Your Stories

Please tell us about your complaint. Did NHS Fife resolve your complaint satisfactorily? Did NHS Fife use any underhand tactics against you? We have identified the following 10 Devious Strategies that NHS Fife uses to silence patients:

  1. Delaying the response to 20 working days or longer
  2. Using non-independent managers to head up internal investigations
  3. Using vague and evasive language to avoid responsibility
  4. Providing minimal information or refusing to provide information
  5. Blaming the ‘system’ (e.g. the lack of a formal policy) as opposed to blaming a specific individual
  6. Using ‘communication’ excuses to explain away clinical errors e.g. ‘there was confusion over medical terminology’
  7. Fabricating the truth in internal investigations and correspondence to patients
  8. Inventing reasons to fit and justify past events/mistakes
  9. Referring complaints to the weakest regulator, the Ombudsman
  10. Lying about future actions e.g. ‘the Board will discuss the issue at the next meeting’

Do you have a story you'd like to share?  Then let us know!

Lack of NHS podiatry care

7th March 2014

What happened?: I was refused podiatry care by Oakley Health Centre. I was told that the NHS is not here for this and that my familiy should maintain my foot care even though I'm a diabetic. No treatment was offered and I was also advised to go private.

What was good?: Nothing.

What could be improved?: Provision of appropriate care which the NHS should provide from cradle to grave.

How did you feel?: I feel frustrated and angry.

NHS Fife Playing the System

As I detailed in my previous post “NHS Fife’s Devious Complaints System” I have had an on-going complaint against Fife NHS for 6 years now. My first post was concerned with the way the NHS colluded with the NMC to close out my complaint against a CAST Team nurse. But Fife NHS was also more than willing to use their knowledge of the complaints procedure to close out any chance of an investigation by the SPSO as well. The SPSO has its limitations anyway, but Fife NHS simply removed any chance that the SPSO would investigate their behaviour.

One of the conditions of the SPSO is that you must raise a complaint against the NHS within one year of the issue occurring. “We don’t usually look at complaints if the matter you want to complain about happened more than a year ago”. In SPSO speak, for “usually” read “ever”.

The other condition of investigation by the SPSO is,

“We can only look at complaints after they have been through the right complaints process”.

Now if you are in the business of not investigating complaints, like Fife NHS, then these two conditions are a godsend. Investigations by the SPSO can be avoided with ease, simply delay the completion of the “right complaints process” by more than a year and hey presto the SPSO are neutralised.

I had an initial complaint closed out prematurely by Fife NHS, I attempted to raise a new complaint when I received some new written evidence to support my original claim. After a lot of letter writing I felt I had made a breakthrough and I was offered a meeting with the General Manager.

The meeting minutes issued to me by Fife NHS gave me hope and indicated that a new enquiry would be started.

“George expressed the fact that "we didn't work well with you". He acknowledged that this does happen from time to time. From his perspective he clarified that it was important to determine whether there had been incompetence or whether there was a malicious element. He acknowledged the resulting issues in terms of break down in trust. He agreed that if the subsequent investigation upheld aspects of the complaint that normally something could be put in the record to state this.”

This meeting took place on 27th July 2010.

After I wrote a few letters and a few emails and made a few phone calls chasing the progress of the investigation, I finally received the following letter from the Nurse Director on 11th March 2011.

“I am writing to apologise for the significant delay in dealing with your complaint. As the Executive Lead for Complaints, this has been brought to my attention. I am aware that an arrangement was made for a further review of your complaint, however, I am clear that there is no scope to carry out such a review. I am sorry that you have been poorly advised. I note you were previously made aware of the role of the Scottish Public Services Ombudsman and would now direct you there. I appreciate this will be a disappointing response but hope it enables you to progress matters.”

The first point is that she was not really “writing to apologise for the significant delay in dealing with your complaint” – she is writing to say she is not going to deal with my complaint at all. But I guess you get used to them never saying what they are actually doing! Anyway, that is an aside.

