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FOCUS: Should patients have the right to get a second opinion on their healthcare?

FOCUS: Should patients have the right to get a second opinion on their healthcare?

Tuesday 30 July 2024

FOCUS: Should patients have the right to get a second opinion on their healthcare?

Tuesday 30 July 2024


A charter which informs patients of Jersey’s Health service of their rights has been approved – but only under the condition that a UK rule which allows people to request a second opinion on their treatment is “explored further”.

The Health and Community Services Advisory Board – made up of specialists who are overseeing changes in the department’s culture, processes and finances – was last week presented with the “Patient Charter”.

Consisting of ten clauses, the document – which has been in development since last year – enables patients to "fully understand their rights when they are receiving treatment from HCS".

However, the report's author Carl Walker, of HCS Patients' and Users Panel, wrote that the "implementation of Martha's Rule in HCS needs to be explored further" under clause seven of the charter.

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Pictured: Martha's Rule allows patients and their families to seek an urgent review if their condition is deteriorating and they feel their concerns are not being listened to.

This rule, which began to be rolled out in NHS hospitals earlier this year, allows patients, families, carers and staff to have round-the-clock access to a rapid review from a separate care team if they are worried about a person's condition.

It was the result of campaigning from the parents of Martha Mills, who died in 2021 at the age of 13 after developing sepsis in hospital, where she had been admitted with a pancreatic injury following a fall from her bike.

Claiming that the rule should be "explored further" in the UK, the latest HCS report added: "The Patients' Panel are happy for the Charter to be published in the first instance without reference to Martha's Rule on the condition that HCS is actively seeking to resolve this."

The report also states the intention to develop a separate charter for children and young people to ensure their voice is heard.

What is Martha's Rule?

Martha Mills died of sepsis at King's College Hospital, after going into the hospital with an injury to her pancreas caused by falling off her bike.

When her condition deteriorated, Martha's family raised concerns, but these were dismissed by doctors.

An inquest later heard that transferring Martha to intensive care earlier would probably have saved her life, and opportunities were missed.

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Pictured: the NHS has started to roll out Martha's Rule across the UK this year.

Following her case, calls intensified in the UK to give parents the statutory right to a second opinion if they are concerned about care.

The Secretary of State for Health and Social Care and NHS England then committed to implement 'Martha's Rule' to ensure the concerns of the patient and those who know the patient best are listened to and acted upon.

Officials decided on a phased approach for introducing the rule, and the NHS announced in May that 143 hospital sites would test and roll it out by March 2025.

Where does Jersey stand on Martha's Rule?

Jersey's former Health Minister, Deputy Karen Wilson, previously said her department was watching developments related to Martha's Rule closely and that they were "continuously focusing effort to improve patient safety".

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Pictured: former Health Minister Karen Wilson said her officers were always looking at ways to improve patient safety.

At the time, she added that she had asked officers to look into whether similar measures "could improve patient safety here in Jersey".

Dr Chris Edmond, a medical director at WorkHealth Jersey who also works part-time in the Hospital's Cardiology Department, has also previously said that he would support greater rights for patients to seek a second opinion.

What is the Patients' Charter?

Clause seven of the Patients' Charter does, in effect, state the right of patients or their carers, guardians or parents, to "make their own decisions, without pressure, about their treatment, and be free to change their mind or request a second opinion".

The Charter was developed following discussions between the Patients' Panel and the previous Health Minister Deputy Karen Wilson.

While the Charter does not bring into being any new rights for patients, per se, it outlines those in existence, which includes those relating to the quality of care they receive, their right to a second opinion and the right to question the care pathway they have been placed on.

The Panel members said they were keen to see some kind of Patients' Charter developed, approved and published to allow all patients to fully understand their rights when they are receiving treatment from HCS.

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Pictured: The Patients' Charter sets out the rights of Jersey patients.

Over the winter, Patient Panel members were researching and submitting suggested clauses for the Charter, which were then discussed at a workshop-style meeting held several months ago.

This first draft was circulated among panel members for further consideration and finalised at the next meeting, before being submitted to the HCS Senior Leadership Team for their observations and approval, with the hope that it would be signed off by the various care groups and executives before being published.

The submitted draft charter was amended slightly following a visit to a panel meeting by Medical Director Patrick Armstrong, before being resubmitted to HCS, and subsequently the Advisory Health Board for final approval.

IN FULL: The HCS Patients' and Service Users Charter

1. All patients/users have a right to be treated with respect and dignity, and free from any form of discrimination.

2. All patients/users will receive utmost care throughout their treatment and aftercare.

3. All patients/users are entitled to clear information that can be easily understood, including the benefits, risks, alternatives, and any costs .

4. All patients/users are entitled to ask questions about their care, treatment or clinicians treating them.

5. All patients/users can ask for another suitably qualified member of staff to explain anything they do not understand.

6. All patients/users have a right to receive support for any language, mental health, sight, hearing or other difficulties.

7. All patients/users, or their carers, guardians or parents, are able to make their own decisions, without pressure, about their treatment, and be free to change their mind or request a second opinion.

8. All patients/users have the right to make a complaint, have it taken seriously and have it acknowledged with a case number within three working days.

9. All patients/users should report anything which they see or hear which makes them feel uncomfortable.

10. All patients/users are encouraged to give positive feedback if they feel a member of staff has delivered an excellent standard of care.

To leave feedback on the care you have received, please call 01534 443515 or email PALS@health.gov.je or visit office at the main Parade entrance of the General Hospital.

This charter was written and published by the HCS Patients and Users Public Engagement Panel on behalf of all in-patients and out-patients receiving care in Jersey.

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