Submission - Redress and Accountability Systems in Jersey - Mrs. X - 12 July 2020

With reference to our recent conversation I have given the matter serious consideration. I am still wary of submitting my details to the panel as my case is still ongoing. Having said that I am beyond frustrated in the delays. I am still wanting to remain private on the matter I feel it may be the time that others are aware of my situation. In a strictly need to know basis. I still am clinging on to the hope that my case will be resolved, not that I have been given any reason to believe that this is even possible after all this time. I trust you to include or exclude some of the information I have provided to you for the eyes of the Scrutiny Panel.

My case is rather complicated as the actual reason for the complaint stems from a Medical Consultants decision back in June 2016, however, there is a long back story prior to this event which is an integral part to my complaint.

I shall try to explain as clearly as possible; I have not included names at this stage but should they be requested at some point I can provide them.

I have been advised by a third party that one individuals name appears in up to 8 separate complaints with the Health Dept but as that is hearsay I can't go on record by stating that individuals name, something that the Scrutiny Panel should be made aware of.

November 2013 - I was seen at an out-patient clinic by a visiting specialist Consultant who had provided treatment for me locally and in the UK previously. This Consultant would no longer be travelling to Jersey. In doing so I was to have an MRI scan locally and that he would review that scan whilst back in the UK to put a care plan together for the local Consultant going forward. Unable to authorise these scans personally this was left up to the local Consultant to submit.

Feb/Mar 2014 - The request for the scan was eventually submitted (admin error) and scans were subsequently taken.

May 2014 - Local Outpatient appointment, waited 2 1/2hrs to be seen. The Consultant then stated that "the scans have been filed and not reviewed"

They would now be sent to the UK Consultant as originally planned. A delay of 6 months since my outpatient appointment.

August 2014 - The UK Consultant had now closed both his Private and Public waiting lists and was about to commence a sabbatical therefore would no longer be in a position to review my scans and provide the much needed care plan.

October 2014 - As a result of the above delay. I was sent to the UK as a tertiary patient to see another specialist. As there was no one locally that 'had that field of expertise' referring to my medical condition. The day trip outpatient appointment was at NHS Nottingham. I was sent via Gatwick by our Patient Travel Service. A round trip by train of 7 hrs. Surgery was the only option to relieve my symptoms, according to the Professor. Though the flight was paid for by the Patient Travel Service dept the train fare wasn't. I had to pay upfront and wait for reimbursement along with other expenses. Costly and exhausting day trip. A flight to East Midlands just a short distance form the hospital would have involved an overnight stay due to flight times. Something that would not be authorised by the Patient Travel Service.

January 2015- Surgery at NHS Nottingham. Patient Travel Service again sent me via Gatwick. I had my knee in a brace by this time and was expected to travel alone. My surgery would involve just an overnight stay on the ward. Another night's rest at the Hospital Hotel that would enable me to fly home direct from East Midlands Airport. Knee in a brace and post op my arm would be in a sling. Patient Travel Service would not cover the cost of a chaperone/family member to travel with me. They would not cover the cost of a taxi fare either as I could "catch the bus from the hospital to the airport as there is a regular service"!!

The surgery was not performed as per the consent form, the Consultant did "something completely different" . A result of which meant that I was kept in hospital on the Short Stay Surgical Ward for 7 days. At no time did anyone from our hospital contact NHS Nottingham 1) Check on my welfare 2) To query my lack of return to the island as planned.

A family member called our Patient Travel Service to arrange for them to fly over to support/escort me home upon my eventual discharge. Due to the change of the planned surgery they now expected this request to be authorised. That request was declined, as I hadn't by this stage been discharged . I was still expected to travel home on my own with my arm in a sling and my knee in a brace. As well as the lack of clothing as I had packed for an overnight stay and had been in the UK for 8 days at this point. My family member made the decision that she would travel to 'rescue me' (her own words) to bring clothing and escort me on the flight home. Retaining the receipts etc for a retrospective expenses claim upon our return.

