Not upheld, no recommendations

Summary

Mr C complained to us about the treatment which he received from a GP at the medical practice. He said that he had been unwell for a period of years and that it was suspected he had Irritable Bowel Syndrome. He reported to the GP that he had further bowel problems and that he wanted to be referred to hospital. Mr C said that the GP refused to refer him to hospital. He continued to be in pain for a further week, and attended hospital himself where he was diagnosed with septicaemia and a cancerous tumour.

The practice maintained that due to the symptoms reported by Mr C there was no indication that an immediate hospital admission was required. The practice were aware that Mr C had already been referred for a colonoscopy and the GP took steps to give the referral more priority.

We took independent advice from an adviser who is a GP. We found that Mr C's GP was aware of his clinical history, took note of his presenting symptoms and made out an appropriate prescription. There was no indication that Mr C reported acute abdominal pain which warranted emergency hospital admission that day, and it was appropriate to speed up the priority of the colonoscopy referral. We did not uphold Mr C's complaint.

Summary

Mrs C complained to us that she had repeatedly asked the medical practice whether they had access to a report on the colonoscopy procedure (examination of the bowel with a camera on a flexible tube) which she underwent in hospital. The practice said that they would have to wait until the hospital advised them of the result. Mrs C contacted the hospital and was told that the practice could have obtained the report electronically. Mrs C complained to the practice and they said that while the result of the report was available electronically it would be for the hospital clinician who requested the report to advise the patient and the practice of the result.

We took independent advice from a GP adviser and concluded that while the result was available electronically it was outwith the role of a GP to report the result to the patient. It was the responsibility of the clinician who arranged the test to report the result. A GP would not be able to interpret the result of the test or know what the patient's management plan was. We also found that the practice had made contact with the hospital who explained that there was a backlog in the reporting of the results and that their involvement actually meant that the result was reported earlier than it would otherwise have been. We did not uphold the complaint.

Summary

Ms C complained that since at least April 2012, her partner (Mr A) had been receiving care for his mental health problems but that it had been inadequate and insufficiently 'holistic'. She said that her views on his illness had either not been sought or had been discounted. She also said that as Mr A's partner, she would have expected to have been more involved and supported.

We took independent advice from a mental health professional and we found that the level of support provided to Mr A, particularly during periods of crisis, was appropriately reactive to Mr A's needs and presenting symptoms. Further, we found that Ms C often accompanied Mr A to his appointments and there was clear evidence that her views were listened to and recorded. While Ms C's difficulties in supporting Mr A were noted, it was also established that she had been supported in a manner and to a degree that was reasonable in the circumstances.

Summary

Ms C was concerned about the way she said she had been treated for colorectal and cardiac problems. Ms C believed that her concerns about her health had not been dealt with reasonably or taken seriously. We obtained independent advice from a consultant colorectal surgeon (the colorectal adviser) and a consultant cardiologist (the cardiology adviser).

We did not find any evidence that the board unreasonably delayed in progressing a referral made by Ms C's GP for rectal bleeding. The advice we received from the colorectal adviser was that all appropriate and necessary tests and scans were carried out at the Western General Hospital. Ms C was diagnosed with internal haemorrhoids, which was considered the most likely cause of her rectal bleeding. We found that the treatment she received for this was reasonable. We also found that the decision to advise against haemorrhoid surgery was a correct assessment and represented good clinical judgement and was in line with surgical guidelines. Taking into account the advice we received, we considered the treatment Ms C received for her colorectal problems was reasonable.

In respect of the concerns raised by Ms C about her cardiology treatment at the Royal Infirmary of Edinburgh, the cardiology adviser said that all reasonable and proportionate investigations had been carried out and had repeatedly shown normal findings. We found that it was appropriate and reasonable of the cardiology department to have concluded that Ms C's symptoms were not of cardiac origin. Overall, the cardiology adviser had identified no failings with regard to the care and treatment provided to Ms C by the cardiology department. We accepted that advice.

Summary

Mr and Mrs C complained about the care their daughter (Miss A) received at Stobhill Hospital for treatment of anorexia nervosa. They were concerned about the care plan that was in place and that the board had acted inappropriately when attempting to remove Mrs C as Miss A's named person under the Mental Health (Care and Treatment) (Scotland) Act 2003. A person being treated under the 2003 Act can choose someone to help protect their interests.

We took independent advice from one of our advisers who is a consultant psychiatrist, and found that the care and treatment was reasonable overall. We considered that staff had appropriately managed situations which could potentially have had a negative effect on Miss A's treatment. We concluded that there was evidence to support that the board were acting in accordance with national guidance and in Miss A's best interests to assist her recovery when attempting to remove Mrs C as named person.

Summary

Ms C complained about the treatment which an out-of-hours GP provided to her late sister (Ms A). Ms A had acute myeloid leukaemia (cancer of the white blood cells that accumulate in the bone marrow) and was receiving chemotherapy. Ms A attended the out-of-hours GP with pain in her back passage. She was diagnosed with haemorrhoids (swollen blood vessels in or around the anus and rectum) and sent home. Ms A continued to be in pain and contacted the out-of-hours service the following day and she was admitted to hospital where she was diagnosed with having necrotising fasciitis (a severe skin infection). As a result, a large area of her buttock was removed and a stoma bag was fitted. Ms C felt that Ms A should have been admitted to hospital on the first occasion.

