Not upheld, no recommendations

Summary

Mr C said the board unreasonably failed to provide the correct care and treatment on two occasions when he attended Stobhill Hospital with an ankle injury. He said that a piece of bone below his ankle bone should have been recognised and he should have been referred to a consultant orthopaedic surgeon much sooner. Mr C also said that during his first attendance, the board failed to tell him that he had a piece of bone below his ankle bone.

We obtained independent advice on the complaint from an emergency medicine consultant. The adviser said that the examination and investigation Mr C received at the hospital, leading to the conclusion of a soft tissue injury, was reasonable on both occasions. He said there were no failings by the board in Mr C's management, as on both occasions his x-rays were reported as normal by the radiology department, this was reported back to Mr C's GP and he did not need to be recalled. The adviser said that if Mr C had ongoing problems with his ankle the appropriate action would have been review by his GP and referral to the orthopaedic service.

Mr C's medical records did not indicate that the emergency nurse practitioner who saw him on his first attendance advised him about the piece of bone. However, the adviser said there were no failings by the board in the management of Mr C's case and the conclusion that he had a soft tissue injury was reasonable. Therefore, on balance, we did not find it unreasonable that the board did not tell Mr C about the piece of bone.

Summary

Mr C complained about the treatment he had received from the board for problems he had with his nose and breathing. Mr C had two operations on his nose, but this did not resolve the problems. We took independent advice from one of our medical advisers, who is an experienced ear, nose and throat surgeon. We found that it had been reasonable to carry out the operations on Mr C's nose. He had also been given appropriate information about the procedures before they were carried out. The operations had been carried out appropriately, but the symptoms Mr C complained of were rarely completely resolved by the surgery. It was also reasonable that the board had decided that that no further surgical options were possible. We found that the board had provided a reasonable standard of medical treatment to Mr C and we did not uphold his complaint.

Summary

Mrs C complained about the care and treatment her late husband (Mr C) received from the practice in the final months of his life. Mr C died after a period of illness and Mrs C felt he did not get the level of care he required as his health deteriorated. In particular, she raised concerns that her requests for GPs to attend were ignored despite Mr C having been very ill and in a lot of pain. Mrs C was also unhappy that the practice recorded the cause of Mr C's death as dementia, as she considered that he had shown signs of many other illnesses.

We took independent advice from one of our GP advisers. Our adviser considered that the practice provided a reasonable standard of care and treatment to Mr C. She said there was a good level of multi-disciplinary involvement, particularly in the last 24 days of his life when he had multiple visits from a range of clinicians. She also considered that the recorded cause of death was appropriate, advising that Mr C's deterioration was consistent with the decline exhibited by patients with dementia. She acknowledged that Mr C had other illnesses that could potentially have been listed in part 2 of the death certificate. However, she explained that this part should not be used to list all conditions present at death but rather only those felt to have directly contributed to the death. She noted that this was a matter of clinical judgement and considered that the practice acted reasonably, and in line with national guidance, in this instance. We accepted the advice we received and did not uphold these complaints.

Summary

Mr C complained to us that his medical practice had failed to diagnose his heart condition. We took independent advice on this complaint from one of our medical advisers and found that there was no evidence in the medical notes that indicated that the practice had failed to follow up on the symptoms Mr C had reported. There were no recorded symptoms of possible heart problems and so we did not uphold the complaint.

Mr C then wrote to us to complain that some of his consultations with the practice had not been recorded accurately. In view of this, we decided to reopen the case to investigate his complaint that his medical records were inaccurate. We obtained a full historical print out of Mr C's computer record from the practice and considered this along with the information he provided to us. However, there was no evidence that the practice had altered or deleted any of the records of the consultations that he had referred to. Our adviser also considered that the GPs had acted reasonably in summarising the consultations in the computer records. In view of all of this, we did not uphold this complaint.

Summary

Ms C attended A&E at Borders General Hospital in September 2013 with a painful knee following a fall. She was treated conservatively (a non-surgical approach) and underwent physiotherapy. Ms C fell a further two times and in April 2014, she was referred to a hospital in another board area for specialist advice. The specialist there diagnosed her with an injury to one of her ligaments and performed reconstructive surgery.

Ms C complained that healthcare professionals failed unreasonably to diagnose her condition until she was referred to the specialist. She said this meant she did not receive appropriate treatment within a reasonable time and that corrective surgery should have been undertaken a year earlier. As a result of the board's failures, she told us she had periods of immobility, and financial and social difficulties, all of which had a negative emotional impact on her.

After taking independent advice from our medical adviser, we found that the clinical picture was complex and, in the circumstances, the initial assessment was reasonable. We also found that it was reasonable to manage the injury conservatively and that she was referred to a specialist within a reasonable time.

