Not upheld, no recommendations

Summary

Ms C complained that following an operation for pancreatic cancer she was discharged home from Aberdeen Royal Infirmary without being given medication (which was specifically for digestive problems involving the pancreas). As a result, Ms C's condition deteriorated and she developed symptoms of severe pain, sickness and diarrhoea. She had to be readmitted to hospital and the medication was re-started, and her symptoms began to improve.

We took independent advice from a medical adviser who noted that it was a discretionary decision for the consultant to make prior to Ms C's discharge from hospital and that this was a reasonable decision for them to take. Some clinicians would prescribe this specific medication on discharge whilst others would not. The fact that the medication was not prescribed was not, in itself, an indication of a failure in service.

We found that the decision to discharge Ms C without medication was appropriate in the circumstances but that it was unfortunate that her condition deteriorated and that she required a further admission to hospital. With hindsight, if Ms C had been given this medication, it may have prevented her deterioration but the consultant had to consider the available information at the time of discharge. We did not uphold the complaint but noted that the matter should have been discussed with Ms C prior to discharge.

Summary

Mr C suffered from cystic acne. He attended his GP practice on a number of occasions over several years and received treatment. Eventually he was referred to a skin specialist. The specialist prescribed Mr C medication that cleared his acne, but he was left with significant scarring on his face. He complained that, when he asked the board to provide treatment to remove the scarring, this was refused on the grounds that it was a cosmetic procedure and could not be funded by the NHS. Mr C felt that the NHS should provide the required treatment.

We found that the board had reached their decision with reference to national guidance on referrals for cosmetic procedures. Although acne was not specifically mentioned in the guidance, we were not critical of its use when considering Mr C's request for treatment. The guidance generally ruled out treatment unless there were special circumstances. We took independent advice from a consultant dermatologist (a specialist in diseases of the skin, hair and nails). The adviser said that the board had appropriately considered Mr C's request and, should he wish to pursue a referral on the grounds of special circumstances, he would have to do this through his GP. We were not critical of the board's handling of Mr C's case.

Summary

Mr C suffered from cystic acne. He attended the practice on several occasions over a number of years and received treatment. His GP referred him for treatment from a skin specialist. The specialist prescribed him medication which cleared his acne. However, he was left with significant scarring on his face which he was reportedly told may have been prevented if he had been referred sooner. Mr C complained that, had he been prescribed the medication sooner, he would not have been so badly scarred by his acne. He considered that the practice should have referred him to the specialist earlier, or that they should have prescribed him the medication directly.

We took independent advice from a consultant dermatologist (a specialist in diseases of the skin, hair and nails). The adviser said that GPs would never prescribe this medication directly and that the correct course of action is for the GP to refer the patient to a specialist for consideration of a prescription. We found that the practice had reviewed Mr C's acne on a number of occasions and had provided treatment according to his presenting condition. His treatment was appropriately altered as required and his acne was noted to have improved at various times. We concluded that he was appropriately referred to a specialist when his acne had recurred and showed signs of scarring, so we did not uphold the complaint.

Summary

Mrs C complained about the board's handling of a surgical procedure that was recommended by a surgeon at Borders General Hospital. Mrs C was dissatisfied with delays in the surgery going ahead because she had been in pain for a long time and had difficulty walking.

We took independent advice from an adviser who is a specialist surgeon. We found that there were appropriate medical reasons initially why Mrs C's surgical procedure could not go ahead. The board had acknowledged and apologised to Mrs C that the 12 week treatment time guarantee had not been met. However, we found that it was an unusual procedure where there were exceptional circumstances for this. It had come to the board's attention that the risks, complications and outcomes of the procedure to treat a nerve related condition had not been properly reviewed. Therefore, we concluded that there was good reason on patient safety grounds for a comprehensive review to be carried out and formally reported on before offering the surgical procedure to Mrs C.

Summary

Mr C asked to have pens in use (in his possession or his room, rather than with his other belongings in prison storage) that he made at his work party. The prison refused Mr C's request which he said was unfair because other prisoners were allowed to have such pens in use.

The prison told us that they had decided not to allow Mr C to have the pens in use because they were decorative and could be used for sale or barter. The prison rules confirm that the governor is authorised to refuse to allow a prisoner to have in their possession any items considered to be prejudicial to the security or good order of the prison. In addition, they said any prisoners who may have such pens in use were unauthorised to do so.

