Not upheld, no recommendations

Summary

Mr C had complained to the housing association about cleaning and repairs. He was unhappy with the way the association then dealt with his appeal to their appeals panel. He said they had not presented all the evidence that he forwarded as part of his complaint, and had allowed a named member of staff, whom he said had blocked his attempts to make his complaint, to remain in the room while the panel were considering his complaint.

We found that Mr C had presented DVDs, containing a large volume of colour photographs and correspondence, which he asked to be given to each of the panel members. The association had produced the photographs in black and white for the panel members but on the day of the panel meeting had made available a ring binder containing the colour photographs. We found that the association had only included relevant correspondence in the pack made up for the panel members, which we considered to be reasonable.

The association's guidance for panel members sets out who will be asked to leave a panel hearing while the matters are discussed, and we found that the named member of staff was entitled to be in attendance.

Summary

Ms C said that she moved into her property in 2007 and early in 2008 reported a water mark on the ceiling in the hall and was told it was from an old leak. Despite reporting every so often that the mark was getting bigger, no action was taken until she reported the matter again in June 2011. An inspection found that there were cracks in her neighbour’s chimney, which was determined to be the likely cause of the damp patch. The chimney was eventually taken down in November 2011. The association’s insurers refused to pay Mrs C's redecoration costs as they said there was no evidence that she had told the association about the problem before 2011.

We found no evidence to support Ms C's claim that between 2008 and June 2011 she had reported the mark on the ceiling getting bigger. Because the chimney was communal, and the other owner shared the responsibility of the cost of any work, the association were required to seek the owner's agreement to the repairs. We also noted that the owner initially agreed to arrange for a repair to the chimney, but because they did not do so, the association eventually had to appoint a contractor to demolish the chimney and reinstate the roof.

We were satisfed that the association responded within a reasonable time when Ms C reported the matter. We did not consider the delay to be excessive, taking into consideration that the owner had initially agreed to take the lead on arranging the repair.

Summary

Miss C's medical practice were concerned about her compliance with her medication. They had, therefore, previously decided, with Miss C's agreement, to dispense her medication on a daily basis. However, Miss C requested that this be returned to weekly or monthly prescriptions, and she complained when this request was refused. The practice told us that, as they continued to have safety concerns about Miss C's compliance with her medication, they had decided that daily prescribing would remain in place. Having taken independent advice from our medical adviser, we considered this to be a reasonable decision in the circumstances.

Miss C also complained that her medication was no longer being prescribed to her in tablet form. She was receiving a liquid alternative and did not feel it was working as well for her. Although the practice had advised her that the tablet form was no longer available in this country, Miss C identified a drug company who could still supply this. However, the practice noted that this was imported and unlicensed and, therefore, did not agree to prescribe it. Our medical adviser took the view that this was reasonable and said that doctors are discouraged from prescribing unlicensed medication when licensed alternatives are available. In addition, he noted that the medication was very expensive and he did not consider that it would be prudent for the practice to prescribe overly expensive drugs that were not clinically necessary.

Summary

Mr C complained on behalf of a constituent (Mr A). He complained about the board's decision to refuse funding for Mr A's weight-loss surgery to be carried out by another health board.

Mr A had serious concerns about the care and treatment he received from the board, when he was admitted to hospital previously. As a result, during the past few years, his GP had referred him for treatment, including weight-loss surgery, to a hospital in another health board area. The hospital offered Mr A weight-loss surgery but said that it would have to be funded by his local health board. The local board decided not to approve Mr A's application for funding and instead offered him the weight-loss surgery service that they provided. Mr A, however, believed it would be in his best medical interests for the surgery to be performed outwith his local health board area.

Our investigation found that the board's decision to refuse the funding of Mr A's treatment at another health board was a discretionary decision that they were entitled to take. We cannot look at such a decision unless we find evidence that something went wrong in the way it was taken. We did not uphold Mr C's complaint, as we found that the board followed their procedures and took all relevant factors into account in reaching their decision.

Summary

Mrs C had a history of tiredness and told us that she had a number of medical conditions. She complained that a medical practice, and one GP in particular, provided her with inadequate care and treatment over a seven year period. Specifically, Mrs C said that the GP; refused to investigate her symptoms; claimed to make referrals which turned out not to be the case which, in her view, prevented other doctors from investigating and treating her symptoms; inappropriately offered her cognitive behavioural therapy (CBT); and inappropriately prescribed and failed to monitor the use of a beta blocker for her symptoms, which Mrs C said almost led to her death.

