Decision Report 201705817

  • Case ref:
    201705817
  • Date:
    September 2018
  • Body:
    Greater Glasgow and Clyde NHS Board - Acute Services Division
  • Sector:
    Health
  • Outcome:
    Upheld, recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

For a number of years, Mr C had suffered with arthritis (inflamation of the joints) and had problems with his ankle and his knee. He attended the Glasgow Ambulatory Care Hospital, where it was considered that he would be suitable for an ankle procedure. However, it was decided that the opinion of a knee specialist should be obtained first. Mr C complained that he had to wait an unduly long period of time before he was given appropriate treatment.

We took independent advice from a consultant orthopaedic surgeon (a doctor who specialises in conditions involving the musculoskeletal system). We found that Mr C was suffering a complex condition and that it was reasonable for his care to involve multiple consultants. However, we also found that Mr C had to wait an unreasonable amount of time before he saw a knee surgeon in the first instance, and that having a combined consultation may have been more effective. Whilst we found that the subsequent care and treatment were reasonable, we upheld the complaint due to the initial delay in Mr C seeing a knee surgeon.

Mr C also complained about poor communication. We found that he appeared not to understand the reasons for the number of consultants involved in his care, and he had not understood his care plan. We considered that these issues were avoidable, and we upheld the complaint.

Recommendations

What we asked the organisation to do in this case:

  • An apology should be sent to Mr C for the delay in obtaining the knee surgeon's opinion. 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:

  • Inter-departmental clinical referrals should be made within a reasonable time.
  • The clinician concerned should take care to ensure that their communication with patients is understood.

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.

Updated: December 2, 2018