Not upheld, no recommendations

Summary

Ms C complained that the treatment provided by an orthopaedic (dealing with conditions of the musculoskeletal system) department was not of an acceptable standard. Ms C was unhappy with the treatment she received in relation to her deformities in her feet as a result of bunions and thought that mistakes had been made.

After taking independent advice from one of our medical advisers, a consultant orthopaedic surgeon, we did not uphold her complaint. We recognised that this had been and continued to be, a difficult time for Ms C and that she had undergone three operations. However, we found no evidence that the treatment provided was not of a reasonable standard. The surgery initially carried out did have complications, and as a result of those complications there was a need for two more operations, however, this was not due to any fault in the treatment provided.

Summary

Ms C complained that her medical practice had not provided her with reasonable care and treatment. She said that they had stopped prescribing medication that she had been on long term, asked her to attend for reviews at the practice and had not supplied her with a neck collar to address the symptoms of her dystonia (a condition which causes shaking, in Ms C's case of the neck muscles). She further complained that they had not re-referred her to the dystonia clinic and declined to issue a certificate to excuse her from appearing in court.

Our investigation, which included taking independent advice from a medical adviser who is a GP, found that the actions of the practice had been reasonable, and we did not uphold Ms C's complaints. We found that Ms C had been taking a high dose of Hormone Replacement Therapy (HRT) since a hysterectomy (surgical removal of the uterus) a number of years ago. Medical opinion is that long-term use of HRT carries serious health risks and our adviser thought it was reasonable for the practice to encourage Ms C to reduce the HRT with a view to stopping eventually. When she declined to do so and also declined to attend the practice for health reviews, we considered it reasonable for them to refuse to continue to prescribe the HRT.

Ms C was also taking diazepam (a tranquiliser) to treat her dystonia. Diazepam is an addictive drug and the practice tried to encourage Ms C to attend for reviews of her long-term use of it. Again Ms C was reluctant to do so and at times the practice, therefore, prescribed a reduced amount of it until she was reviewed. This also happened when her son abused her supply. Again we considered the actions of the practice to be reasonable.

On the matter of the neck collar, our adviser said that current medical opinion is that neck collars cause the muscles to weaken and waste away which is the opposite to what is required in a patient with dystonia. Ms C had been seen twice at the dystonia clinic, where the only treatment they were able to offer her was botox injections, which she had declined. The practice invited Ms C to come in and discuss this but she declined to attend. We took the view that in the circumstances it was reasonable for the practice not to supply a collar or to re-refer Ms C to the clinic.

Ms C had not been seen in person at the practice for some six months when she asked one of the GPs by phone to write her a certificate to excuse her from attending court. The GP said that he could not do so without seeing her but Ms C said she did not want to visit the practice. We found that it was, therefore, reasonable for them not to provide the certificate.

Summary

Mrs C cancelled an appointment for a scale and polish (dental cleaning) and x-rays that her dentist had advised her to have. The dentist wrote to her explaining why he recommended the treatment. He said that she had excess tartar (dental plaque) accumulation and that x-rays of her back teeth would help determine if there were underlying problems. He also said that in most cases where patients suffer from sensitive teeth, he uses a local anaesthetic, which helps to decrease sensitivity during cleaning. He acknowledged that a patient can choose whether to continue with treatment but went on to say that if she did not have it, her teeth would require extensive scaling which might cost more. Without x-rays, he also could not guarantee that there were no undiagnosed areas of decay etc. When Mrs C attended an appointment with the dentist some eight months after the cancelled appointment, she asked for a standard clean and polish with no anaesthetic. She said that the dentist refused to treat her and when she asked to speak to the practice manager she was told to put her complaint in writing. She was removed from the dentist's practice list and not allowed to transfer to another dentist within the practice.

Mrs C was concerned about the insistence of using anaesthetic to proceed with the clean and polish and failure to provide an adequate explanation regarding why anaesthetic was required. Mrs C was also concerned about the dentist's attitude, saying he was condescending and unprofessional. She was unhappy at being removed from his list and not being allowed to transfer to another dentist within the practice. In relation to the complaints handling, Mrs C complained that she could not speak to the practice manager and that there was no attempt at informal resolution, that the dentist's response failed to answer some of her points and that the matter was investigated and responded to by the person she was complaining about. As a result, she said that she suffered anguish and upset and that she was left without NHS dental provision when she lost half a tooth which had previously been treated by the dentist.

