Personal Injury, Serious Injury & Clinical Negligence

Scottish NHS ‘failings’ may be a lesson for all

NHS-ScotlandAlthough health provision in the UK is now devolved, with Scotland, Wales and Northern Ireland having responsibility for their own NHS budgets, there are issues which continue to effect healthcare across the UK as a whole. Much has been made of the longer waiting times and poor outcomes experienced in Wales, a problem highlighted thanks to the campaign pursued by Ann Clwyd MP following the death of her husband in hospital.

Now the NHS in Scotland has come under scrutiny with The Academy of Medical Royal Colleges and Faculties identifying “systemic failures”.

The Academy represents a range of health professionals across Scotland and has produced what is now the fourth report into shortcomings in the Scottish health care, having set up a working party intended to learn from past failures.

The working party scrutinised historical incidences of poor care such as the Aberdeen Royal Infirmary above-average mortality rates and the worst ever recorded outbreak of C-difficile infection, at Vale of Leven Hospital in an effort to identify the underlying causes of unacceptable practice.

In their report entitled “Learning from Serious Failings in Care” they highlighted four particular areas of concern which were, in their view, common to the incidence of historical poor care. Poor staff morale, staff shortages, poor leadership from NHS boards and poor leadership from senior staff were the focus of the report, much as they had been in the Mid-Staffordshire Enquiry in England.

The findings come as no surprise, although in the experience of the specialist clinical negligence practitioners in this firm, do not tell the whole story. In particular, the failure to implement training in particular disciplines for particular issues across the whole country increases the risk of failure and  ignores the valuable opportunity to learn from mistakes. For example, training schemes directed at improving outcomes in the survival and health of new born babies at point of delivery have proved effective in this country and across the world but are not universally adopted by all NHS Trusts in England.

The report made over 20 recommendations, including minimum staffing levels, although again, quality of care as well as quantity is a major factor in cases where substandard treatment arises.

Prof Alan Paterson, Chairman of the working party commented: “It is clear that serious failings in team working between clinical staff and NHS management played a significant role in the failings in care identified.

“These failings are deep-rooted and systemic. They must not be ignored if we are to learn from them and to prevent repetition.

It is also clear that a combination of factors led to some appalling failings in care, a loss of basic compassion and the prioritisation of inappropriate targets over patient care. In addition, leadership and accountability were all too often sadly lacking and bullying endemic.

While there have been responses to the individual published reports of inquiries and reviews into failings in care, there is little evidence to suggest that we are tackling the underlying systemic failings which exist.”

The lack of basic compassion is sadly an oft present feature in cases of clinical negligence but one which before Mid Staffs, was deemed virtually unmentionable, such was the inviolable status of the NHS.

In response, Prof Jason Leitch, the Scottish government’s national clinical director for healthcare quality,  defend the position of NHS Scotland: “We are committed to driving up standards in our NHS which is why we have led the way in responding to the reports detailed in the Scottish Academy’s report. We are absolutely clear about the value we place on staff and the safe and effective service they deliver to patients”. He went on to emphasise that “We currently have the highest staffing levels across our NHS than ever before, with increases under this government of over 1,300 more consultants, and 2,300 more qualified nurses and midwives”. Which perhaps reinforces the view that quality and not quantity is an often overlooked criterion in this debate.

If you have experienced an instance of poor healthcare anywhere in the UK and would like to discuss your experience please contact Chris Thorne, partner at Clarke Willmott LLP at