Patients Rights Updated In New Code

11th October 2012

NHS Highland recently discussed the new Patients Rights Act.

The Patient Rights (Scotland) Act 2011 aims to improve patients' experiences of using
health services and to support people to become more involved in their health and health
care. The rights and responsibilities it reflects are not new, and are not enforceable by
legal action. Rather it codifies and explicitly states aspects of existing national policy and
good practice guidance.

Patients Rights and Responsibilities: The Act codifies a number of patient rights, none of
which are new or enforceable by legal action. These are grouped under the headings
Access, Confidentiality, Communication & Participation, Respect, Safety, and Comments &
Complaints. The emphasis is on consideration of individual needs and preferences and
encouraging patients to take part in decisions about their health & wellbeing. A Charter of

Patient Rights and Responsibilities were be published on the 1st October 2012 and set
out in detail what patients can expect from the NHS in Scotland and include -

Schedule of Healthcare Principles: A schedule of actions that health boards, individual
staff, and anyone that provides services on our behalf must adhere to has been developed.
These cover Patient Focus; Quality Care & Treatment; Patient Participation;
Communication; Patient Feedback; and Waste of Resources.

The Treatment Time Guarantee (TTG): The Patients Rights Act (2011) states that from 1
st October 2012 all eligible patients requiring inpatient or daycase treatment are to start
treatment within 12 weeks of the patient and clinician jointly agreeing that the treatment is
to take place. This is a legal maximum wait of 12 weeks and includes planned care for
mental health services. The following services are excluded from the TTG.
• Assisted Reproduction
• Obstetric Services
• Organ, tissue or cell transplantation
• Designated national Specialist Services for Spinal Scoliosis
• Treatment of injuries, deformities or disease of the spine by an injection or
surgical intervention - exemption only until October 2013

NHS Scotland Waiting Time Guidance was published in August 2012 to provide Boards with clarity on the implementation of the Act to ensure consistency of measurement and approach in providing access to services. This includes setting this in the context of the other national waiting times standards i.e. 90% of patients to be treated within 18 weeks of referral; no patient to wait more than 12 weeks for their first outpatient appointment and no patient to wait more than 6 weeks for one any one of the 8 key diagnostic tests. The 31 day and 62 day Cancer targets remain unchanged.

The Act and supporting guidance stipulate a very comprehensive framework of written
communication with patients regarding the TTG which is a significant increase on current
practice. This may be electronically if the patient has consented to this in writing. The
guidance has identified that Health Boards must advise TTG patients in writing in each of
these instances,
1. The patient is eligible for the TTG
2. The patient is deemed indefinitely unavailable for treatment
3. The patient has been recorded as unavailable for a known period, noting start and end
dates, and any review dates
4. The patient has refused 2 or more offers of an appointment
5. The patient does not attend an agreed appointment (DNA)
6. The patient has accepted a reasonable offer of an appointment but then the patient as
cancelled 3 or more times
7. The patient is removed from the waiting list
8. To confirm a patient request to be treated in a different Health Board
9. The responsible Health Board is unable to meet the waiting time standard within its own
area
10. The patient chooses to be treated in a specific location within the Health Board
11. The patient chooses to wait for a named consultant at their own request, for continuity
of care, patient safety or for other clinical or exceptional reasons
12. If TTG is not met the Health Board must provide an explanation of why, and details of
the advice and support, and how to raise comments or complaints

Patient Advice and Support Service (PASS): A new independent service is to replace the
IAAS service (Independent Advice & Support Service) currently provided. It will be provided by the Scottish Citizens Advices Bureaux (CABx) Service. A Service Level Agreement has been agreed between CABx and the Scottish Government. This is being funded through top slicing of our budget in the region of £120K per annum, a similar amount to the cost of the IASS. The service will be provided by Patient Advisers located in CABx offices in Lochgilphead, Thurso, Golspie, Inverness, Fort William, Nairn, Kinlochbervie, Alness and Portree. The locations were agreed within the national SLA.

The PASS will provide:
 Advice about patient rights and responsibilities
 Guidance on how to raised a concern/complaint
 Practical guidance and support in making a complaint
 With patients consent make enquiries about a persons care and treatment
 Guidance on how to access person health information and with person's consent help
with accessing and interpretation of information given by healthcare professional about
health records
 Information about the appeals process against discharge from NHS continuing care
 Information about confidentiality, other support services and supporting with access to
these services.