'Poor communication behind many complaints'
By Niall Hunter-Editor
The HSE is working to improve the communications skills of its staff, its head of consumer affairs has told irishhealth.com
Mary Culliton, head of the HSE's Consumer Division, said many of the issues the division is addressing fall into the category of communication, and the need for staff to improve communication skills.
"We are now putting in place training to make sure that every person who has contact with someone who uses HSE services is fully equipped through proper training in knowing what we as an organisation expect of them."
Mary Culliton-head of HSE's Consumer Division
In a video interview with irishhelath.com, Ms Culliton said the HSE is doing a lot of work to ensure that it has the right people in the right places with the right training.
The HSE has many people with excellent communication skills but there were some staff who were maybe not so good at communicating with service users, she said.
Mary Culliton pointed to a recent survey carried out by the HSE on patient satisfaction with hospital emergency departments.
Seventy-six per cent of patients overall said they were satisfied with the service they received.
However, 24% were not satisfied, and she admitted that this was still a considerable number.
"We now, however, have clear pointers as to how we can improve that. Twenty-four per cent would be an issue of concern. Any business would be concerned that people who are using their services are not happy with the services."
Ms Culliton stressed, however that their information was that an average satisfaction rating with this type of healthcare survey was 80%, "so we are only slightly below the average that would be expected."
"We are now putting in place the systems and processes to make things better."
The HSE has recently moved to beef up its complaints system through the recent launch of the statutory complaints process. It now has the 'Your Service Your Say' comments and complaints service on its website...http://www.hse.ie/
It is also training new complaints officers. Each service in the HSE will have a named complaints officer and every hospital will have more than one complaints officer, according to Ms Culliton.
Is this a recognition that the old complaints system, for example, in hospitals, was not effective?
"The existing complaints system in hospitals was not consistently good across the system, " Mary Culliton said.
"Clear policies and procedures will be in operation in every area of the health service. And the role of the complaints officer in every location has been strengthened."
The HSE, she said is currently training complaints officers so that they know what the statutory complaints legislation expects of them.
She felt the fact the relevant legislation excludes complaints relating to clinical judgement in the new procedures was not a weakness in the system.
"While the legislation points to the fact that issues relating solely to clinical judgement cannot be dealt with, issues of a clinical nature can still very much be dealt with. Clinical judgement would be where we are talking about diagnoses."
She said very few complaints about the health service would deal solely with clinical judgement issues.
Where a complainant is still unhappy with a clinical judgment issue of a complaint he or she would have the opportunity to go to the Medical Council or Bord Altranais or another professional body, Ms Culliton said. This would also have been the case under the old complaints system, she said.
"Our procedures will deal with a complaint up to the point of clinical judgement."
She said that when someone is unhappy with a service that has been provided there is no doubt that people saying they are sorry face to face with the serviced user is what the majority of people who use the service want.
"We start from the premise of what happened, how did it happen, why it happened and how can we make sure it does not happen again. Complaints officers will be very well trained at getting to the root of the problem."
Mary Culliton says that the new system will aim to ensure that when something goes wrong an improvement should be put in place immediately. "We should not be waiting for reports."
View the full video interview at...
It's important that everyone communicates - including consultants, and that it's done on the spot - rather than weeks later. Communication when there has to be an autopsy is particularly bad.
My son is type 1 diabetic and we have experienced terrible difficulties with his consultant in the past not listening or understanding the difficulties or challenges associated with this condition. I have recently stopped him from talking too sternly to my son as this achieves nothing. I also keep a note of all that has been discussed at appointments and this comes to each meeting as a reference for me. I have noticed a difference in how we are all getting on. The consultant is very skilled and experienced which is what we want for our son but communications skills are lacking in a big way. I am not the only parent who feels this way unfortunately.
I too have experienced an appalling lack of communication from a number of consultants in different hospitals over the last four years. The service from a vet I often think would involve more communication. I have had injections where the consultant just injects/does a procedure with no lead up to what he's doing and unfortunately the attitude is "you can ask questions" rather than the consultant feeling that it's his responsibility to tell you what he's injecting into you and what you can expect from it. Really atrocious. Often a patient is too sick or in too much pain to think of what to ask and there should be a standard of what each patient needs to know for each procedure and a list of possible questions at the end of the factsheet. I am very disappointed with the care I have received and I have felt that to voice those concerns I would be dealt with as a crank rather than being in a position to give feedback. Feedback is not something they are concerned with. It's just a case of I only want to deal with easy cases for easy money. The attitude must change and I feel when more consultants are posted there will be more choice as presently many consultants know that you have no choice but to see them as you could be another 6 months waiting to see someone else. Too much power in too few hands.
If consumer interface is good it reflects a healthy internal comms. and culture. What do staff say about internal comms?
On the subject of consultants, some years back my father had heart surgery and the consultant atthe time asked that my father bring my Mum along to the consultation so that he could address any fears or questions she had as well and also the fact that she might think of certain questions which might only occur to my father later. I thought that this was something very positive. My own consultant (gynacologist) is also very open to questions and very interested in how a problem is affecting the patient and their views on a treatment. On the downside however I have come accross many junior doctors in hospital who while they might be very medically competent and very caring simply do not have sufficient level of english to make themsleves understood. This problem is exaccerbated when they are attempting to communicate with the very young, old or hearing impaired. =
The HSE at all levels need training. Pharmacists recently received a disgraceful letter from the corporate pharmaceutical unit\'s chief pharmacist. the letter had many errors. Start at the very top, send Prof Drumm on a training course.