Not upheld, no recommendations

Summary

Mrs C complained about the care and treatment provided to her late niece (Miss A) by the practice. Miss A had reported gynaecological symptoms and after examinations and tests, she was diagnosed with an infection. Miss A received treatment for this, however, a few months later, she reported similar symptoms. She was seen on a number of occasions and provided with treatment. When her symptoms persisted, a referral was made to the local gynaecology department and a scan was arranged. Miss A was later diagnosed with cervical cancer following an emergency hospital admission. Mrs C complained that, given the level of contact Miss A had with the practice, she had not received appropriate care for her reported symptoms.

After taking independent advice from a general practitioner, we did not uphold Mrs C's complaint. We found that Miss A had had an infection and that the symptoms she reported later were consistent with infection or complications of an infection. The advice we received was that it was reasonable to consider that her symptoms were due to infection and that the practice had arranged appropriate tests and referrals for Miss A.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Ms A). She said there had been a delay in Ms A's medical practice making a referral for her to attend the orthopaedic department when her back problems continued. She further said that the practice failed to follow up on the referral when it was eventually made. While the practice recognised that Ms A felt unsupported, they nevertheless said they had been appreciative of Ms A's difficulties and had tried to help her.

We took independent medical advice from a GP. We found that while Ms A attended the practice prior to her referral, the medical records showed that she had been treated reasonably, that her condition had been monitored, that she had been appropriately examined, and that she had been prescribed medication in accordance with her symptoms and published guidance. There were no 'red flags' (signs to warrant urgent referral).

Although we found that the practice did not issue the referral immediately, once the error was discovered it was issued and sent within the time-frame required by local guidance. An apology had been given to Ms A for the oversight. We did not uphold Ms C's complaint.

Summary

Mr C complained about the care and treatment he received when he attended at the board's out-of-hours service at the New Victoria Hospital. Mr C had been suffering from abdominal pain, nausea, vomiting and fever. He saw a GP on his first attendance and although Mr C had suggested he might have appendicitis, the GP dismissed this and felt it was viral gastroenteritis. Mr C was sent home after having an injection for the nausea. The pain continued and Mr C re-attended the out-of-hours service three days later and saw another GP. The GP thought Mr C was suffering from trapped wind and gave a further injection and told Mr C to return home. He did so but returned to the same GP two hours later as the pain had not settled and he was then referred to hospital for a specialist opinion. The hospital then diagnosed that Mr C had appendicitis where he was required to undergo emergency surgery. Mr C felt that the GPs at the out-of-hours service had failed to take his concerns seriously and that he should have been referred for a specialist hospital opinion sooner.

After taking independent medical advice, we did not uphold Mr C's complaint. The advice we received was that the examinations carried out by both GPs were reasonable with appropriate advice and treatment being provided on the basis of the findings. The adviser explained that Mr C had not shown any of the classical signs of appendicitis at the time of the first two examinations and that it was appropriate to refer him to the hospital specialists on the third attendance as his clinical condition had worsened.

Summary

Ms C complained about the care and treatment she was given by a consultant surgeon after her GP made an urgent referral for her to attend the board's breast service. She said that her appointment took too long to be arranged after referral and then the examination given had been brief. She believed that she should have been sent for a mammogram because of her presenting symptoms and her reported family history. Ms C complained that by the time she was diagnosed with breast cancer, she required a full mastectomy. The board considered that she had been treated reasonably and appropriately in terms of the relevant protocol. Ms C remained unhappy and complained to us.

We took independent advice from a consultant breast surgeon and we found that when Ms C presented initially, there was no need to perform a mammogram and she was appropriately examined and investigated. Five months later, after being urgently referred, Ms C was examined and had a mammogram and ultrasound imaging with biopsies taken. She was diagnosed with an invasive form of breast cancer for which she was given chemotherapy and then a mastectomy.

We found that Ms C's treatment had been reasonable, appropriate and timely, in accordance with Scottish Government targets. For these reasons, we did not uphold the complaint.

Summary

Mr C, who works for an advocacy and support agency, complained on behalf of his client (Mrs A). Mrs A complained about the care her late son (Mr A) received at Queen Elizabeth University Hospital after he was taken there by emergency ambulance. It was identified that Mr A was suffering from limb and life threatening ischemia (a lack of blood supply that could be life threatening or cause the loss of a limb) requiring urgent surgery. Mrs A complained that the board's consultant vascular surgeon did not share this information with the family in a more private area of the hospital, that there was a lack of action by staff in response to Mr A having complained of severe stomach pain following surgery, and that Mr A had been placed in a single room containing equipment prior to his death a few days later.

We took independent advice from a consultant vascular surgeon. We found that, although the cubicle environment in the emergency department was not ideal, the communication that took place with Mr A and the family was reasonable and we did not uphold this complaint. We also considered that there was no undue delay in carrying out a scan following the surgery after Mr A's concerns about his stomach pain were identified. We did not uphold this complaint. We further identified that the board had reflected on the family's concerns about there being equipment stored in the single room due to essential maintenance work. They acknowledged that this should have been explained to the family at the time and they apologised for this. We concluded that it was not unreasonable to transfer Mr A to the single room to allow the family more privacy, and on balance we did not uphold this complaint.

