Not upheld, no recommendations

Summary

C complained on behalf of their child (A). A, who has additional support needs, transferred to a new school. C complained about one of A’s National 5 grades, unhappy at the level of the award submitted by the school to the Scottish Qualifications Agency. C believed the decision on the level of award was made using incomplete or inaccurate information. C was also concerned about how the school shared information with staff concerning the additional support needs for A. C was also unhappy at the level of communication received from the school in relation to A.

C complained to the council but was unhappy at their response and brought their complaint to this office. The council said that A’s needs were communicated to all staff with an enhanced provision of support in place, that the school regularly communicated with C including highlighting a risk of a non-award in a National 5 subject and that there was a range of evidence used by staff in conjunction with moderation of standards against the National 5 assessment criteria to make a professional judgement.

We found that the school shared information about A’s health and support needs with staff and that there was reasonable proactive communication between the school and C. We found no evidence that A’s projected National 5 grade was based on incomplete or inaccurate information.

We did not uphold C's complaints.

Summary

C was removed from their GP practice patient list. The practice were contacted by Practitioner Services (part of NHS National Services Scotland who support primary care providers) after this and suggested the practice refer C to the board's Challenging Behaviour General Practice (CBGP). The practice referred C to the CBGP.

C complained that the practice had unreasonably referred them to CBGP. C said the practice were not required to refer C to CBGP, did not have a good reason to refer them and did not follow the correct procedure.

We found that once the practice’s request to have C removed from their patient list was actioned, they were not obliged to arrange any future care for C. However, Practitioner Services found themselves unable to place C on a patient list of another GP practice in the area. They went back to C’s most recent practice and asked them to refer C to the board’s CBGP. The referral the practice sent meant C might (if the referral was accepted) have access to primary care services. We decided that the decision to refer C to CGBP was reasonable in the circumstances. As such, we did not uphold this complaint.

However, we found that the processes in place were not helpful to guiding the situation C found themselves in. Understandably C was left confused about why the referral was made and had to contact the practice themselves to find this out. We passed on our feedback to the relevant health board.

Summary

C complained that the board's community mental health team recorded their transgender status in their medical records, without C's knowledge or consent. In their complaint response, the board said that they considered C's gender transition was relevant to their mental health treatment and medical staff would require access to the information when providing C with treatment.

We took independent advice from appropriate clinical specialists. We found from a clinical perspective that, at the time the information was recorded, it had been reasonable for staff to conclude that consent had been given as this information was provided by C, and that the information was relevant to the treatment being provided and, therefore, reasonable to record. We did not uphold this complaint.

However, we did not make a decision on specific points raised about the ongoing and future management of personal data in the records as we considered these were ultimately more appropriate for the Information Commissioner’s Office.

Summary

C underwent re-root canal treatment from the dentist in an attempt to treat an abscess (a painful swelling caused by a build-up of pus) which had formed under one of their teeth. After attempts to resolve the issue were unsuccessful, C was referred to a specialist. C complained that the re-root canal treatment was not carried out by the dentist in a reasonable manner and limited further treatment options for C.

We took independent advice from a specialist in dentistry. We found that the treatment provided was reasonable. While the treatment did not resolve the presence of C’s abscess, it was not unreasonable.

As such, we did not uphold this complaint.

Summary

C, an advice worker, complained on behalf of their client (B) about the treatment which B’s late adult child (A) received from their GP practice. The practice is being managed by the board. A had contacted the practice on a number of occasions over a six-month period reporting problems with their mental health. A was a student studying away from home.

A subsequently completed suicide. B felt that the staff from the practice had failed to take fully into account A’s personal circumstances which all pointed to the fact that A was at increased risk of attempting suicide and that they failed to provide them with appropriate treatment.

We took independent clinical advice from a GP. We found that the GPs involved had formed a good relationship with A. They had recorded A’s mental health symptoms and provided a reasonable level of care and treatment by prescribing appropriate medication and monitoring A’s behaviour. There was also the involvement of a counsellor but there was nothing to indicate that A was going to take their own life. We did not uphold the complaint.

Summary

C attended the Grampian Medical Emergency Department (GMED) out-of-hours service with severe pain in their arms and shoulders. They were referred to the Acute Medical Initial Assessment Unit (AMIA) and then transferred to the Stroke Unit, a unit that has capacity to receive patients with non-stroke problems when the hospital is busy.

