Not upheld, no recommendations

Summary

Mr C complained that the housing association were failing to carry out repairs to his home in line with their obligations under the tenancy agreement. He had reported leaking taps to the association, who visited to carry out repairs. He was concerned about the level of water damage and was of the view that the association should make right the water ingress problems he had identified.

The association said that they had responded to Mr C's complaints of leaking taps promptly, and within the timescales required by the repairs procedure. They said that they had inspected his property, at his request, and were satisfied that any residual dampness and minor damage to his property was not of a level which required their intervention.

We considered the evidence and established that the association had reacted promptly, and within the appropriate timescale, to Mr C's requests for repairs to his taps. We were also satisfied that they had inspected any damage caused to ensure that the property was still habitable and of a standard required to meet the terms of their tenancy agreement. For this reason, we did not uphold the complaint.

Summary

Miss C complained about the care and treatment provided to her late father (Mr A). Mr A became unwell and an ambulance was called. The ambulance crew examined him and suspected a heart attack. They contacted the coronary care unit at the Royal Infirmary of Edinburgh and it was agreed that Mr A should be brought there. However, Mr A went into cardiac arrest on the way and, despite the ambulance diverting to the nearest hospital at that time, he could not be resuscitated and he died. Miss C complained about the time taken for the ambulance to set off for hospital and also about the decision to take Mr A to Edinburgh rather than his local hospital.

The ambulance service noted that the ambulance was present at Mr A's home for a total of 33 minutes. They advised that this included all the patient assessment process, liaison with the Royal Infirmary of Edinburgh, and transferring Mr A to the ambulance. They indicated that the only issue that may have created a slight delay was difficulty in establishing intravenous access (where a thin tube is placed inside a vein to administer or withdraw fluids).

We took independent clinical advice from a paramedic. They considered that the ambulance crew had provided appropriate clinical treatment and acted within Mr A's best interests. While they noted that the ambulance was at Mr A's home for 13 minutes more than the optimum recommended time for a coronary case, they considered that the delay was not unreasonable in the circumstances. They advised that it was the correct decision to transfer Mr A to Edinburgh for specialist treatment, right up to the point that he went into cardiac arrest. They informed us that it was accepted practice to bypass nearer hospitals to take patients to the best possible place of treatment and they said it was not certain that Mr A would have survived the cardiac arrest had he been in hospital when it occurred. We accepted this advice and did not uphold the complaint.

Summary

After suffering recurrent ear infections, a child had surgery to insert grommets in his ears (a small tube inserted into the ear to help drain away fluid in the middle ear and maintain air pressure) at a private hospital in 2013. He then attended the Royal Hospital for Sick Children from early in 2014 as he had been experiencing nose bleeds. The child had a number of procedures carried out in May of that year but soon afterwards experienced another ear infection. He was seen in hospital again and a further set of grommets were inserted in August. He was reviewed in November and it was planned to see him in six months but his appointment was brought forward as he had been suffering constant infections and pain.

In April 2015 after attending at hospital, a decision was taken to allow a three month period of 'watchful waiting' before taking a decision to insert grommets again. The child's mother (Miss C) was unhappy with this and arranged for him to be treated privately. She complained that the board had not treated her son appropriately.

We took independent advice from a consultant ear, nose and throat surgeon and we found that the child had been treated in accordance with established guidance. This was because the type of problem from which he suffered could often resolve spontaneously, and it was usual to recommend a period of 'watchful waiting' before taking a decision to proceed with surgery. For this reason we did not uphold Miss C's complaint.

Summary

Miss C complained that doctors at her GP practice had failed to refer her for appropriate tests in order to diagnose a tumour in her bowel.

After taking independent advice on this case from a GP adviser, we did not uphold Miss C's complaint. The advice we received was that the appropriate guidance had been followed and that there had been no delay in referring Miss C for further investigations.

Summary

Mr C has suffered from spondylolisthesis (where a bone in the spine slips out of position, either forwards or backwards) for a number of years. After his lower back pain became worse his GP referred him for physiotherapy. Mr C attended an appointment with a physiotherapist and was told to self-manage his condition by undertaking core stability exercises and maintaining posture awareness. Mr C had previously found massage therapy to be beneficial to him and he was unhappy that this treatment was not offered to him despite his requests. Mr C had previously obtained massage therapy privately but no longer had the resources to do so.

Mr C wrote to the board to complain that the exercises recommended by the physiotherapist were not helping his condition. Mr C stated that he had obtained private treatment (for massage therapy) on occasion, and that he believed that this treatment should be offered by the NHS. The board investigated Mr C's complaint and concluded that whilst massage therapy can help lower back pain for short periods of time, the exercise programme recommended to Mr C was the most appropriate for managing his condition.

