Not upheld, no recommendations

Summary

Mr and Mrs C complained that the council failed to properly consider a planning application to build a house next door to their property. They said that their objections had not been properly taken into account and that the council failed to implement the terms of the permission granted in a reasonable way. They said that their amenity and enjoyment of their home had been detrimentally affected. They alleged that their representations about this were not dealt with properly.

We took independent advice from one of our planning advisers and we found that, in initially considering the planning application, the council had dealt with it both reasonably and appropriately; Mr and Mrs C's objections were taken into account and permission was granted subject to conditions. Thereafter, as works progressed, Mr and Mrs C brought the council's attention to the fact that not all the conditions were being complied with. The council decided to pursue a negotiated settlement with the developer (rather than to take enforcement action), which they were entitled to do. There was no evidence that Mr and Mrs C's representations were ignored although it was clear that they were not dealt with in the way that Mr and Mrs C would have preferred. The complaint was not upheld.

Summary

Mr C was a planning applicant who had his application refused. Mr C complained about what he felt to be inexplicable and unjustifiable inconsistencies in the council's approach to planning policy. He was concerned that the council had taken a different approach to determining the planning application for the development, compared with their processing of other planning applications that he regarded to be very similar and within the same local plan area.

We took independent advice from one of our planning advisers. Our adviser was satisfied that the council demonstrated that they dealt properly with their assessment and determination of this particular planning application, in terms of procedure and in full accordance with their statutory duties and obligations.

In the absence of evidence of administrative failure, we did not uphold the complaint.

Summary

Mr C complained about the council's handling of several concerns he brought to their attention in relation to health and safety at a caravan site. In particular, Mr C was concerned that he contacted the council about health and safety concerns about an unfenced bridge on the site but several months later the bridge was still unfenced, and the council did not tell him that they did not consider this to be a health and safety issue (as they are required to do under their policy, if they decide not to investigate a reported issue). Mr C also said that statements by the council that signs on the site had been updated and that raised manhole covers had been addressed were incorrect. Mr C said that, although some signs had now been updated, this was not done at the time the council said it was. In relation to the manhole covers, Mr C said there were a number of manhole covers which were raised above ground level, which he considered to be a tripping risk (and he provided some photographs of these).

The council said they had inspected the unfenced bridge and raised this with the site owners, but did not intend to take any further formal action (as there was no significant health and safety breach). The council also said that signs on the site had been updated, and provided photographs of these. In relation to the raised manholes, the council explained that this was a misunderstanding. Their previous statements that the manholes had been fixed referred to concerns that the manholes had inadequate covers, and that there was a risk of vermin or small children accessing the manhole. The council said they were now satisfied that this had been addressed, and provided photographs of the work. In relation to Mr C's concerns about the raised manholes constituting a tripping risk, the council said they did not share these concerns and did not consider this to be a health and safety risk.

After investigating these issues, we did not uphold Mr C's complaints. We found that the council had complied with their policy in responding to Mr C's concerns about the bridge, and had kept him updated about the overall work on the site, as well as offering to meet to discuss all of his outstanding concerns. We accepted that the misunderstanding about the manholes appeared to be a communication error, and we found no evidence that the council had acted unreasonably in determining that the manholes no longer constituted a health and safety risk. In relation to the signage, we noted that both parties agreed signage had now been updated, and so we did not consider that there was value in pursuing this matter further.

Summary

Mr C complained that when he attended the practice in February 2015 for dental treatment he was told that he would have to agree to a new treatment plan as the previous one had lapsed. This meant that Mr C would have to pay additional costs for his dental treatment. However, Mr C said that his costs under the previous treatment plan had been capped and that he had reached the limit and, as such, the outstanding dental treatment should be provided at no extra cost to himself. He maintained that at no time was he told that there was a time limit to complete a course of treatment.

The practice maintained that the previous treatment plan began in August 2013 and that they had to repeatedly send reminders to Mr C to attend for further appointments under the treatment plan. Mr C last received treatment under the plan in October 2014 and the practice wrote to the health board in December 2014 and asked that the treatment plan should be deemed to be closed. The practice maintained that their staff verbally advised Mr C to attend regular appointments in order to complete the treatment plan.

We sought independent dental advice from two advisers. They confirmed that there was no obligation on dental practices to provide written information to patients with advice that should they fail to attend regular dental appointments under an agreed plan then the plan would be closed.

We did not uphold the complaint as we felt on balance that the practice staff had verbally encouraged Mr C to make regular appointments and that there was also an obligation on him to contact the practice if he had difficulty in being available for appointments. It was also noted that the practice now provide patients with written advice about the importance of attending regular appointments to complete an agreed treatment plan.

Summary

Mrs C said that following gastric band surgery (a procedure where a band is used to reduce the stomach's size, so a smaller amount of food is required to result in feeling full), her complaints about discomfort and difficulty swallowing were ignored by medical staff. The band then slipped, which caused her significant internal damage and, as a result, she required major surgery which involved removing her entire stomach. Mrs C said she had not been seen appropriately by the consultant responsible for her care and that much of her post-operative care had been provided via a nurse-led clinic.