My aunt arrived on the ward and I was discharged just 30 mins later. I was then given just 45 minutes to travel from my hospital bed to East Midlands Airport for my flight home. The flight had been booked without my knowledge by the Patient Travel Service who had been contacted by the Ward Sister when the Doctors had agreed on my discharge. My Aunt was able to secure a seat on the same flight. Having only just flown out, not expecting such a quick turnaround. The journey home was eventful. I had been pumped so full of strong analgesia that the taxi driver had to stop on the short journey to the airport as I was taken ill by the side of the road. Upon arrival at the airport the staff were incredibly helpful. I was provided with a wheelchair and my aunt and I were given priority boarding. However, 30 minutes into the flight I apparently collapsed. (not that I am aware of any of this). The Cabin Crew immediately came to my aid and the Captain put out an emergency call to Jersey Airport. The flight was given priority landing, the aircraft was met by the Airport Fire Service and then the Ambulance crew when they had gained access to the runway. "You should have never been allowed to fly with the shed-loads of medication you are on' was stated by the Paramedics. Even though my Aunt provided the 'fit to fly' letter signed by the NHS Nottingham doctor. I eventually made it home.

In due course I submitted all the receipts for expenses for both myself and my aunt to the Patient Travel Service - the claim was denied. I appealed but that was unsuccessful.

I had written to NHS Nottingham with regards to surgery without consent but they failed to address my questions/concerns including my discharge. My case was then transferred to the UK Government Parliamentary and Health Ombudsman in May 2015. Whilst they concluded that there was a serious case to answer (investigate) their hands were tied. Even though I was treated as a Public Patient on a public ward as the Jersey Health Service paid the NHS for my care I was seen as a Private Patient and was therefore outside the Jurisdiction of the Ombudsman. The case was then transferred to our own local hospital to investigate. They concluded that they also had no authority to investigate the NHS. This episode brought to light the vulnerable position of all the island's tertiary patients. There is no protection when being cared for by the NHS.

This was brought to the attention of the Health Minister by the Chief Minister in April 2019 by letter, requesting further a response. That letter remains unanswered, 15 months later.

Due to these exceptional costs I had incurred I submitted a letter to the local Consultant stating that I was unable to return to NHS Nottingham for my post op care as expected. It was therefore agreed that I would receive the care locally in the out-patient department.

I never did return to see the Consultant in Nottingham even at a later date that summer for a review. The Professor/Consultant retired in September.

I was then referred to our local Pain Clinic.

May 2016 - After an out patient clinic appointment where possible care pathways to follow were discussed. I was informed that I would be contacted in due course with a decision after the Consultant had spoken to his colleague.

30th June 2016 - I received a letter advising me that a decision had been made for me to be referred to the UK as a tertiary patient for care as there was no service available locally (as per their own policy for tertiary referral criteria) and that 'you can look it up on the internet to see what they offer'. I was only provided the city's name, not the actual name of the hospital!

4th July 2016 - With my knowledge and experience from my previous referral as a tertiary patient, I made the informed decision and wrote back immediately referring to my letter of the previous year that I was unable to travel to the UK. By this time I had been off work for a considerable amount of time and was reliant on support from Social Security. Previous enquries with that department revealed that there was no additional support for islanders requiring tertiary care off island.

August 2016 - I received a letter directing me to Patient Travel Services!! To which I responded accordingly.

19th December 2016 - Pain Clinic Out Patient appointment - This appointment date and time had been changed 3 times by the dept of whom I had spoken to as I was surprised that I had even received the initial appointment date. Conversations with the staff and information provided ,I drew the conclusion that the Consultant had acted upon my letter and sought advice from the UK hospital. The new appointment was for 2hrs, so I believed this was the opportunity to discuss the care/treatment I would receive  locally  as  opposed  to  as  a  tertiary  patient.  Upon  entering  the  Consultants  room I  was immediately asked "How did you get on in Bath?" I was lost for words. The Consultant stated that he had sent a referral back in the summer and thought I had been. I referred back to my letter in July and that of the previous year, stating that I couldn't afford to travel to the UK. As well as the vulnerable position I could find myself in again after my experiences in Nottingham. The Consultant then dictated a letter in my presence to the head of Patient Travel Services, seeking information for charities that could offer assistance, whilst also seeking authorisation for my tertiary care. This was the first time I realised that the Consultant had not sought approval/funding for my tertiary care over 6 months previous and that of my previous letter the year before. During all this time I had been without any medical care and remained off work. I was seen out of the clinic after just 30 minutes citing "other patients to see" Challenging as my appointment had been allocated a 2hr time slot.