After taking independent medical advice from a musculoskeletal out-patient physiotherapist, we did not uphold Mr C's complaint. The adviser concluded that it was reasonable of the board to refuse Mr C massage therapy as there was limited evidence to support the effectiveness of the treatment in managing chronic lower back pain. The adviser also thought that the exercise programme treatment that was recommended to Mr C was reasonable. In view of this, there was no evidence that the board had unreasonably refused to offer Mr C massage therapy and we did not uphold the complaint.

Summary

Mrs C complained about care she received from the medical practice when she attended with an injury to her toe. Mrs C has diabetes which makes foot complications more common and harder to treat. Mrs C had been prescribed an antibiotic to treat the infection but she had returned to the practice around a month later as she was still in pain, at which point she was referred to hospital. She had to have emergency surgery, resulting in the amputation of her big toe. Mrs C said that she had attended the practice three times before being referred to hospital and that the amputation could have been avoided if the practice had provided appropriate care and treatment when she had first attended.

The practice said that they had conducted an audit and could not find any evidence that she had attended on the first occasion. We took independent advice from a GP adviser. The adviser considered the records available and found the treatment Mrs C was given was appropriate, and that Mrs C's GP could not have foreseen that Mrs C's condition deteriorated or recurred between the point at which she was prescribed antibiotics and being referred to hospital. We also found no evidence of the initial appointment that Mrs C referred to. We did not uphold Mrs C's complaint.

Summary

Ms C, a voluntary agency worker, complained on behalf of Mr A that the dental care and treatment he had received had been inadequate. We took dental advice which stated that the care and treatment had been appropriate. It noted Mr A had not attended regular dental reviews, which had contributed to the damage to his teeth.

We found that the dentist had acted reasonably and that the care they had provided was appropriate, and we therefore did not uphold this complaint.

Summary

Ms C, who works for a voluntary agency, complained on behalf of Mr A that the care and treatment he received was inadequate and that his subsequent complaint had been poorly handled. Mr A had suffered repeated problems with dental bridgework failing. Ms C said he had been seen by a number of different dentists, causing problems with continuity of care. Mr A also believed that a tooth had been prepared for a crown inappropriately and that he had had an unnecessary extraction, and that he had unreasonably been refused bridgework treatment.

We took independent dental advice, which stated that Mr A had received a comprehensive examination. It was not practical to fit a bridge because of decay in the teeth it would have to be attached to. It would also not have been appropriate to attempt any other restorative work until Mr A's gum disease issues were dealt with. The advice noted that Mr A had been insistent that a bridge be fitted, but the dentist had correctly refused on the basis that this would be inappropriate and would worsen the condition of his teeth.

We found that Mr A's care and treatment was reasonable in the circumstances. His complaint had been thoroughly investigated and a response provided within a reasonable timescale.

Summary

Ms C, an advice agency worker, complained on behalf of the family of Mrs A. Two GPs at the practice had visited Mrs A's home on request and diagnosed that she had a urinary tract infection, for which they prescribed medication. After the GPs left, the family tried to move Mrs A upstairs to her bedroom, but in the process she suffered a leg injury. An ambulance was called and she was admitted to hospital for that injury.

The family complained that Mrs A was not very mobile and that the GPs should have admitted her to hospital, rather than simply leave them on their own to manage an elderly, immobile patient in a home with steep stairs.

We took independent advice on this case from a GP. Our investigation established that the GPs had acted in line with guidance on hospitalisation in the SIGN guideline, 'The Management of Urinary Tract Infection in Adults'. (SIGN is the Scottish Intercollegiate Guidelines Network, which is an organisation that develops clinical guidelines for the NHS in Scotland.) In other words, they had appropriately identified that, in her case, Mrs A should be treated at home but that hospitalisation might become appropriate. The GPs had also appropriately arranged urgent referral to a multi-disciplinary team, who would be able to help Mrs A with self-care and mobilisation.

The GPs considered that they had advised the family that Mrs A might need to remain downstairs initially. In the absence of independent evidence, the facts around this could not be established either way. The lead GP felt on reflection that he could have checked more whether the family had understood his advice and information, and said he would check this more in future cases.

Summary

Mr C complained about the involvement of a senior charge nurse in relation to a dispute on the ward between him (Mr C) and a relative of his, both of whom happened to be visiting Mr C's mother (Mrs A) at the same time. Mrs A was a patient on the ward at Aberdeen Royal Infirmary. The relationship between Mr C and his relative had been strained for a long time, and difficulties arose because they both wished to visit Mrs A before she died.

We took independent advice from a nurse. They considered the various actions of nursing staff, particularly those of the senior charge nurse. They were satisfied that staff had appropriately tried to act in Mrs A's best interests by trying to give both relatives separate time with Mrs A and that it had not been their responsibility to check that one relative had left the premises before the other arrived.

Mr C also expressed concerns about the board's handling of his complaint. We saw no evidence to support such concerns.