We accepted the independent advice of one of our medical advisers that the use of anaesthetic in these circumstances is reasonable and that the dentist provided a reasonable explanation about this. We did not find evidence to support Mrs C's complaint about the dentist's attitude and we found that her removal from the list and not transferring her to another dentist in the practice to be reasonable. On complaints handling, we found that arrangements should have been made for Mrs C to talk to the practice manager but that on the whole the complaint was handled properly - Mrs C's complaint was fully considered and addressed, and she received a written response to her complaint from the dentist.

Summary

Ms C's medical practice referred her to a consultant surgeon at the hospital because she had rectal bleeding and loose stools. Tests were carried out and an inital diagnosis of proctitis (the mildest form of colitis, which is inflammation affecting the lining of the bowel causing diarrhoea and rectal bleeding).

As Ms C's symptoms did not improve with the medication that she was prescribed, she was referred to a consultant gastroenterologist (a medical professional specialising in the treatment of conditions affecting the liver, intestine and pancreas). Ms C attended several clinic appointments between March 2010 and June 2011 and had various investigative procedures carried out in response to her ongoing symptoms of fatigue and passing blood. Ms C's condition worsened in October 2011 and she was admitted to a different hospital where she underwent an emergency colectomy (an operation to remove the large bowel).

Ms C complained that the consultant gastroenterologist had failed to diagnose the severity of her condition. She felt that earlier diagnosis would have allowed alternative drug therapy to be tried which might have avoided the need for the colectomy and a stoma (a surgically made pouch on the outside of the body). Ms C was unhappy that the consultant gastroenterologist had not clearly told her that she had ulcerative colitis and that he had said at an appointment in June 2011 that there was nothing seriously wrong.

We did not uphold Ms C's complaint. After taking independent advice from one of our medical advisers, we found that Ms C was correctly referred to the consultant gastroenterologist and reviewed with a frequency appropriate to her condition and symptoms. In addition, Ms C was prescribed appropriate medication although it was identified that she had an intolerance to one of the drugs. Our adviser explained that flare-ups in ulcerative colitis can happen unpredictably and that Ms C's severe episode that led to the colectomy could not have been predicted or prevented. We found evidence that the consultant gastroenterologist clearly explained at an early stage the results of the investigative procedures and Ms C's diagnosis. However, we could not say exactly how much information they shared with Ms C about her condition, as there was a lack of documented information about this. Although we did not uphold Ms C's complaint, we drew the board's attention to the lack of information and to the relevant guidance about keeping records.

Summary

Mr C complained that the university failed to properly investigate his complaints about his tutor. He said that they did not consider all the evidence he submitted to them, and based their decision on matters not raised by him and on his tutor's previous performance. He also complained that university staff advised him that he had grounds to make an appeal, but that his appeal was then unreasonably rejected and he was not provided with adequate support in making his complaints.

Our investigation found that the decision made was based on all the evidence available, including the tutor's current performance. The university found that there had been a delay in providing feedback to Mr C on his independent study project and they apologised for this. They also wrote to the tutor to remind him or the requirement to give timely and professional feedback when requested by students. Following a further complaint from Mr C, the university also asked the tutor to write and apologise to Mr C, which he did.

Although Mr C was not satisfied with that letter of apology, we found that the tutor had done what was asked of him. We were also satisfied that the university had considered all the evidence that Mr C provided. On the matter of the advice given on the appeals process, we found that university staff had appropriately advised Mr C about the next stage of the complaints procedure. The fact that Mr C was given this information did not give, and should not have given, him an unrealistic expectation that any appeal he made would be upheld. In relation to the support provided to Mr C, we found that the university had, in compliance with their complaints procedure, given Mr C information about the support and assistance available and he had taken advantage of that support. Members of university staff and the students association had provided support and information to Mr C during the complaints process.