We were now into the Christmas Holidays. I did however request access to my medical records. This request was dealt with promptly.

Within those records it was revealed that the Pain Consultant had written to the Tertiary Hospital in the previous August but not for a referral as alleged but for "Advice and Opinion' as per the opening line. The (re)referral was only sent mid February, 8 weeks after my local outpatient Consultation.

27th February 2017 - Frustrated by the lies and time wasted I submitted a two part complaint to Feedback@health.gov.je, the Hospitals own Patient Complaint Service. 1) Patient Travel Services 2) Consultant.

If I thought I was disappointed and frustrated by the service I had received so far that was nothing compared to what I was to endure over the coming years and continue to this day. My complaint remains unresolved and no action has been taken.

The due process (at the time) was for a response to complaints for Stage 1 to take 25 working days. I wasn't contacted until the 21st March for additional information. Full details contained within the independent report requested by the former HSSD now the HSC in April 2018, where there is a detailed list of diary dates during the summer of 2017, where no progress was made. To the extent, the letter I received in July 2017 from HCS hoped that this would conclude my case and resolve any issues but all it did was list diary dates of correspondence with the staff signing off the letter hoping that the contents would conclude my complaint!

Stage 1 took approx 92 days.

Stage 2 commenced after my telephone call to the dept on the 19th July 2017 and remained at Stage 2 until January 2018 when I was informed by a senior clinician that 'as your case remains unresolved we will commence Stage 2' ! You honestly could not make that part up if you tried.

The complaint was to be sent to Guernsey for investigation. All the paperwork was signed off and then sent but bounced straight back as there was "a conflict of interest'. The Consultant named in my complaint also worked for the Guernsey. Health Authority. Something that should have been checked at the outset not after several more weeks of delays.

The senior clinician then made the decision to appoint a UK independent consultant to investigate the complaint process not the complaint itself. The investigation was to take 3 weeks. The report was finally released 6 weeks later. A FOI request revealed thta this report cost the HCS far more than the claim for expenses I had submitted back in 2015.

No progress was made even after the independent report was released in April 2018 which upheld the complaint (process) as being wholly unsatisfactory and made several recommendations. None of which has been addressed by HCS. Full focus was directed to the Complaints process rather than the complaint itself which appeared to have been lost over time. Meanwhile the Consultant was continuing his administrative work without supervision or accountability. How many other patients have also been affected? Not that I was asking on behalf of anyone else but it does raise that question.

4th October 2018 - Without any progress and still without any medical care a SCB hearing was held. Within the hearing the Patient Travel Policy was stated as being under review. That policy remains unchanged, no review has taken place. The 'Advice and Opinion' letter sent in the August was a Referral according to the representative from HCS which contradicts a letter contained within my medical file from the NHS hospital. The opening line of the letter quite clearly states that the 'advice and opinion' letter was exactly that. The UK referral Doctor requested a formal referral letter from our local Consultant. That was in February 2017, which sparked the decision to submit my complaint.

January 2019 - Scathing report was released by the SCB which upheld my complaint (process). Found HCS 'wanting'.

21st January 2019 - As a result of this report and my complaint still not being investigated and after seeking advice I submitted a request to the SEB naming four senior individuals, these four who had failed in their duty. During this long running case at least 64 States of Jersey employees (GOVJ) had been involved but these four individuals who had a personal involvement at one stage or another, had the seniority and authority to resolve my complaint and to address issues raised without further delay. More importantly to ensure I have access to the medical care I required but failed to do so. This was from the highest level. Since that date I could add a at least three more senior names to that list, who have also failed in their duty.

11th March 2019 - After many emails I secured a meeting with the Chief Minister.

