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Annual Report 2014


Independent Adjudication


The following areas are examples of learning points around service provision: • Failure to give sufficient attention to recording the detail of conversations about consent – doctors’ clinical notes sometimes give scant reference to discussion about risks or are closed to scrutiny by illegible handwriting; and consent forms often have the appearance of being written in haste, with only the briefest detail on risks.


• Patient expectations regarding the outcome of cosmetic surgery – where the desired outcome is subjective, disappointment with what constitutes an acceptable outcome can quickly give rise to complaints. For this type of surgery, having a witness present and taking ‘before and after’ photographs can help to support the consenting process.


• Misleading or exaggerated claims about the skills and experience of doctors – including describing one doctor as a ‘surgeon’ and a ‘specialist Gynaecologist and Obstetrician’ who was not on the General Medical Council’s specialist register and was in fact a GP. It is beholden on healthcare providers to make sure that all communications with patients are accurate when describing the skills and experience of the doctors providing services.


Escalating concerns Over the last year we have strengthened our focus on escalating issues of concern to the ISCAS Governance Board. This has included notifying the Board of:


• Concerns over how ‘Patient Coordinators’ were being used in one cosmetic surgery organisation; • The number of telephone calls another cosmetic surgery organisation made to a prospective patient; • Failures by one hospital group to deliver the distinct two-stage complaint process at local level; and • The impersonal and anonymous letters of response sent by one provider.


Highlighting concerns in this forum has resulted in actions that should benefit future patients and their families. For example, one hospital group acknowledged deficiencies in its complaints handling at the Complaints Review stage (Stage 2) and outlined several positive responses, including re-focusing training and awareness for those who oversee the investigation and responses to Stage 2 complaints, and improving the tracking and recording of complaints.


It is tempting to focus on where organisations go wrong when it comes to complaints handling, but we also see examples of good practice and one of our objectives for 2015 is to find ways to share this good practice across the sector.


The Independent Adjudication team has achieved a great deal during 2014. Our focus during 2015 will be on consolidating the achievements of the last year, and understanding where further improvements are needed.


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