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‘Unacceptable’ four-year delay for NHS Highland operation criticised by watchdog

Disgruntled patients can often seek compensation. Image: DC Thomson
Disgruntled patients can often seek compensation. Image: DC Thomson

An NHS Highland patient who waited almost four years for the reversal of a stoma operation has had a complaint upheld by Scottish Public Service Ombudsman.

The person, who did not want to be named, made a complaint to the Scottish Public Service Ombudsman (SPSO) about their treatment between January 2018 and September 2021.

They were waiting for an operation to reverse an external stoma – and only eventually had the operation in June 2022 after being told the operation could go ahead in April 2018, and being placed on the waiting list in December 2018.

‘Unreasonable time’ for procedure

An independent advisor to the SPSO catalogued a list of failures by the NHS Highland board to complete the procedure.

The advisor said the person had waited for an “unreasonable” time to have surgery, which had in turn led to further complications.

In a report, published today, the SPSO told NHS Highland to apologise to the patient and to improve the way in which it investigates complaints from members of the public in its care.

Lauren Tulloch next to an animation of a stoma
A stoma operation may mean a bag has to be worn externally.

The report said that after receiving an emergency procedure the patient had an external stoma, which they were told at the time could be reversed.

The report said: “The complainant (C) complained to the SPSO about the care and treatment provided during the period January 2018 to September 2021.

“In April 2018, C was seen in an outpatient clinic and informed it would be possible to have a stoma reversal.

“C complained that the board had continually delayed the stoma reversal surgery which they required, which as of September 2021 had not taken place.”

While taking into account of delays during the pandemic, the report added: “C also complained that Covid-19 could not account for the delays between the board informing C they were ready for surgery around December 2018 and the start of the pandemic in March 2020.

“C noted that as a consequence they had developed significant complications: a large hernia.

“C added that this had severely impacted their personal life and self-esteem, and left them unable to work and reliant on welfare benefits.”

Impact on personal life and self esteem

The report said the NHS Highland board explained that “despite a positive reintroduction of surgery in June 2021, it was required to significantly reduce elective surgical activity as Covid-19 patients again increased.”

In spite of C being at the top of the list for surgery, two consultants were required to perform a joint procedure.

The health board also said there were limited high dependency beds available, necessary for C’s post-operative care, causing further delay.

The report continued: “The SPSO sought independent advice from a consultant general and colorectal surgeon.

Two surgeons were required for the procedure.

“The adviser said it was unreasonable for C to have waited eight months between being seen in an outpatient clinic in April 2018 and having a flexible sigmoidoscopy, a non-surgical examination, in December 2018.”

The investigation found that C had been placed on a particular surgeon’s list, when the procedure could have been carried out by any surgeon.

It also noted that there was a further delay before C was placed on the waiting list for surgery and that it appeared that there was no monitoring of C’s timeline during this period.

The report said: “There appeared to have been insufficient priority given to C’s treatment post-pandemic.

‘Very sorry’

“In conclusion, the adviser said that the delays were unreasonable and noted that as a consequence C required more complex, demanding, and risky surgery.”

An NHS Highland spokeswoman said: “We fully accept the recommendations of the report and are very sorry for the failures identified in our care for this patient.

“Our chief executive will be writing to the patient to apologise and explain what has been put in place since this happened.

“The report has also been shared with our teams.”

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