2nd April 2019 - Letter from the Chief Minister to the Health Minister on my behalf requesting answers to several questions incl that of protection for Tertiary Patients. That letter remains unanswered to this day, with no accountability as to why the Health Minister has not responded. I had been informed that the response was being drafted in the August, that never materialised.

April 2019 - Auditor General was involved and sent an Affiliate, flown in specially from the UK to meet with me to discuss my case. Whilst not able to intervene they expressed their dismay in the way the HCS had handled my case and the way I had been treated. Coupled with the total disregard of the recommendations made by several independent reports and subsequent findings. My case was to be used in their report to be published later that year. I've had no further involvement with Affiliate or the AG office.

August 2019 - Out of the blue I was informed that the Chairman of the SEB had appointed a UK Lawyer to handle my case. A senior Civil Servant was now my point of contact.

24th September 2019 - I met with the appointed lawyer, who had traveled to the island especially for this meeting. The meeting lasted 4hrs. Three recommendations were agreed upon. Whilst this would not involve investigating my initial complaint or that of the one I submitted to the SEB at the beginning of the year, these 3 recommendations would expedite the conclusion of my case and hopefully allow both parties to move on. The original Civil Servant appointed to handle my case left GOVJ employment 3 days after my meeting. No explanation as to why he was even appointed in the first place as he was already working his notice.

A report by the Lawyer was submitted to the SEB. Another Civil Servant (Group Director.......) was appointed to carry out those recommendations.

8th November 2019 - The recommendations were approved by the SEB. The Civil Servant went cold and was not answering any of my emails, unbeknown to me at the time, my case had been bounced back to the Health Minister.

17th December 2019 - Meeting (accompanied by the Deputy States Greffe) with the Chief Minister (35mins) then back to back with the Health Minister (17mins). The Minister initially did take the opportunity to offer his apologies but when questioned on what he was apologising for he admitted that he didn't know ! Just that the meeting was for him to apologise!! I handed the Health Minister a letter containing bullet points of questions I was hoping to gain answers for during the meeting but was unable to in the short time allotted. The Health Minister set his own response deadline as 'Mid January'.

3rd March 2020 - Response eventually received without any explanation or apology for the delay. The opening line was factually incorrect I was left confused and frustrated as to why the response had taken so long to be sent when one reason had been given that "facts needed to be checked" . Which is made even the more interesting as factually incorrect letters and delays were highlighted in several reports published surrounding my case. Even with all the rebranding and new management structure within the GOVJ?Hospital there has been no change in the work carried out.

Multiple chase up phone calls and emails since then.

28th April - Letter from the Health Minister, a deja vu moment as this to also contained factually incorrect information.

Multiple chase up phone calls and emails since then.

10th June 2020 - Latest email sent after a request made by the Health Ministers PA. Still no response. Still no action on the 3 recommendations agreed upon by the SEB in Nov 2019 and still no action either by the SEB to investigate the senior staff members named in my correspondence from January 2019.

Throughout all of this my greatest ally has been the Deputy States Greffe and the staff within. Despite the independent reports and the SCB findings all upholding my complaint and conveying their shock and disdain to the way I have been treated and continue to be treated by the very people that are employed to care for the most vulnerable members of the community I have been let down time and time again. No one has been held accountable, no policies have been changed and one of the named individuals has even been promoted since my complaint was submitted something that would never happen in any other business or organisation. Even requests by the Chief Minister have gone unanswered and without any accountability.

No one could honestly make this up if they tried. The saddest part is that I am probably not alone.

My health has suffered and continues to do so, not forgetting the impact this case has had on my children.

I have no faith in our hospital and the management therein. Let alone my faith in the abilities of the Health Minister to step up and address the issues raised. Instead he has condoned the poor service of the employees of his own department by continuing with the delay and errors. If the senior management can't get it right how can they possibly lead their junior staff to reach a higher standard when they can't do that themselves.

