A watchdog has upheld complaints by an NHS Grampian worker who raised patient safety concerns about a service at Dr Gray’s Hospital.
The complainant, known only as “C”, had tried to highlight the issues with management for several years before resorting to whistleblowing in 2023.
They claimed the unnamed service was “unsustainable” due to a “lack of service planning” over the years, and health board bosses failed to reassure “C” in their response.
The grievance was then escalated to the Independent National Whistleblowing Officer (INWO) who investigated the authority’s handling of “C’s” complaint.
In a published report, the INWO upheld three complaints made by the whistleblower, criticising NHS bosses for failures in the long-term management of the service and how they answered to “C’s” concerns.
Watchdog highlights NHS failures
The INWO concluded that NHS Grampian bosses:
- failed to adequately plan for a specific service at Dr Gray’s Hospital
- failed to ensure the service was being delivered in line with National Service Standards
- failed to ensure an adequate advice line service for patients using the specific service at Dr Gray’s Hospital
The health board had acknowledged that the service was unsustainable and was on the hospital’s risk register.
It explained to “C” that planning for a regional “Pan Grampian” service was underway, however, “C” felt the response “lacked detail” and took the matter further with the INWO.
NHS Grampian’s position was that the service at Doctor Gray’s Hospital had not been reduced and patients were not at risk because joint working arrangements were in place at other hospitals.
But, the watchdog’s probe found that, despite attempts to reassure “C”, “minimal detail” was provided to them concerning what the Pan Grampian plan entailed, progress made to date and implementation timescales.
Missed opportunities and vague answers
According to the report, the INWO found that NHS Grampian “missed a number of opportunities” to further assess patient risk when C’s concerns were investigated through the whistleblowing process, and the health board’s response did not provide “any evidence that risk to patients had been considered”.
The INWO also found “no evidence that the Board have prioritised planning” for the service changes.
They explained: “I have found that minimal progress has been made toward developing a plan and no meaningful consultation on the future of the service has happened.
“The proposal paper provided by the Board in response to this investigation lacks detail, there are no clear timescales and no evidence of risk assessment.”
NHS Grampian given time to make changes
A deadline of April 16 has been set by the INWO for the north-east health authority to produce:
- a plan that evidences the actions and timescales to prioritise, develop, and implement a risk-based Pan Grampian service plan, reflecting the findings in the report
- evidence that the Pan Grampian plan for the service details how National Service Standards are being met across each of the specialisms, or that there is a clear timetable for it set out in the action plan
- evidence that the findings of this investigation have been incorporated into the Pan Grampian plan as it relates to the provision of the advice line
NHS Grampian also came under fire for “issues” with its cooperation with the watchdog’s probe and the quality of the information it shared with the INWO.
“The Board’s handling of my request for information caused delay to our investigation.
“Although I appreciated the efforts to inform me about a separate external review, this should not have prevented the Board from providing me with the information I had requested,” the report noted.
It added: “This caused unnecessary delay with the potential to create further concern to the whistleblower.”
In another section commenting on NHS Grampian’s response to “C’s” concerns about the service not being delivered to National Service Standards, the INWO’s report stated: “I found the Board’s response to be insufficient”.
It went on: “It is not enough to simply state that the Standards are being met.
“I would have expected the Board to have provided evidence as to how each of the relevant Standards are being delivered.
“Where standards cannot be met at DGH, I would have expected greater detail on how these standards would be delivered by a Pan Grampian Service Plan.
Questions still hang over troubled NHS service
The INWO said “it remains unclear how the service at [Doctor Gray’s Hospital] and the Pan Grampian Service will deliver a service in line with the relevant National Standards”, noting that despite a request for “further detail” there remained a “lack of information”.
This meant it was “unclear” how patients from the local area were assessed and monitored and “opinions varied” among staff asked whether Service Standards were being met.
A spokesperson for the health board said in line with the INWO they could not identify which service was investigated in order to protect the identity of the whistleblower.
He told The Press and Journal: “We accept the findings and recommendations of the INWO report.”