Summary

Mrs C complained that after her late husband (Mr C) was admitted to Crosshouse Hospital for surgery in October 2013, the care and treatment he was shown were inadequate. In particular, she said that he was discharged too early and with inappropriate follow-up. Later, after he had been admitted again (in January 2014) for further planned surgery to create a stoma (a surgically made pouch outside the body), he was not provided with timely or appropriate treatment. She said that it was as a consequence of these failures in his care that Mr C died.

We took independent medical advice from a consultant general and colorectal (bowel) surgeon and found that on the day of his discharge in October 2013, Mr C was reported as well and that his discharge was reasonable. We also found that arrangements were made to see Mr C again in six weeks' time, which was common practice for follow-up in similar circumstances. Afterwards, when Mr C was admitted again for the creation of a stoma, it was found that part of his small bowel was sticking to a surgical connection which had been formed during his operation the previous year. As soon as this was released there was a leak of faeces which caused a serious infection which required an operation the next day. There had been no evidence of a leak until it became apparent. Despite appropriate and timely treatment, Mr C did not recover from the infection, and he died in March 2014. We did not uphold Mrs C's complaint.

Summary

Miss C was a self-funding postgraduate student who decided to withdraw from her programme after facing some personal difficulties and feeling depressed since moving to the university. She complained that the university had not given her support, had not made the process of withdrawing clear and had not agreed to the refund of tuition fee she requested. We considered the correspondence between Miss C and the university, internal correspondence in the course of the university's investigation, and the policy on tuition fee refunds. We found that the university had thoroughly investigated Miss C's complaints and considered new issues that arose through the course of Miss C's withdrawal and complaints. The university clearly explained why they upheld some complaints and not others, and appropriately identified ways their service and communication could be improved. The decision not to refund the fee was taken in line with the university's policy and reasonable consideration given as to whether her mitigating circumstances were exceptional.

Summary

Ms C complained that Business Stream or Scottish Water had rejected her claim for compensation following damage to her business's property. We explained to her that our role in complaints about compensation claims was very limited. For example, it was not for our office to establish legal liability or decide whether, or how much, compensation was payable. We could solely consider whether her claim had been reasonably considered.

Scottish Water were involved in the issue as they own the public water pipework network. However, Business Stream were also involved as Ms C's licensed water provider. Therefore, we considered the actions of both organisations.

We concluded that both Business Stream and Scottish Water had looked carefully into the issue. For example, Business Stream had put a number of enquiries to Scottish Water about the events and the claim decision. And Scottish Water had considered the circumstances in detail before reaching their decision, which was that they had no legal liability, which meant that they had no requirement to pay compensation. In the circumstances, we did not uphold the complaint.

Summary

Mr C owns a substantial garage, which he used for storage but that was formerly used for a business. It had no toilet or kitchen facilities but there was a stopcock at the entrance. He was charged for drainage of rainwater from the roof but not for water services. However, in 2014 Business Stream sent him a demand for payment for the provision of water there. Mr C said that after Business Stream visited to verify his information about the lack of facilities, he made enquiries about permanent disconnection of the water supply. A few days later, a contractor called and fitted a meter, although Mr C said he explained that what he wanted was disconnection. He told us that he was asked to pay a fee to proceed with disconnection, but Business Stream then sent him an invoice seeking a further, larger, payment for it. Mr C complained that Business Stream failed to give him prior notice before a water meter was fitted and that the proposed charge for disconnection was expensive for what was required.

We found from our investigation that Mr C had initially applied for a reassessment of charges, which is for the installation of a water meter if possible, before he applied for disconnection of the water supply. There was no record of him changing his mind about having a meter fitted before he applied for disconnection, and we did not uphold the complaint as we did not find evidence that Business Stream were required to give prior notice.

Summary

Ms C told us that other houses in a similar or better condition than her own were included by the council on a programme of works and were re-rendered and insulated. She complained that her home was not included in this programme of works and was not upgraded. She told us her home was non-standard construction and was very hard to heat.

The council said the purpose of the improvement programme was to make sure that their housing stock met the Scottish Housing Quality Standard (SHQS). They instructed a surveyor to carry out a visual inspection of all housing stock so they could identify properties which might fail to meet the SHQS. The surveyor found that Ms C's property was not one of those which failed to meet the standard. It was not, therefore, included in the programme of works.

When Ms C raised concerns about the outcome of the survey a member of the council's capital investment team, who were responsible for the upgrade programme, inspected Ms C's property again and reached the same conclusion, that the property needed a few repairs but did not fail the SHQS.