My case has lasted over 5 years, with the incident at NHS Nottingham as the benchmark. Then the Consultant unable or unwilling to step up and admit then correct the oversight on the referral to the tertiary hospital and deal with the matter promptly when this oversight was revealed along with the Head of the Patient Travel Services being able to understand their own Travel policy. None of which would have had an impact on the HCS overall budget. Citing that he was "relatively new to the island' He had been my point of medical contact at the hospital for over 2 1/2 years! Instead they have continually let me down and spent 5 years bouncing my case around 64 employees, appointing independent Consultants to tell them something that was blindly obvious to anyone else that took time to read my file and then a UK top lawyer to suggest a way to resolve the case and at what cost but then to sit on those recommendations for a further 7 months.

Throughout this ordeal I have worked very hard at retaining my anonymity. Not just as the case involves my personal medical records and not one to live my life in the public forum but also out of respect for my children's right to privacy. I have also not put the names of the individuals given to the SEB out in the public domain. The SEB have received bad press in recent times but I have been again careful not to get involved even though now I am unfortunately beginning to believe everything that I have read.

I would therefore request that I remain as Mrs X (as per SCB) and preferably throughout the involvement with the Scrutiny Panel.

This email has sat in my draft box for several days, still in the hope that my case will be resolved.

The most recent post by the GOVJ comms department has changed all that. "would like to remind islanders to look after their mental health and wellbeing........" which must be some form of joke but no one is laughing. The in-actions of my case by certain Ministers and senior Civil Servants of GOVJ and HCS have been a major contributory factor of my poor mental health.

Please let me know if this is enough or the Panel requires more information from me. The reports I have mentioned are available through the Deputy States Greffe.

Update 30th July 2020

I have a short Appendix to include on my case.

I have finally received the long overdue (promised) letter from the Health Minister, in which he expresses his disagreement with the decision the Health Dept made after my SCB hearing. Dating back to October 2018. Not too sure why this was even included within the letter. It's just raking over old ground. Ground that has settled long ago.

The Minister had been instructed by the SEB in Nov 2019 to carry out 3 recommendations as agreed during my meeting with the UK appointed lawyer back in Sept. This was what I was expecting within the letter.

There's still no movement on these three recommendations. However, I was directed to call the Ministers Secretary. Something I had been doing over the past three weeks. Without any success.

I have now made contact. The conversation did not go well. I was told in no uncertain terms Forget the past and move on'. This obviously conflicts greatly with the Ministers own letter expressing his view on the decision of his own Health

Dept back in 2018. Not just once but on several occasions during the conversation I was told to move on'. Does a secretary now have more authority than the Chairman of the SEB? Don't worry I'm not expecting a response but it does raise the question. Who exactly am I now dealing with.

Moving on - Is exactly what I have tried to do since this whole matter began. Unfortunately, there are those well above my pay grade who are determined that this is never going to happen. It's not like I went searching for advice and creating three recommendations to expedite the conclusion of my case. I was preparing my paperwork to send to the SEB for a disciplinary hearing as a result of the SCB findings. It is the SEB

that made the decision to avoid the disciplinary hearing by appointing the Uk lawyer and encouraging me to agree to the recommendations. But then failing to follow through with them.

Update – 4th September 2020

I've conceded defeat with the Health Minister.

I've abandoned any hope that I may have had in the Health Minister carrying out the three recommendations made by the SEB last year, for my case to be concluded.

I've written to the Chief Minister (As Chairman of SEB) and expressed my total dissatisfaction. The Health Ministers first duty was to offer an apology. The apology was for the way I was treated, reason for the complaint and then the delays. As the Minister of Health has himself repeated all of the above that he was supposed to apologise for doesn't bode well for the other 2 to be carried out.

Since my last email I've also been the victim of bullying and intimidation by two administrative staff closely linked to the Minister. Something I won't tolerate after everything I've been through.

I've therefore been left with no option but to take my case back to the SEB and proceed with the disciplinary hearing for four very senior staff at the centre of my complaint within the HCS. Whilst also naming the involving the two staff that have bullied and intimidated me. I've done nothing to warrant this behaviour by others. Being completely exonerated within the complaints procedure and independent reports surrounding my case.

I'm under no illusion that the SEB will delay the proceedings yet again. They sat on my case for 9 months last year but enough is enough.