We took independent advice from an adviser in general practice and concluded that the GP who initially saw Ms A carried out an appropriate examination and that the diagnosis of haemorrhoids was reasonable. Ms A's GP had made a reasonable diagnosis based on the presenting symptoms and in view of Ms A's previous medical history. Ms A's condition had deteriorated quickly in between attending the GP and being admitted to hospital. We did not uphold Ms C's complaint.

Summary

Mrs C complained about the clinical treatment and nursing care that her late mother (Mrs A) received at the Glasgow Royal Infirmary. Mrs A was admitted after becoming unwell at home and it was suspected that she was suffering from gallstones blocking the bile duct. Mrs A had a number of existing conditions and had been prescribed clopidogrel (a drug that reduces blood clotting) for one of these conditions.

As Mrs A was on clopidogrel, which increases the risk of serious bleeding during invasive tests, it was decided that a scan would be carried out to investigate. This confirmed that she had a blockage in the bile duct and it was agreed that an endoscope (a thin flexible tube) procedure would be arranged to investigate further and clear the blockage. Mrs A's clopidogrel had been stopped the previous day due to other test results and so arrangements were made for the endoscope procedure to take place in six days' time. Mrs A's condition deteriorated a few days later and she developed sepsis (blood poisoning) before the procedure could be carried out. She was transferred to the high dependency unit but passed away.

After taking independent advice from an adviser who is a consultant surgeon, we did not uphold Mrs C's complaint about clinical treatment. The adviser considered that appropriate investigations had been carried out and that while having the endoscope procedure earlier might have avoided sepsis developing, it was reasonable practice to have waited until the clopidogrel had been stopped for a period of seven days before undertaking the procedure. The adviser also considered that the drug had been stopped at a reasonable point in Mrs A's admission.

After taking independent advice from a nursing adviser, we did not uphold Mrs C's complaint about nursing as no failings in care were identified.

Summary

Mrs C complained on behalf of her late husband (Mr A) about care he received from his GP practice. Mr A attended the practice having been diagnosed with oedema (where fluid collects in the legs and abdomen). He had been prescribed medication to combat the oedema. Mr A was referred to his GP to investigate the cause of the oedema and the GP took blood tests, which were normal. The GP also noted that, apart from the oedema, there were no signs of heart failure. As Mr A was obese, and therefore at greater risk of heart problems, the GP referred him for an echocardiogram (a heart scan that uses sound waves to create images) to investigate any potential heart problems. Mr A passed away before he was seen for a heart scan. The cause of death was an enlarged heart.

We took independent advice from a medical adviser. The adviser was satisfied that the practice had made appropriate investigations into Mr A's symptoms and made an appropriate referral. For this reason, we did not uphold the complaint.

Summary

Ms C, who works for an advice agency, complained on behalf of Mrs A. Mrs A said that her husband (Mr A) had been provided with inadequate care during an admission to Glasgow Royal Infirmary. Mrs A believed that Mr A had not been provided with appropriate antibiotics and that there were delays in providing him with medication. Mr A had undergone surgery, but had subsequently deteriorated. He had suffered a heart attack at the start of visiting hours and Mrs A had to wait in a day room. Mr A had subsequently died before Mrs A was able to see him.

We took independent medical advice on Mr A's care and treatment. The adviser said Mr A had suffered from a serious heart attack, as well as kidney problems. Although there were instances when he did not receive medication promptly, these did not impact on his prognosis, or the outcome of his treatment. Mr A had suffered two major heart attacks in succession on the day he died. All reasonable resuscitation techniques had been tried, and it was reasonable that Mrs A was not allowed in to see Mr A whilst resuscitation was being attempted.

We found that Mr A had received reasonable clinical care and treatment and the delays in administering medicine had been investigated and addressed appropriately by the board. We therefore did not uphold the complaint.

Summary

Mr C complained on behalf of his wife (Mrs A) about the board's management of his wife's labour at the Southern General Hospital. He also complained that the board's communication with him and his wife during her admission was unreasonable. His concerns included that the midwife's initial assessment of his wife was incompetent and the obstetrics and gynaecology registrar who became involved in his wife's care unreasonably failed to assess his wife. He said the board unreasonably refused to provide antibiotics for his wife for an existing infection, resulting in his baby having to have antibiotics via cannula (a tube inserted into the body for the delivery of fluid). Mr C was also concerned that when he and his wife first attended the hospital it was unreasonably suggested that they could go home.

We obtained independent medical advice on the complaint from a midwife and a consultant obstetrician and gynaecologist. The midwifery adviser said that the midwife's clinical assessments of Mrs A were competently carried out to best practice standards. The obstetrics and gynaecology adviser said they could see no reason for the obstetrics and gynaecology registrar to repeat the midwife's initial assessment and/or initiate a different management plan for Mrs A.

The midwifery adviser said it was unusual for women to labour so rapidly and because of this there was not an opportunity for the midwife to provide the antibiotics to Mrs A and the treatment was given directly to their baby. The adviser said this was a difficult situation where the clinicians were recommending a treatment plan which Mr C did not agree with and as a result Mrs A did not get the support she required when her labour progressed so rapidly. The obstetrics and gynaecology adviser explained that the antibiotics would need to have been given to Mrs A at least four hours prior to delivery and the postnatal administration of antibiotics by cannula to their newborn daughter was unavoidable.

The midwifery adviser said that as Mrs A was in very early labour when she first attended hospital, following initial assessment, it was reasonable for the midwife to offer that Mr C and his wife either remain at the hospital to see if labour established or go home. We did not uphold Mr C's complaints.