Not upheld, no recommendations

Summary

Mr C raised a number of concerns about the demolition of two sites close to his property. In particular, he was concerned that he had not received neighbour notification prior to the demolitions being carried out. He also complained that the council had failed to respond reasonably to his concerns about the two sites.

We took independent advice from one of our planning advisers. During our investigation the council provided evidence of the action taken in relation to both sites which included instructing emergency action in relation to one of the sites under the terms of the Building (Scotland) Act 2003. We found no evidence which required that neighbour notification should have been carried out prior to the demolitions carried out on both sites. Overall we were satisfied that that the council had taken reasonable action in response to the concerns raised about the two sites, so we did not uphold Mr C's complaints.

Summary

Miss C rents a property from the housing association. Over a number of years she experienced problems with the plumbing in her kitchen which affected her washing machine. She said she had to replace five washing machines at a substantial cost. She complained that, although the association ultimately fixed the problem, it took them several years to do so, and they refused her request for reimbursement of the cost of the replacement washing machines. Miss C also complained about the standard of other maintenance work carried out at her property. She said that this left her family unable to use the bedrooms. She felt that her rent should be reduced as a result of this.

We found that Miss C first raised the problem with her plumbing in 2011. We accepted that this was not resolved after two visits from a plumber, however, she did not raise the matter with the association again until 2014. As such, we were not critical of the association for failing to carry out further investigations until 2014. The cause of the plumbing problem was identified, but it was not resolved for five months due to an administrative error. We were satisfied that the association acknowledged and apologised for this oversight, and offered compensation in line with their policy. As Miss C did not provide evidence of her out-of-pocket expenses or the damage to her washing machines, we found it reasonable for her claim to be rejected.

We acknowledged that Miss C had found the other maintenance works to be disruptive, however, we were satisfied that the association considered whether temporary relocation to another property was required. We also found that work was carried out in line with their repairs and maintenance policy, and that the minimum standards expected of them were met.

Summary

Mr C complained because he felt the care and treatment he received from the prison health centre was unreasonable. In particular, Mr C said that since taking his prescribed methadone he had been feeling ill. Mr C said a doctor concluded that he should not be prescribed methadone and made arrangements for an alternative medication to be prescribed. However, before that happened, Mr C was reviewed by another doctor who decided that the prescription for methadone should continue. Mr C was unhappy with that decision because he felt he was allergic to the medication.

The board explained to Mr C that, following review, the doctor considered the symptoms he had were not because of the methadone and there were other potential causes that needed to be excluded. The doctor suggested Mr C undergo further assessment with the mental health team, and offered treatment to reduce the symptoms he was suffering, which Mr C declined. In addition, the doctor concluded that Mr C's symptoms were not severe enough to justify changing treatment.

We took independent advice from one of our GP advisers and asked for their view on whether the care and treatment provided to Mr C had been reasonable. Our adviser considered that Mr C had been thoroughly assessed by the doctor. She also reviewed Mr C's medical records and noted he had a long history of multiple drug misuse. Our adviser commented that, in her view, with Mr C's history of multiple drug misuse and then stopping all drugs in favour of methadone, his symptoms could reasonably be interpreted by the doctor as having been related to drug withdrawal. As such, she said that the options offered to him – mental health assessment and a trial of allergy medication – and the reasons for not prescribing the alternative medication were reasonable. Our adviser commented that she could see no evidence that Mr C was not adequately assessed by an appropriate professional or that the treatment offered was inappropriate.

In light of the evidence available in Mr C's case and our adviser's view, which we accepted, we did not uphold the complaint.

Summary

Mr C complained about the care and treatment that his wife (Mrs C) had received from the GP practice before her death from bowel cancer. Mr C said that Mrs C had attended the practice on a number of occasions over a three-year period with abdominal pain. He said that the practice had failed to provide Mrs C with appropriate treatment and had delayed in referring her to a specialist.

We took independent advice on Mr C's complaint from one of our medical advisers, who is a general practitioner. We found that Mrs C had initially attended the practice on a number of occasions with heart burn/dyspepsia (persistent or recurrent abdominal discomfort or pain located in the upper abdomen). Heart burn/dyspepsia are not clinical symptoms identified in patients presenting with bowel cancer and Mrs C had received appropriate treatment for this.

Mrs C had subsequently attended the practice with symptoms of abdominal pain, change in bowel habit and anaemia. She was then urgently referred to the colorectal service in line with the relevant guidelines and was diagnosed with bowel cancer. We found that Mrs C had attended the practice with two different sets of symptoms, which were not related. The practice had provided a reasonable standard of care to Mrs C and we did not identify any failings. We did not uphold the complaint.

Summary

Ms C's child was born with a number of unexplained clinical concerns and a series of tests were undertaken to establish their cause. The child was referred to the department of clinical genetics. Ms C complained about the care and treatment her child received there, in that staff were slow to give her an appointment and then to provide her child's test results. She maintained that little time was taken to explain the disorder or to get to the bottom of the problem. No follow-up appointment was made.

We took independent advice from a consultant clinical geneticist and we found that the child was seen within seven weeks, well within the recommended time frame (of 18 weeks). We noted that the appointment lasted 75 minutes and it was explained that although the test results had been inconclusive, other appropriate steps had been taken. A chromosome test was taken from Ms C and similar testing was recommended for the child's father, and Ms C was given comprehensive information which was later confirmed in a letter. No further appointment was made for the child pending the results of parental testing. While Ms C regularly phoned the department asking for the test results these were not available and the child's father had not been in touch to be tested.