Summary

Mr C complained that the university mishandled an appeal into allegations of misconduct by his son. In particular, he complained about what he considered to be an excessive penalty of exclusion and the time taken by the hearing to reach their decision. He also complained that they unreasonably considered previous misconduct by his son (during his stay in residential student accommodation) when reaching their decision but failed to take account of the successful completion of his previous year of study and placements.

We found that the correct penalty was imposed in terms of the university's procedures as this was the second episode of non-academic misconduct. We noted that although there was some delay in arranging the hearing, this was reasonable because evidence had to be gathered beforehand. We also found that, although the university were entitled to take account of the residential accommodation misconduct, this did not have a significant bearing on their decision. In addition, the university explained that they do not take previous academic performance into account when imposing a penalty of this nature, which we accepted.

Summary

Miss A was a nursing student at the university. She was removed from her placement and then from the nursing course. Miss A’s MP (Mr C) complained that the university inappropriately removed Miss A from the nursing course; unreasonably failed to have a clear policy in place for supporting students on placements; and failed to communicate the termination of Miss A’s studies, and explain her full appeal rights, in a clear and timely manner.

We did not uphold Mr C’s complaints. Our investigation found that the university had taken Miss A’s personal circumstances into account during her course. On three occasions Miss A had been offered the chance to defer her studies, but she declined. Taking this into account, as well as relevant university and nursing organisation guidance and regulations, we could not conclude that the university inappropriately removed Miss A from the course.

We found that the university were using a toolkit on dyslexia, dyspraxia and dyscalculia (all types of learning disorder) that was published by a nursing organisation. The university also had documents which showed that training specifically about dyslexia was undertaken with placement mentors.

In addition, we found that letters from the university did explain that her studies were being terminated. The university provided Miss A with copies of their appeal procedure which, in any case, she had a responsibility to be aware of as a registered student. University staff also explained the appeals process and referred Miss A to sources of advice and support.

Summary

Mr C had experienced a recurring problem of raw sewage being discharged into his back garden during heavy rainfall. Scottish Water had investigated and carried out some repairs, but this had not resolved the problem. Mr C believed that this was happening because the sewer was not able to cope with sudden heavy rainfall, and said that it should be replaced. Scottish Water told Mr C that they did not have the funding to do this. He considered this unacceptable, and believed that they should seek additional funding if this was what was needed to resolve the problem.

When we investigated the complaint, Scottish Water confirmed that a problem could occur during heavy rainfall, but said that they were tied by issues of funding and prioritising (internal flooding in a property has a higher priority than external flooding, and has to be addressed first) but they had, as far as they were able, taken action to address the problem. We noted that the indications were that they were trying to find a solution. On this basis and given the evidence that the problem was one of funding, rather than coming about as a result of maladministration or service failure, there was no further action that we could take.

Summary

Mr C complained that Scottish Water failed to respond adequately to his complaint about damage caused by a fish pass they had built. He said that this was causing erosion to a riverbed beside his property. In response to our enquiries, Scottish Water confirmed that they had built the fish pass because their sewer pipe was stopping salmon from getting up the river. They said they had a duty under legislation not to restrict salmon movement upstream. However, they said that the fish pass was not their asset and that it had not been shown that this was causing the erosion. They told us that there had been erosion in the riverbed before the fish pass was built.

Scottish Water said that they were not liable for the problem. We cannot establish legal liability. Only a court can look at legal liability between individuals and organisations. However, we can consider complaints about how a body have handled such matters. We were satisfied that Scottish Water had investigated the matter and there was no evidence of administrative error. We also found that Scottish Water's explanation to Mr C about the matter was satisfactory.

Summary

Mr C, who is a prisoner, complained about a delay in getting on to a particular behaviour course in prison. He thought the delay might hold up his release from prison. From previous complaints, we were aware that the Scottish Prison Service were dealing with a temporary backlog of people waiting for courses since a new type of assessment of suitability for courses had been introduced. The new assessment was intended to benefit prisoners by combining various assessments into one.

From our investigation, we were satisfied that the prison were doing what they could to prioritise places fairly and improve the situation. For example, they had tried to arrange for some prisoners to attend a course at another prison. Therefore, although there were delays, we did not consider that the prison had acted unreasonably in relation to Mr C and we did not uphold the complaint.