So by throwing me the promise of a new investigation, then simply ignoring me for nearly 8 months, they had played the system and made it impossible for me to comply with the SPSO conditions, as the “matter” had occurred more than a year ago by the time I received the close out on 11th March.

Obviously I tried to make the SPSO see the tactic, but to no avail, they are not flexible and insist that their charter does not allow them to be flexible.

Their willingness to play the rules to avoid investigation is worrying enough, but if you read the words of their General Manager, “important to determine whether there had been incompetence or whether there was a malicious element.” He acknowledged that the CAST team may be led by a malicious nurse, something you would hope it was part of their duty to discover – complaint or no complaint. But apparently 8 months later they are not really bothered if they were sending a malicious nurse into people’s homes or not. Apparently following the process is more important than doing their duty as Managers or Directors.

So, beware, Fife NHS understands the system, they are experts at delaying - blatantly reneging on promises to delay a complaint does not appear to trouble their conscience. If you are launching into a complaint with the NHS, learn the rules early, because time is against you, as is the NHS.

NHS Fife's Devious Complaints System

I have had an on-going complaint against Fife NHS for 6 years now, it is, as far as they are concerned closed, although a legal letter has been logged with them for some time now.

It is a long and convoluted case, during which Fife NHS and in particular, their Central Assessment & Support Team (CAST) have behaved in a manner consistent with the 10 Devious Strategies you have listed on your website, but there have been a few additional ones as well. One very clear avoidance strategy involved The Nursing and Midwifery Council, NMC.

I raised a complaint against a Fife NHS nurse, a member of CAST, due to her behaviour after an assessment, of which she was in charge. In addition to raising a complaint with Fife NHS, I raised a complaint with the NMC, as they have the power to remove an individual’s right to operate as a nurse if they think the person does not meet the required level of skill, or breaches the code of conduct.

Although I was still requesting information from the NHS to support my complaint and had not even fully detailed my initial complaint, it was dismissed by Fife NHS. The paragraph below is from their close out letter,

“Also I would like to point out that it is not my intention to revisit any professional issues that have been raised with the Nursing & Midwifery Council in respect of the nurse as I understand that the NMC have decided that there is no case to answer.”

The NMC also dismissed my complaint, with the following statement in their report,

“Furthermore the panel noted that the employer had no concerns in respect of the professional standards of the registrant, had taken no action and continued to employ her. The panel therefore agreed that there was no real prospect of a finding of impairment of fitness to practice being made.”

This circular closer all sounds a bit convenient. But, if you think of the logic of this, it is even worse than that, it is impossible. One of the organisations must have completed their investigations first; they then can’t have quoted the other investigation, because by definition it has still to be completed. The only way this is possible is if they colluded before writing their reports. This means at best there is only one investigation, but in reality there is every chance this strategy could be used to avoid either organisation actually carrying out an investigation at all. Perhaps the thing I should be most insulted about is that they thought I would not notice!

As a footnote, armed with this point and substantial amounts of new information, I asked both Fife NHS and the NMC to reopen the investigation. The NMC at least had the decency to agree to reopen the case, if only they had also had the competency to actually carry one out. In their first new attempt they investigated the wrong nurse. In their second new attempt they investigated the right nurse but for a complaint I had never made. When I pointed this out to them again, their lawyer wrote to say it did not pass the “legal test” to be reopened. This is another Devious Strategy worth ending on - the application of a very narrow definition of what will be investigated by these bodies, never to the advantage of the victim.