While we acknowledged Ms C's anxiety about her child, there was no evidence to suggest that the care and treatment given were unreasonable, and, accordingly, we did not uphold her complaint.

Summary

Mrs C's father (Mr A) visited the practice on several occasions with stomach problems. Although an endoscopy (an investigation of the stomach using a camera) was considered early on, Mr A was instead treated for stress and anxiety for about six months, before an endoscopy was arranged. The endoscopy led to a diagnosis of stomach cancer.

Mrs C raised concerns that Mr A was not referred for an endoscopy sooner, and referred to an online article that recommended urgent referral for patients over 55 with unexplained and persistent dyspepsia (indigestion).

After taking independent medical advice from a GP adviser, we did not uphold Mrs C's complaints. Our adviser considered the GP's actions were consistent with the national guidance on dyspepsia, and reasonable in light of the information known at the time. Our adviser said that Mr A's dyspepsia was not unexplained, as he had been diagnosed with stress (and there were several factors that supported this diagnosis, including that Mr A's symptoms seemed to respond to medication for this). Our adviser also noted that the GP had appropriately checked for any 'alarm features' and regularly checked Mr A's blood tests. When Mr A's blood test showed an abnormality, he was appropriately referred for an endoscopy.

Summary

After Ms C was diagnosed with Lyme Disease (an infection transmitted by the bite of ticks) in 2014, she complained that her GP practice had failed to identify the symptoms of the condition at a consultation a year earlier. Ms C said that in 2013 she presented with a tick bite and large surrounding rash on her arm but the doctor she saw on that occasion did not offer her blood tests or antibiotics. Ms C was concerned that an electronic record of the consultation differed to the hand written entry by that doctor in her medical records and that a second doctor did not put accurate information in a referral letter to an infectious diseases specialist. Ms C also complained that a health care assistant was unprofessional with matters related to her blood test in 2014.

We took independent advice from one of our medical advisers who is a GP, and found that there was no evidence to indicate that Ms C had a bite mark on her arm or that the rash was typical of that associated with Lyme Disease. We considered, on balance, that the first doctor's assessment, diagnosis and suggested treatment were reasonable at the time. We also found that the electronic medical record did not differ materially from the handwritten record. Furthermore, the referral letter to the infectious disease specialist was consistent with the recorded entries in the medical records and were not inaccurate or misleading.

We concluded that it was good practice that the health care assistant had sought advice from a senior colleague regarding the blood test and took steps to appraise himself of the laboratory guidance. Whilst it was difficult for us to comment on the discussions between Ms C and the health care assistant, we obtained electronic records which provided an audit of the likely advice that Ms C was given by him during a phone conversation about the blood results.

We, therefore, did not uphold the complaints.

Summary

Mr C complained that the prison health centre unreasonably refused to prescribe him detoxification medication. The board advised that a nurse carried out a number of assessments on Mr C which confirmed that he was not showing signs of withdrawal from drugs. Therefore, it was decided there was no medical need for him to be prescribed detoxification medication. We took independent advice from one of our GP advisers who confirmed that the care provided to Mr C appeared to be appropriate. Therefore, we did not uphold his complaint.

Summary

Ms C complained that she had not been provided with the appropriate post-operative treatment following a bunion operation in 2011. She had had a second procedure in 2014. This, however, had left her with nerve damage and requiring a brace on her foot to walk. Ms C said she had not been properly assessed for surgery in 2014 and that the appropriate treatment had not been carried out.

We took independent advice from a surgeon who specialised in operations on the foot and ankle. The advice we received was that Ms C's operations had been carried out properly and that she had received appropriate care and support after both operations. The risks had been explained to her before the operation, including the risk that the operation would make Ms C's foot condition worse. Our investigation found the evidence showed Ms C had been appropriately assessed for surgery and that the operation carried out was the appropriate treatment.

Summary

Mr C complained that the GPs at the practice had failed to provide adequate care to his wife (Mrs C) resulting in the late diagnosis of her pulmonary embolism (a clot in the blood vessel that transports blood from the heart to the lungs). Mr C said that this late diagnosis had led to subsequent serious health problems for Mrs C. He said she had repeatedly attended the practice with symptoms consistent with a pulmonary embolism, but that GPs had failed to refer her for the appropriate investigations. He added that on one occasion his wife had been asked to contact a hospital by herself, despite a dangerously elevated heart rate.

We obtained independent advice from an adviser on general practice medicine. They found that Mrs C was appropriately investigated initially. The advice also said that Mrs C's symptoms were non-specific and appeared to resolve for extended periods following treatment, so it was reasonable of the practice to have adopted a policy of watchful waiting. The advice noted that Mrs C's incidents of elevated heart rate were in fact in keeping with the monitored limits as defined by her pacemaker clinic and that it was, therefore, appropriate for her not to be referred as an emergency on that occasion.

We found that although Mr C had repeatedly referred to alternative medical opinion having been provided which supported his complaint, no attributed submissions were contained within his complaint. We found the actions of the practice were reasonable and appropriate, although we acknowledged the experience had been distressing for Mr C and his family.