addition a new national standardised Complaints Management System (CMS) was developed to capture and record comprehensive complaints data which will provide a greater understanding of trends and issues of concern and will help to prioritise service improvements.

“Casebooks are published annually which capture the individual patient/service user voice and offers a valuable opportunity to reflect on service delivery and understand the issues experienced by Service Users and apply the learning gained to prevent similar issues.

“The HSE continues to support and enable the effective management of feedback through relevant policies, guidance, systems and expert support.

“In 2020, there were 15,029 complaints received by the health services of which 73% were responded to within the legislative time-frame of 30 working days or less.

“The HSE is committed to providing high quality and safe services. Listening to the experiences of those who use our services can provide unique insights into standards of care and offers opportunities to improve the quality and safety of health services in a way that will deliver measurable benefits for patients and service users.”

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