C received multiple tests, including multiple electrocardiograms (ECG, test to check a patient’s heart rhythm and electrical activity) in order to diagnose the cause of their symptoms. It was determined to be a trapped nerve in C’s neck and C was discharged from hospital with a prescription for medication for nerve pain and sensitivity.

C complained that there were failings in communication and record-keeping during their admission and that this lead to the unnecessary repetition of ECG tests and a delay in administering pain medication. They also raised concerns that they had been told they had a liver infection requiring antibiotics but this was not recorded, meaning that antibiotics were not prescribed.

We took independent advice from a consultant geriatrician (a doctor who specialises in medicine of the elderly). We found that the treatment C received during their stay in hospital was reasonable and consistent with the symptoms they experienced and that the communications recorded were reasonable. Therefore, we did not uphold these complaints.

Summary

C underwent shoulder surgery at Borders General Hospital. Following the surgery, C’s shoulder dislocated on a number of occasions and they were referred to another hospital outwith the board area for consideration of further treatment. C was advised that the cause of the problems was that the glenoid socket (socket part of the ball-and-socket shoulder joint) had been placed at an incorrect angle during the original surgery and that it was the cause of their continuing symptoms. C believed that there had been a failure in treatment. We sought independent clinical advice from an orthopaedic (conditions involving the musculoskeletal system) consultant. We found that from a clinical perspective, there were no indication that problems had been encountered during the original surgery or that the glenoid socket had been mispositioned. We did not uphold the complaint.

Summary

C complained that treatment was provided without their express consent at a clinic. After the treatment was explained to C, C said that they refused to have the treatment, however instead, the clinician attempted to take a biopsy (tissue sample). C also complained that the partnership did not respond to their complaint appropriately by forcing them to accept further treatment and arranging an appointment without their consent.

We took independent clinical advice. We could not find any reliable evidence that demonstrated a biopsy was attempted or taken without C's consent. We concluded that the partnership's response to the complaint was reasonable as they arranged meetings with C to discuss their concerns and took appropriate steps to investigate the complaint. We did not uphold C's complaints.

Summary

C complained about the treatment provided at the Royal Infirmary of Edinburgh to their late parent (A) after they were admitted having suffered a stroke. C complained that the board failed to discharge A in a reasonable timescale.

We took independent advice from a consultant geriatrician (a specialist in medicine of the elderly). We considered that, while medically well, A was not fit for discharge, requiring a further period of in-patient care to recover prior to being ready to return home. As such, we did not uphold this aspect of C's complaint.

C complained that the board failed to provide reasonable care to allow A to maintain function in their legs. We found that board staff were trying to maximise what A could do, however due to their stroke, pre-existing conditions and subsequent infection, their attempts were unsuccessful. Physiotherapy input started two days after A's admission, which we considered to be prompt. We also found evidence that A attended sixteen physiotherapy sessions, with more offered but A was not well enough to accept them. This indicated that there was regular input by physiotherapists. As such, we did not uphold this aspect of C's complaint.

During A's admission, they contracted influenza (flu). C complained that the board failed to provide reasonable treatment after they contracted influenza. We found that antibiotics were administered reasonably and A's condition was appropriately monitored. We noted the challenges in determining if a worsening of someone's condition was related solely to the initial influenza infection, or if an additional (secondary) infection with another organism was involved. Therefore, we did not uphold this aspect of C's complaint. However, we noted that consideration should have been given to anti-viral treatment for A, as indicated by the guidance available at the time and we fed this back to the board.

Summary

C, an advocate, brought a complaint on behalf of their client (B) about B's child (A). B was unhappy that A was discharged by the Child and Adolescent Mental Health Services (CAMHS) after A was diagnosed with autism (a developmental disability that affects how a person communicates with, and relates to, other people). B felt that the discharge was premature as A was suffering with both behavioural and mental health issues.

We took independent advice from an appropriately qualified adviser. We found that A's discharge from CAMHS was reasonable and that their mental health needs were reasonably responded to. It was determined that A did not present with a moderate or severe mental ill health comorbidity alongside their diagnosis of autism and it was reasonable for the board to discharge A, knowing that social work was supporting them and their family. As such, we did not uphold this aspect of C's complaint.

C also complained that the board unreasonably refused referrals for A to CAMHS, submitted by A&E after discharge. We found that CAMHS and A&E staff assessed A and concluded that, while A was upset and distressed, there was no evidence of moderate or severe mental ill health that would make intervention from CAMHS appropriate. As such, we did not uphold this aspect of C's complaint.