Not upheld, no recommendations

Summary

Mrs C went to her medical practice with a thickened and discoloured toenail. The GP suspected a fungal nail infection and sent clippings for testing but the results were negative. The practice took no follow-up action until, after seeing a private podiatrist (foot specialist), Mrs C went back to her GP almost a year later. At the recommendation of the podiatrist, the GP made an urgent referral to a dermatologist (skin specialist). Mrs C was diagnosed with a malignant melanoma (a type of skin cancer) and her toe was later amputated. She complained that the practice unreasonably failed to refer her for further diagnostic tests. She also complained that the practice did not respond appropriately to her complaint about this.

Mrs C had complained by phone to the practice manager. During the call she said that she did not want to speak to the GP. Despite this, the GP called Mrs C a few minutes later. Mrs C spoke to the manager again the following day, who confirmed that she had passed Mrs C's message to the GP but that he had phoned her anyway, thinking that it would be of help. Mrs C then complained in writing and the GP responded but Mrs C did not receive the letter. About four months later, she chased up the response and was provided with a copy.

Our investigation, which included taking independent advice from a medical adviser, found that the cancer was very rare and difficult to diagnose, and that national guidelines confirmed this. The adviser commented that in general practice it is usual for patients who are having investigations to be told to return for review when the results are available. The GP had noted on Mrs C's record 'RV [review] with results' when the nail clippings were sent for investigation. Mrs C did not return for review but our adviser said that as the results were normal, no further investigation was required at this time. When Mrs C did return, having been reviewed by a podiatrist, the GP then took appropriate and timely action to follow the podiatrist's recommendations.

Mrs C was concerned that when discussing the negative fungal infection results with her, the GP did not advise her to make an appointment with the in-house podiatrist. The GP said that he was certain that he had advised Mrs C to do so, but conceded that he had not documented this. We were unable to determine which version of events was correct, but overall our adviser was of the view that the care and treatment provided to Mrs C was reasonable.

On the handling of Mrs C's complaint, our view was that in view of Mrs C's specific request not to speak to the GP, it was inappropriate for him to call her. While early and direct discussion of a complaint can bring about a speedy resolution, in this case contact was not helpful. However, we did consider that it was reasonable for the GP to have written the response letter to Mrs C. This contained the GP's personal apologies for the experience Mrs C had been through and also his explanations of why he had not thought the condition in her toe was serious at the outset.

We noted during our investigation that the practice's complaints literature was out of date, but that the timescales for both the previous and current NHS guidance on complaints handling had been met. Also, Mrs C was given the correct information about the next stage of the complaints process at the correct time. Although we did not uphold this complaint, we brought this to the attention of the practice.

Summary

Mr C, who is a Member of Parliament, complained on behalf of his constituent (Mr A) about a fine Mr A received for driving in a bus lane. Mr A was dissatisfied that he did not receive the initial penalty charge notice, and, therefore, was unaware that he had been fined. He said that when he did find out about it, when a charge certificate was sent to his home address, a surcharge had been applied and the council refused him his right of appeal as they had not received it within the prescribed time limit. Mr C told the council that Mr A did not dispute the offence, but was concerned that he had not received the original charge notice allowing him the opportunity to appeal and pay the lower charge. Mr C said that the council had not replied to two emails Mr A sent them about this.

The council said that there were no procedural errors in the handling of the charge notice, but offered Mr A the opportunity to pay the reduced charge which he subsequently paid.

We acknowledged that Mr A tried on two separate occasions to raise concerns about not receiving the charge notice, but we found that he had not used the correct email address. We did not identify any failings by the council in processing the charge notice, and, on balance, considered that they had acted reasonably in offering Mr A the opportunity to pay the reduced charge.

Summary

Mr C complained that the board had failed to carry out an appropriate investigation into his concerns about his daughter (Miss A)'s treatment in Stobhill Hospital. His concerns included a lack of information from staff about matters affecting Miss A; inappropriate behaviour and actions of staff; and staff not displaying their name badges.

We found that the board had treated Mr C's concerns seriously, had made appropriate and detailed investigations into them and had provided him with a reasonable response. The board explained that at times staff name badges may not be visible and that they had reminded staff of their responsibilities in that regard.

ummary

Mr C complained to us about the care and treatment given to his late wife (Mrs C). Mrs C had been diagnosed with emphysema (a lung disease) and fibrosis (scarring of the lungs) some years ago. When she attended her medical practice in 2013 complaining of a cough, she was initially treated with antibiotics but after attending again a few weeks later she was referred for a chest x-ray. This showed little change from an x-ray taken a few years before.

A few months later, Mrs C returned to the practice and was referred again for an x-ray. This showed signs of infection and she was given more antibiotics. After at first feeling a little better, Mrs C began to experience shortness of breath and a cough and was referred urgently to the respiratory team at the local hospital. She was then given an x-ray which showed that she had a tumour. Mrs C's condition deteriorated and she died a few months later, around seven months after initially attending the practice about her cough.

Mr C complained that the care and treatment given to Mrs C by the practice was unreasonable. He was particularly concerned at the length of time it took for Mrs C to receive a scan and, therefore, the time taken to provide a diagnosis. He also said time was spent on treating her for a chest infection rather than diagnosing her condition.

