NHS Highland has been ordered to apologise to a patient who suffered serious complications after waiting more than three years for bowel surgery.

A report by the Scottish Public Services Ombudsman (SPSO) said the health board's own investigation into the patient's complaint was of "poor quality" and "failed to acknowledge the significant and unreasonable delays" suffered.

The delays led 'Patient C' to develop a severe hernia which left them unable to work, reliant on welfare benefits, and requiring riskier and more complex surgery than originally planned.

The watchdog criticised NHS bosses for blaming Covid for the delays when the patient had been ready for surgery since December 2018, and said there had been "no sense of urgency" despite "the gravity of C's situation".

The report said: "It is of significant concern that the Board has failed to fully acknowledge the consequences of the delays and the adverse effects upon C's physical and mental health as a result.

"The consequences for C of these delays cannot and should not be underestimated."

READ MORE: Forth Valley placed in special measures amid repeated safety warnings

Patient C's ordeal began in January 2018 when they underwent emergency surgery to remove a section of their bowel and create a stoma - an opening in the bowel.

In April 2018, at an outpatient's appointment, Patient C was told the stoma could be reversed subject to a flexible sigmoidoscopy taking place - a procedure to examine the inside of the bowel using a tiny camera.

This went ahead eight months later, in December 2018. The SPSO said this was an "unreasonable" length of time given that average wait times are under three months, and was partly due to NHS Highland's use of a named person waiting list - whereby a specific doctor carries out certain procedures.

The watchdog said this did not make sense when the sigmoidoscopy could have been carried out "by any competent endoscopist" and called on NHS Highland to "urgently review their use of named person waiting lists to ensure they are being appropriately utilised and managed".

By December 2019 - a year on from the sigmoidoscopy - Patient C's GP contacted Raigmore Hospital in Inverness to raise concerns that they were still awaiting an appointment date for surgery.

In January 2020, Patient C attended an outpatient clinic where it was noted that they had developed an abdominal hernia.

By October 2021, with their condition "increasingly complicated", Patient C had still not been given a date for surgery.

NHS Highland blamed the pandemic blamed for stalling elective procedures, but a consultant colorectal surgeon who advised the SPSO said there "appears to be a lack of orderly prioritisation...to ensure that non-cancer elective cases, such as C's case, are appropriately prioritised".

READ MORE: Debate future of NHS or face inevitable slide into privatisation by stealth

Figures from Public Health Scotland show that, by the end of September this year, there were 7,650 patients on NHS inpatient and day case lists who had been waiting more than two years for an elective procedure.

Patient C was eventually given a date for surgery at a hospital in Glasgow in March 2022, but the operation was called off due to staff shortages.

The procedure to reverse the stoma and repair the hernia was finally carried out in Glasgow in June 2022.

A spokesman for NHS Highland said: "We fully accept the recommendations of the report and are very sorry for the failures identified in our care for this patient.

"Our Chief Executive will be writing to the patient to apologise and explain what has been put in place since this happened. The report has also been shared with our teams."