Background
A patient was admitted to a private hospital for urgent investigations and treatment relating to a suspected infection. The admission occurred at short notice, and the patient’s care pathway evolved during their stay. During the admission, the patient had concerns about the standard of care, clarity of clinical information, and transparency of hospital charges.
Feeling dissatisfied, the patient discharged themselves and subsequently submitted a formal complaint, which went through the local stages and was then escalated to stage 3 for ISCAS adjudication.
The Complaint
The patient raised concerns in three key areas:
- Clinical Care and Test Accuracy
The patient questioned the standard of care provided and expressed concerns that some blood test results were inaccurate or falsified. - Staff Interaction
The patient reported feeling uncomfortable with the communication style and manner of one of the consulting clinicians. - Costs and Charging Structure
The patient believed that they had been over-charged and reported that the basis for the charges was unclear, particularly when their circumstances changed during admission.
Adjudication and Findings
Internal investigations at both Stage 1 and Stage 2 of the complaint process confirmed that there had been an issue with the handling of diagnostic testing, requiring samples to be repeated. The hospital identified where processes had broken down and implemented corrective actions. These steps were communicated to the complainant.
Concerns about the manner of a consultant were acknowledged, and assurances were provided that the issue was being addressed through appropriate internal processes.
The complaint highlighted a gap in how cost information is communicated during rapid or unplanned admissions. While staff kept comprehensive notes throughout the patient’s stay, which supported the factual review, it became clear that patients may not always fully understand how charging works when treatment plans change, or when a stay changes from a fixed price package to a pay-as-you go package.
The adjudication decision found the complaint had been well managed at stages 1 and 2. The complaint was not upheld, and no financial goodwill award was made.
Key Learning Points
- Clear Communication of Fees in Rapid Admissions
Admissions at short notice can limit the time available for discussing detailed pricing. The case underlines the importance of having robust, simplified processes that ensure patients understand:
• What a treatment package includes
• Situations in which additional charges may arise
• How changes in clinical needs affect overall costs
The hospital identified this as an area for improvement and committed to reviewing communication practices and documentation. - Maintaining High Standards of Courtesy and Transparency
Even when clinical care is appropriate, patient experience can be significantly shaped by staff communication and interaction. This case reinforces the need for consistent, compassionate engagement, especially with highly anxious patients. It showed the use of levity cannot always ease an anxious patient. - Value of Detailed Record-Keeping
In this case, staff maintained thorough records, which proved essential for resolving factual disputes and providing clarity during the investigation. Accurate documentation remains a cornerstone of effective complaint handling.
Outcome
The hospital responded at each stage of the complaint with transparency, acknowledged where standards fell short, and implemented remedial actions. The case prompted a wider reflection on how to strengthen cost-communication processes during urgent admissions.
Conclusion
This case demonstrates how a patient complaint, particularly one involving anxiety and disputed facts, can provide important learning opportunities. By addressing clinical process issues, improving communication around costs, and maintaining high standards of professionalism, healthcare organisations can enhance patient trust and deliver a more positive experience, even in time-critical situations.