We took independent advice on this complaint from one of our medical advisers, who is a GP. We found that Mrs C's case was unusual in that she had an x-ray that showed no signs of cancer only four months before having another which showed she had a fairly advanced cancer. The tumour was particularly aggressive and fast growing, and Mrs C was frail and had other illnesses. We did not find the the way in which the practice cared for and treated Mrs C unreasonable.

Summary

Mrs C complained that when she was admitted to Aberdeen Royal Infirmary staff did not take account of her specific condition when treating her, did not appropriately access her medical notes, and did not keep accurate and secure test results.

Mrs C suffers from a chronic condition which can cause an imbalance in blood chemistry, particularly sodium and potassium. She had also just had a bout of gastroenteritis (vomiting and diarrhoea) and had been prescribed dioralyte (a medication used to replace fluids and regulate blood chemistry after diarrhoea) by a locum (temporary) GP. When she saw her own GP after she had been ill for six days, she was referred to the hospital, and was admitted. Mrs C was given a saline drip (to prevent dehydration) and kept in overnight then discharged the following day. Since then Mrs C has suffered ongoing symptoms of tiredness, weakness and an inability to tolerate any foods containing sodium or potassium, which she attributes to the treatment she received.

Mrs C said that when she tried to tell medical staff that the combination of treatment she had received from the locum GP and the hospital would have a negative effect on her, they dismissed her views and began writing in the medical records of another patient with a similar surname to hers. Mrs C also said that a person wearing a white coat told her that they had amended her blood test results to read as normal to prevent her getting treatment.

Our investigation included taking independent advice from one of our medical advisers, who said that the medical records showed that Mrs C's treatment was reasonable, appropriate and would have been very unlikely to have caused the symptoms she described. We were also satisfied that there was no evidence of any gaps, inaccuracies or tampering with Mrs C's medical records or blood test results. We asked the board what they had done to investigate Mrs C's concerns about her medical records and blood test results, and were satisfied that they had carried out extensive and appropriate investigations and found no evidence to support her concerns.

Summary

Mr C complained that the university had not handled his appeal fairly when he was unwell during his examination period. His illness was only correctly diagnosed later, and he produced new medical evidence to us of his ill health and the adverse effects it had on the medication he took for his additional support need. We contacted the university because they had not had the opportunity to consider the new evidence, and they agreed to explore the possibility of reopening his appeal in the light of that evidence. After considering whether there were grounds to reopen the appeal, the university decided that they could not reconsider it as Mr C had not disclosed any illness to the university either before or during his exams.

Our investigation considered all the documentation provided by the university and by Mr C, including medical evidence, appeals documentation and relevant policies. We found that Mr C had not declared any special circumstances in good time as he was required to do, and that the university had considered all the evidence and his appeal in line with their policies and procedures.

Summary

Mr C experienced external flooding at his property in early 2014. This had happened before, and in 2010 Scottish Water had put a plan in place to address the problem, which included removing tree roots and regularly checking the section of sewer that was causing the flooding. Mr C felt that this plan was not working, and he wanted a permanent solution to the matter. He complained to us that Scottish Water failed to replace the sewer part that had tree roots in it.

Our investigation considered the actions Scottish Water had already taken and what they proposed to do in order to permanently resolve this. We found that Scottish Water had been thorough in responding to Mr C's complaint. As well as their ongoing maintenance of the affected area over the years, they had recently replaced a section of sewer larger than that the survey had suggested. We also found that Scottish Water had been proactive in finding a long term solution, and planned to resolve the external flooding problem in Mr C's street in 2015, in conjunction with another project to resolve internal flooding issues nearby. We considered their actions to be reasonable in the circumstances and did not uphold Mr C's complaint.

Summary

Mr C complained that a reference in a Transport Scotland document to an external agency’s guidance was misleading. Transport Scotland had developed noise level standards for assessing whether properties near a railway line would qualify for noise mitigation, and a document about this had been issued on their behalf in which this reference was made. In responding to Mr C’s complaint, Transport Scotland explained that the agency's guidance was not exhaustive and was open to interpretation. However, Mr C told us that his complaint centred around the way Transport Scotland referred to the guidance, not the status of the guidance itself.

We reviewed the document and the reference that was the subject of Mr C’s complaint. We considered that Transport Scotland's reference did not make it clear enough that they were referring to the external agency's guidance as a whole, as opposed to this being an actual, standalone guideline from them. However, although we took this into account, there was no evidence to indicate that this specific reference was linked to their development of the noise criteria. After the disputed reference, the document went on to explain that the noise criteria were principally based on separate considerations and so we did not uphold Mr C’s complaint.

Summary

Mr C, who is a prisoner, complained that the prison failed to investigate his complaint appropriately. Mr C had complained to the prison because he said money that had been sent to him in a letter had gone missing. In response to Mr C's complaint, the prison said a full investigation had been carried out and no evidence of tampering with his mail had been identified.

The Scottish Prison Service provided us with a copy of the written statement made by the officer who opened Mr C's mail. That statement confirmed Mr C's mail had been opened in his presence and no money was inside the envelope. The evidence available confirmed the prison took Mr C's complaint seriously and took proper steps to investigate it. In light of this, we did not uphold his complaint.

Summary

Mr C complained that a council committee had gone beyond its remit under the council's scheme of delegation. He said that when considering whether to sell or rent out a property, the committee had altered a council officer's proposals and then approved those alterations.

Our investigation concluded that the committee's actions had not gone beyond their remit, and we did not uphold the complaint.