The board said Mrs C was provided with the appropriate level of care, and that nurse-led clinics were standard practice. The board said they did not wish to minimise the seriousness of Mrs C's subsequent band slippage, but that this could not have been predicted from the symptoms she presented with following her operation.

We took independent medical advice. The advice we received was that Mrs C's concerns were taken seriously and that the appropriate investigations were carried out to identify the cause of her symptoms. Unfortunately the band slippage, whilst a recognised complication in a small number of cases, could not have been predicted. The nurse-led clinic was an appropriate setting for Mrs C's post-operative care and had, on occasion, accessed medical staff as required in order to assess her condition.

We found there was no evidence that the care provided was not appropriate and in line with the relevant clinical guidance.

Summary

Ms C complained that her medical practice unreasonably continued to prescribe a medication to her for significantly longer than they should have. She felt the practice should have informed her about the updated guidance on this medication, and she was also concerned that they had unreasonably failed to note that she was receiving double prescriptions.

We obtained independent advice from a GP adviser, who said that prescribing this medication long-term was appropriate for Ms C's condition, although this medication was not recommended for long-term use for other conditions. We found that the practice acted reasonably in prescribing this medication for Ms C. We also noted that Ms C's prescribing had been regularly reviewed in line with the relevant guidance. We noted that, for a period, Ms C was obtaining a double prescription but, when this was brought to the attention of the practice, they correctly stopped the repeat prescription, and placed her on a fortnightly acute prescription. As we were satisfied with the practice's actions in this case, we did not uphold the complaint.

Summary

Mrs C complained that there were unreasonable delays in her being diagnosed and treated for functional neurological disorder (a problem with the functioning of the nervous system). She also felt that the board's response to her complaint was inadequate, mainly in that there were inaccuracies regarding her care.

The board did not identify any failings in the care but acknowledged that there had been some incorrect dates given in their response to her complaint.

We took independent advice from two of our medical advisers and concluded that Mrs C received timely assessments with treatment given within a reasonable timescale (about a month after the final diagnosis was reached). We also considered that the board's overall responses adequately responded to the complaint with an apology given for the minor inaccuracies.

Summary

Miss C attended an orthodontic clinic for treatment in 2008 and had braces fitted. She was discharged in 2011 but in 2014 returned to say that part of the retainer had cracked. The clinic offered to repair this but said that it would have to be paid for privately as Miss C had already had one course of paid-for NHS treatment. Miss C felt she should not have to pay for private treatment because she felt that her initial NHS treatment had not been completed adequately, and she was of school age when her treatment started in 2008.

We took independent advice from one of our dental advisers who found no evidence to show that Miss C's course of treatment between 2008 and 2011 was unreasonable. Furthermore, from the evidence available, we found that Miss C did not meet the criteria for NHS-funded treatment when she re-attended the practice in 2014.

Summary

Mrs C complained on behalf of Mr A that the vasectomy (where the tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed) operation he had at Dr Gray's Hospital was not performed properly and that his aftercare was inappropriate. We obtained independent medical advice from a surgeon experienced in carrying out this procedure, and found that there was evidence from the operation records and the samples taken during and after the surgery to show that the operation was carried out to a reasonable standard. We also considered that Mr A received appropriate care for persistent pain following his surgery and that the review appointments and treatment given were in line with national guidance. Whilst we noted that it took around four months for Mr A to be reviewed at a pain clinic, we found that this period was acceptable and with in the timescales set out in national guidance which acknowledges the constraints on pain clinic services.

Summary

Mr C fractured his ankle which was put in a plaster cast for six weeks. He was told not to bear weight on the foot and was prescribed medication to prevent blood clots forming during this period.

When Mr C's cast was removed, the medication was stopped. He was referred for physiotherapy which took place one week later when he was provided with a sandal-type shoe to wear and given exercises to complete. A follow-up physiotherapy appointment was arranged for three weeks ahead.

Mr C died of a pulmonary embolism (a clot in the blood vessel that transports blood from the heart to the lungs) and deep vein thrombosis (DVT - a blood clot in a vein) a week before the follow-up physiotherapy appointment.

Mr C's wife (Mrs C) complained to us, and said that a failure to provide Mr C with appropriate and timely treatment following the removal of his plaster cast had allowed a blood clot to form. This caused him to suffer the pulmonary embolism and DVT which caused his death.

We took independent medical advice from a consultant orthopaedic surgeon who said there was no evidence that Mr C's medication should have been continued after the removal of the plaster cast. Our adviser also considered there was no difference between providing a patient with footwear and leaving the ankle completely free after the removal of the plaster cast. Furthermore, the adviser said that starting early physiotherapy treatment was not known to have any impact on the risk of developing a pulmonary embolism and a DVT.

Our adviser also said DVTs are difficult to diagnose. It was uncertain when Mr C's DVT had started, and fatal pulmonary embolism is a rare but an ever-present risk with surgery even if full prevention measures have been taken. On the basis of the advice we received, we found that the treatment Mr C received was reasonable.