Achi news desk-
Patients in Scotland have a legal right to treatment within 12 weeks of referral. Duty of candor legislation in place since 2018 was meant to move NHS Scotland closer to the “no blame” culture of the airline industry. And a law promises to make safe staffing a legal duty.
Do these legal “rights” really make any meaningful difference to patients and frontline workers, and how can they even be enforced?
“Guaranteed” treatment within 12 weeks?
In 2012, the Patients’ Rights (Scotland) Act came into force. The SNP’s flagship legislation created the “treatment time guarantee” (TTG) which meant that any patient referred for a planned operation or day case should not wait more than 12 weeks for treatment.
For a while it came close – as recently as the end of 2014, compliance was hovering around 97% – but the downward trajectory was established long before the pandemic. By the beginning of 2020, around 70% of patients were being treated on time and by the end of 2023 that had slipped to just under 58%.
More than 26,000 people who had planned treatment on the NHS in October, November or December last year waited more than 12 weeks. Furthermore, by the end of December more than 37,600 people were still on waiting lists who had already been waiting for over a year.
So where was their legal redress?
Back when the legislation was being drawn up, it was made clear that patients would not be entitled to sue for compensation if their treatment fell outside the 12 week window. Failing health boards would also not be fined.
Although patients could “expect” to be offered treatment in private hospitals or another health board area instead, there was no legal right.
The only option available to patients is to seek judicial review. So far, there is no record of anyone doing so.
Read more:
Openness and transparency
In April 2018, a new duty of honesty law placed an obligation on all care providers – including health boards and care home operators – to publish an annual report disclosing the number and types of adverse events where individuals suffered “unintended or unexpected harm”. , such as death or serious injury.
The regulators must be notified of any such incidents and a meeting is held where the affected person and/or their next of kin are informed of the fact and invited to ask questions.
Speaking to the Herald at the time, the Scottish Government’s national clinical director, Professor Jason Leitch, said it should make whistleblowing “less necessary” in the long term because the law would foster a culture that n more like the culture of the airline industry where staff feel “able. tell the truth in a safe environment and use it for learning”.
Measuring just how bona fide organizations have become is a difficult thing, of course: if events have occurred that should have been disclosed, but were not, how do you know?
Safe staffing
On Monday, Scotland became the first part of the UK to implement safe staffing legislation across health and care (Wales has had a similar law since 2016, but only for nurses).
It places a legal duty on employers (health boards and social care providers) to ensure that “suitably qualified staff are always working in the right numbers for safe and effective care”.
Quite clearly, a law cannot create vacancies overnight: the NHS alone is missing around 4000 nurses, 430 doctors, and 770 allied healthcare professionals, while the Care Inspectorate is already taking some home care for the court and are forced to close due to staff shortages. make them unsafe.
Neil Gray, the Scottish health secretary, admitted that the government “has not prescribed what a safe staffing level will be because it will be different for different settings”.
Sign up for Inside the NHS and read our health reporter every week in your inbox.
Once established, it will be up to employers to report “openly and transparently” back to ministers, who will then report to parliament. The data will be used to draw up “local and national workforce planning”, said Mr Gray.
Might it be fairer, for example, to detail how many jobs are filled by locum doctors or agency nurses – vacancies that were historically missing from official statistics?
And if staffing levels fall short? There would be “the possibility of enforcement action”, said Mr Gray. Exactly what that is remains unclear.
