• Case ref:
  • Date:
    October 2018
  • Body:
    Lothian NHS Board - Acute Division
  • Sector(s):
  • Subject:
    admission / discharge / transfer procedures
  • Outcome:
    Upheld, no recommendations


Mr C was seeking a referral to children's Occupational Therapy (OT) services for an assessment. Mr C was told he was not eligible for this service as he was 17  and no longer attended school. He was asked to make a new referral for adult OT services. Mr C did this and was assessed but discharged as the OT decided that his needs would be best met by local services in a community setting. Mr C was unhappy about this and complained to the board. He made a further referral to children's OT Services at the same time as his complaint and was this time seen by the service. Mr C complained that the board failed to progress his referrals to OT in a reasonable manner.

Mr C had also highlighted that the NHS website states the children's OT service is for children aged 0-18 and, therefore, he should have been assessed by them from the outset. The board responded by initially reiterating that Mr C was 17  years old and not at school so was more suited for adult services. However, in subsequent responses to Mr C they clarified that the children's OT service only has standardised assessments from age 0-16. They also advised there is no set criteria but instead, a flexible approach is adopted depending on the patient's individual circumstances. They acknowledged that Mr C had not received a clear explanation about why he was referred to adult OT services and apologised for this failing.

We considered that there had been poor communication and mixed reasons given to Mr C for directing his referral and upheld his complaint. However, the board advised that they had taken steps to review the triage service (a process in which things are ranked in terms of importance or priority) for the OT department. This included staff phoning children or parents who made referrals to gather more information to help signpost or assess patients from the outset. Additional staff have had training to make these calls and the board advised that the data they had reviewed so far indicated this was a positive change to the process. As a result of the positive steps taken by the board, we made no further recommendations.