We were satisfied that the prison were authorised to refuse Mr C's request and, therefore, we did not uphold his complaint.

Summary

Mr C complained to us that there had been unreasonable delays by the Scottish Prison Service (SPS) in facilitating his movement through the prison system in time for his parole hearing. Mr C had been transferred from a prison in England so that he could receive family visits. However, he needed a cell of his own and there was a waiting list for single cells in the prison he had been transferred to. Therefore, Mr C was transferred to another prison so that he could be given a single cell. Although Mr C considered that this had delayed his progression through the prison system, we found that this was a decision that the SPS were entitled to take.

Mr C was also unhappy that his former parole officer in England had not attended a meeting to discuss his progression. We found that the SPS had taken steps to try to arrange for the parole officer to participate in the meeting. As Mr C was unhappy that he had not attended, the SPS agreed to postpone this meeting to a later date so that the parole officer could participate and provide further information. We considered that this had been reasonable. We did not find evidence that there have been unreasonable delays by the SPS in facilitating Mr C's movement through the prison system and we did not uphold the complaint.

Summary

Mr C had complained to a local authority about their services. When they did not investigate his complaint he asked a councillor to review the matter. The councillor felt that this would go beyond his remit and declined to become involved. Mr C complained about the councillor to the Commissioner for Ethical Standards in Public Life in Scotland (the commissioner). Mr C alleged that the councillor's code of conduct had been breached. The commissioner investigated Mr C's complaint and concluded that there had been no breach. Mr C subsequently complained to us that the commissioner had investigated a different complaint to the one he had raised, had accepted evidence that was not relevant to his complaint and had taken an unreasonably narrow interpretation of the code of conduct.

We found that, whilst the commissioner's summary of Mr C's complaint was different to the point he had raised, his concerns were addressed fully in the commissioner's decision. We were satisfied that the commissioner reached his decision having followed guidance as to how the code of conduct should be interpreted and that he had carried out the investigation reasonably.

Summary

Mr C complained about the Scottish Fire and Rescue Service (SFRS) after they extinguished a fire he had set to dispose of garden waste. They had received a call from a member of public to say that the fire was in a public park. However, Mr C informed them that the fire was actually on his property, which borders the park. The decision was taken to extinguish the fire nonetheless, as they considered that there was the risk of repeat calls requiring further emergency responses.

We found that decisions to extinguish controlled fires are taken at the discretion of the attending officers. As there was no evidence of administrative or service failure in the decision-making process, we found that the decision to extinguish the fire was a discretionary one the SFRS were entitled to take, and that they had acted reasonably in making this decision.

Summary

Miss C complained that the council failed until 2014 to notify her of works to her home carried out under a statutory notice served in 2007. She said it was only in 2014 that she was informed of the amount of money that she owed. She also complained that the council failed to follow the correct tendering process when carrying out the works.

We found that the original statutory notices were issued to her agent at the time and it would, therefore, have been the agent's responsibility to pass this information on to Miss C. We also looked at the tendering processes followed by the council and noted that they were not required to follow an open tender process for each statutory notice served. We found that the council had used their major works framework agreement when tendering for this work and that this was in line with their obligations. For this reason, we did not uphold her complaints.

Summary

Mr and Mrs C complained on behalf of their son (Mr A) about care he received on two visits to A&E at Gilbert Bain Hospital. Mr A attended the hospital and was diagnosed with a viral infection. He returned two days later and was again diagnosed with a continuing viral infection. A further three days later, Mr A became very unwell and was admitted to hospital. He was later transferred to a hospital in another board area and diagnosed with osteomyelitis (a bone infection caused by bacteria).

Mr and Mrs C complained that Mr A had not been reasonably assessed and treated. We took independent advice from an adviser in emergency medicine. They said that Mr A was given a thorough and appropriate examination on both occasions. The adviser said the symptoms were consistent with a viral infection and there were no symptoms which indicated further tests should have been carried out. The adviser also noted that osteomyelitis is a very rare condition and one not often seen in children Mr A's age.

Considering the advice we received, we did not uphold this complaint.