Summary

Mr C complained about the care and treatment provided to his late wife (Mrs A) when she was a patient at Inverclyde Royal Hospital. Mrs A suffered from vascular dementia (a type of dementia caused by reduced blood flow to the brain) and was admitted to hospital for further assessment when she became confused, possibly due to a urine infection. Mrs A's condition deteriorated and she died two weeks after being admitted to hospital. Mr C said that she was not given appropriate medication within a reasonable time and that staff failed to communicate with him in a reasonable way.

We took independent medical advice from an adviser who specialises in general medicine. We found that the board provided a reasonable standard of care and treatment and that Mrs A's deterioration was recognised in a reasonable time and treated appropriately. We also found evidence that healthcare professionals had discussed Mrs A's condition with Mr C. We did not uphold the complaint.

Summary

Mr C complained about the way his medication was handled by the prison healthcare centre, in particular that his medication had been stopped, the board had stopped his medication before investigating his complaint about the medication and that the board did not reinstate his medication.

We took independent GP advice. We found that the decision to stop Mr C's medication was taken in line with the board's and the General Medical Council's guidance on safe prescribing. Mr C had signed an agreement before starting the medication which set out the circumstances under which the medication could be stopped. We were satisfied that the decision to stop the medication was taken in line with this agreement. The evidence demonstrated that when Mr C's medication was being stopped, he was reviewed by a doctor and was offered support in line with policy. The advice we received was that the decision to not restart Mr C's medication was reasonable and in line with policy. We did not uphold these complaints.

Mr C was also unhappy with the handling of his complaints, in particular that there had been an unreasonable delay by the board in dealing with his complaint. He also said that the investigation of his complaint had been inadequate, and that the response to his complaint was unreasonable. We decided to consider these issues together. We were satisfied that the board had handled Mr C's complaint in line with the complaints process and therefore did not uphold his complaint about delay. We were also satisfied that the board had adequately investigated his complaint and did not uphold that complaint. Finally, we were satisfied that the board's response to Mr C's complaint was reasonable and did not uphold his complaint.

Summary

Mr C complained that the prison healthcare centre's decision not to prescribe him a medication used to treat insomnia was unreasonable. Mr C said that he had been prescribed the medication in his previous prison, but when he transferred to a new prison, his prescription was stopped which he said caused him significant problems. Mr C also raised concerns that this decision had been taken before he had had a chance to discuss his condition with a psychiatrist and before the prison healthcare centre had access to his community medical records. Mr C wanted to be prescribed the medication again as he felt this would improve his sleep, keep him safe, and reduce the chance that he would be put in an observation cell.

We reviewed documents provided by Mr C and the board, and we took independent advice from a psychiatric adviser. We found that the decision to stop the medication was reasonable. However, we noted that Mr C had been on this medicine for some time and that it may have been hard for him to understand why it was suddenly stopped. We found that national guidance said it should only be given for short periods and that it was therefore reasonable to stop it when there was no clear need for it. We were critical that Mr C did not get a full explanation from medical staff about why the medication was stopped, but were satisfied that it was a reasonable decision and we did not uphold the complaint.

We noted that the board did not respond well to Mr C's initial complaint as their initial response was inaccurate. We also noted that this response did not signpost Mr C to us if he was still unhappy. The board also only gave a full response to Mr C's concerns when we became involved. We were therefore critical of the board's complaints handling and we highlighted this to them.

Summary

Ms C complained on behalf of her daughter (Miss A) about the care provided to her at Forth Valley Royal Hospital following an ultrasound scan which confirmed that she had lost her baby. Ms C was concerned that a sonographer, rather than a midwife, had told Miss A that the baby had died, and that she then had to wait for 45 minutes to see the doctor and midwife. She was also concerned that her daughter was not given a full explanation of the medication she would receive and of the process which would lead to the birth of her baby. She felt that the level of support and information provided to her daughter was inadequate. Ms C was also unhappy with what happened when her daughter returned to the hospital two days later to give birth to her stillborn baby. She felt that the support provided by the midwife was poor and this meant that her daughter eventually gave birth without the midwife being present. She was also concerned about the level of pain relief provided, documentation which suggested the baby would be cremated when this was not the intention of the family, and that the time of the birth was misreported in the records.

We took independent advice from a midwifery adviser. We found that it was appropriate for the sonographer to report the ultrasound findings to Miss A. We noted the subsequent delay in seeing a doctor or midwife, but we did not consider that this delay was unreasonable for the hospital at that time. We were satisfied that the records showed that Miss A was provided with a reasonable level of support and advice and that she was given the opportunity to ask any questions she had at that time about medication or the birth process. Following her attendance at hospital two days later, we were satisfied that the level of support provided to Miss A was reasonable. We noted the issues with the form suggesting cremation, but we also noted that the board had agreed to review this literature when they responded to Ms C's complaint. As we were satisfied that the level of care and support provided was reasonable, we did not uphold these complaints. However, we did highlight to the board the importance of ensuring that their record-keeping is accurate as we did note a discrepancy in the times recorded in the midwifery records.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Ms A). Ms A had complained to the council about anti-social behaviour from a neighbour, in particular noise and dog fouling in the garden, but felt that they had failed to properly investigate her concerns. The council advised that they had responded appropriately to all of Ms A's complaints of anti-social behaviour, including carrying out regular visits to the property.

During the course of our investigation we found that there had been a number of occasions where Ms A had not allowed the council officers access to her property so that they could witness the noise from her neighbour. We also found that the council had contacted the neighbour and spoke to them about the complaints. The council also visited the area a number of times to look for dog fouling, and found no evidence. We did not uphold the complaint.