• Case ref:
  • Date:
    March 2018
  • Body:
    The City of Edinburgh Council
  • Sector(s):
    Local Government
  • Subject:
    primary school
  • Outcome:
    Upheld, recommendations


Mr and Mrs C complained about the council as they were unhappy with the way their child (child A) was dealt with when they suffered a head injury at their primary school. The head injury occurred when child A fell during playtime. Following the injury they were confused, distressed, and were suffering from loss of memory. Mr and Mrs C felt that an ambulance should have been called immediately. Instead, the school observed child A for a short time, before calling Mr and Mrs C and asking them to pick child A up and take them to the GP. This meant that there was a period of around 45 minutes from the injury occurring to them attending to pick up their child. Mr and Mrs C complained that the relevant council procedure was not appropriately followed when the school were dealing with child A's head injury. Mr and Mrs C were also dissatisfied with the standard of the council's complaints handling.

The council provided us with a copy of their Accidents to Pupils procedure, which instructed staff on when emergency medical assistance should be sought for head injuries, as well as providing more general guidance about how injured children should be transported to hospital if medical treatment not needing an ambulance was required. The procedure said that an ambulance should be called immediately where: the child was unconscious for any length of time; the child was vomiting frequently; neck pain was associated with the injury; or where the child's condition was 'giving cause for concern'. It appeared clear from the council's records that staff were concerned by child A's condition. This is why staff requested the child was collected and taken to their GP. However, the procedure required that they should have called an ambulance or, if they did not consider their condition serious enough to warrant emergency transport, they should have arranged for them to be transported directly to hospital by taxi or a member of staff's personal vehicle. Instead, they attempted to call Mr and Mrs C, resulting in the delay of around 45 minutes before they could collect their child and seek medical attention for them. We upheld the first complaint.

Further to this, we did not consider that the council's Accidents to Pupils procedure was sufficiently detailed for use by non-medical staff. We took independent advice from a GP adviser and we were advised that child A's condition should have been a cause for concern. The adviser's recommendation would have been that an ambulance was called. However, it is not reasonable to expect school staff to have detailed knowledge of complex medical issues, which is why it is important that the council's procedures are robust and give clear guidance that is easily understood. The adviser suggested that the school should liaise with NHS 24 to review the Accidents to Pupils procedure to ensure that it is both manageable for their staff and clinically sound.

We considered that the council's complaints handling had been unreasonable. In particular, we felt that a reasonable investigation should have highlighted that the school's failure to arrange direct transport to hospital was in clear contravention of the Accidents to Pupils procedure. As such, we also upheld the second complaint.


What we asked the organisation to do in this case:

  • Apologise to Mr and Mrs C for failing to follow the Accidents to Pupils procedure, for the delay this caused in child A receiving medical attention and for failing to identify this as part of their complaints investigation. The apology should meet the standards set out in the SPSO guidelines on apology available at https://www.spso.org.uk/leaflets-and-guidance.

What we said should change to put things right in future:

  • The council should liaise with NHS 24 to review the Accidents to Pupils procedure.
  • All relevant staff should be aware of the Accidents to Pupils procedure and ensure it is followed when a pupil is injured.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.