NHS Fife surgeon, Stuart Oglesby, 'failed to assess patient's fitness for surgery'

According to the General Medical Council, Mr Stuart Oglesby, an NHS Fife surgeon, made a catalogue of errors in his medical examination of the patient:

  • ‘It is important, however, that any decisions made are with the full understanding of the patient and relatives, and it would appear that his consultations were deficient in this respect.’
  • ‘It is my opinion, therefore, that Mr Oglesby’s assessment of the patient's fitness for surgery was inadequate.’
  • ‘In my opinion, therefore, other more objective methods of assessment of fitness should have been used to assess the patient's fitness for surgery.’
  • ‘Mr Oglesby had not made an adequate assessment of the patient's fitness for surgery, and therefore his decision that the patient was not fit for surgery was not appropriate… significantly more information should have been gathered about the patient's fitness… Furthermore, all these issues must be discussed with the patient and family, and particularly in borderline cases, their views taken into account. This clearly did not happen.’
  • ‘In my opinion, therefore, Mr Oglesby failed to explain adequately the implications of the different management options to the patient and his family. Furthermore, it is likely that if these options had been explained properly, much of the confusion would have been prevented.’
  • ‘It is clear, however, that this [assessment phase] was not explained properly to the patient and his family, and there is no evidence in the patient's records of any discussions about this.’
  • ‘… it is clear that the multidisciplinary team did not discuss the issue as to whether or not the patient was fit enough for surgery… When there is doubt about someone’s fitness to withstand surgery, it is appropriate to discuss further with other colleagues, particularly surgical, anaesthetic or critical care colleagues. In this case it would appear that Mr Oglesby made this decision unilaterally without discussing it further with others. Although ultimately the responsibility for managing the patient (and therefore the decision as to whether surgery is appropriate) does rest with the Consultant in charge, it is considered good practice to discuss borderline cases with other colleagues, whether in the multidisciplinary team meeting or outside. This does not appear to have happened. The patient did, however, withdraw himself from further investigation and management under the care of Mr Oglesby, and clearly further discussions would have taken place at the multidisciplinary team if the patient had remained under the care of Mr Oglesby. It is conceivable that there may have been discussions about the possibility of surgery (and fitness for such surgery) at subsequent meetings, but on balance I think this is unlikely, as it would appear that Mr Oglesby had already made up his mind on that matter.’
  • ‘Mr Oglesby… did not assess the patient's fitness for surgery properly… it is essential to discuss all treatment options fully with the patient and consider the patient’s views when deciding upon the appropriate treatment plan, and it is clear that Mr Oglesby did not do this. If he had done this properly, and these issues discussed fully in a multidisciplinary setting, it is possible that the patient would have had a more detailed assessment of his fitness for surgery, and other treatments options, including surgery, considered.’
  • ‘Under the circumstances it really should have been possible to get a letter to the patient, if not in time for his departure, then at least to be given to his son for subsequent delivery to Hong Kong.’
  • ‘Only a few brief notes were written relating to the outpatient consultation on 18th May, and nothing was written in the notes relating to the second consultation on 1st June. Thus, the standard and adequacy of Mr Oglesby’s note taking was very poor.’
  • Conclusion: ‘Mr Oglesby… did not assess the patient's fitness for surgery adequately, and there was no multidisciplinary discussion or input into this aspect of the patient's assessment… there were significant deficiencies in Mr Oglesby’s communications with the patient and his family… It would appear in this case that Mr Oglesby was rather more conservative than others might have been, specifically with respect to consideration of surgery for his tumour… My main criticism is of the lack of objective assessment of the patient's fitness for surgery, and the lack of discussion of these issues with the patient and his family, thus preventing them taking part in the decision making process of this aspect of the patient's care.’

    Read more: NHS Fife surgeon, Stuart Oglesby, 'failed to assess patient's fitness for surgery'

Arthritis Consultation

19 September 2012

Dear Mr Wilson

Re: Arthritis Consultation

I am writing to complain about the standard of care I have received recently under NHS Fife.

I was referred in May 12 because of successive flare-ups of pain and stiffness in my joints, particularly my shoulders, by my GP and received a consultant appointment very promptly on 10th May with Dr X in the Adamson, Cupar. She postulated that it could be several different conditions and sent me for an MRI of my lower back to rule out ankylosing spondylitis, which also was very prompt (14th June). The radiographer told me that the consultant would summon me back to discuss the results.

Read more: Arthritis Consultation

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