Mrs C's letters and the medical records showed that the experiences she described were clearly very difficult and distressing for her. However, the GPs and hospital doctors she was referred to had not been able to medically explain her symptoms or find any abnormalities from their investigations. We did not uphold Mrs C's complaint. Our investigation found that the practice explained to Mrs C how they had treated her. Also, our medical adviser did not find any evidence that Mrs C's GP acted unreasonably when investigating her symptoms, making referrals, offering CBT or prescribing the beta blocker.

Summary

Mr C complained about the care and treatment that his late wife (Mrs A) received from her medical practice from early 2010 when she went there complaining of irregular bleeding. He said that it was not until mid-2011 that a diagnosis of endometrial cancer (cancer in the lining of the womb) was confirmed. He said that his late wife's care and treatment had been inadequate and that the relevant guidelines were not followed.

In investigating Mr C's complaint we carefully considered all the relevant information, including the practice’s complaint’s file and Mrs A’s clinical notes. We also obtained independent advice from our medical adviser. The adviser said that this type of illness usually presented after the menopause and was usually benign (not cancerous). However, Mrs A’s case was unusual as it did not fit this pattern and the symptoms of irregular bleeding with which Mrs A presented appeared to indicate that she was starting the menopause. The adviser said that in the circumstances this was not an unreasonable view to take, and that throughout 2010 and early 2011, investigations appeared to bear this out. It was not until after Mrs A had reported that her symptoms were ongoing and was referred to a gynaecologist, that tests confirmed, in June 2011, that Mrs A had endometrial cancer. Her condition deteriorated rapidly and she died in October 2011.

Having taken this advice, we found that Mrs A’s care and treatment had been good, and well within the limits of acceptability. We also found that there had been no delays on the part of the practice and they had followed all relevant national guidance.

Summary

Mrs C attended the medical practice with her son (Master A), who was complaining of a high temperature, sore throat and sore ear. A GP diagnosed a virus, however, his condition worsened over the next few days and they returned to the practice.

During this visit, another GP diagnosed Master A with an ear infection and prescribed antibiotics. The following week, Mrs C and her son returned to the practice and were referred to a hospital for treatment. A doctor at the hospital diagnosed Master A with an abscess and carried out an ear procedure.

The following week, Mrs C returned Master A to the practice as he had pain behind his ear. The GP prescribed more antibiotics, but several days later Mrs C took her son returned as the area behind his ear had worsened. The GP cut the lump to drain it. Mrs C said this was done without any anaesthetic and was painful. Master A's condition failed to improve and when they returned to the practice 11 days later, a GP diagnosed an infection of one of the bones in the ear and advised them to return to the hospital to see another specialist. However, Mrs C took her son to another country for treatment. She said that he was then diagnosed with inflammation of the lymph node and received appropriate care there, and that the condition cleared within two weeks.

Mrs C complained that the practice failed to diagnose the problem accurately. She also said that the ear infection would not have become so severe if the GP at the first consultation had prescribed antibiotics, and that they had failed to take her concerns seriously or to document the consultation.

We did not, however, uphold Mrs C's complaints. After taking independent advice from our medical adviser, we found that the practice's treatment, decisions and management were reasonable, including that the GP did not use a local anaesthetic when cutting the abscess. This is because an anaesthetic can spread the infection to surrounding tissue. We also found no evidence that the GP failed to properly examine Master A or take her concerns seriously at the first consultation, which was clearly documented.

Summary

Mr C complained that the board had unfairly invoked their 'Unreasonable, Demanding and Persistent Complaints Procedure' (the procedure) against him as he had made numerous contacts with them over a period of time. Mr C raised concerns that the board were not actioning his requests for information from his clinical records and other matters. Mr C also felt that by having to channel all requests through a named member of staff that this would affect his access to NHS services.

Our investigation found that the board were entitled to invoke the procedure due to the disproportionate amount of contacts which Mr C had made with numerous staff from varying departments. The board previously told Mr C that they would invoke the policy should his behaviour continue and when it did they invoked it. We found no evidence that invoking the policy would affect Mr C's access to NHS services and did not uphold the complaint.

Summary

Mrs C complained to the board about the treatment she received from a hospital doctor. Mrs C's GP had referred her there because Mrs C was suffering from urinary incontinence. The hospital doctor had conducted tests then referred her to neurology and a bladder specialist. Mrs C said the doctor failed to ask about her vaginal discharge and failed to carry out a pelvic ultrasound scan. Mrs C was subsequently diagnosed with a tumour in her womb. She believed that, had this been found sooner, then the cancer would not have spread to other organs.

We took advice from our medical adviser who noted that he saw no indication that a pelvic ultrasound scan was required given Mrs C's presented symptoms. Mrs C was assessed by three different clinicians with expertise in different areas. All the correspondence and medical notes suggest that Mrs C's symptoms were of incontinence rather than of vaginal discharge. When the symptoms did not ease, Mrs C was appropriately referred for further investigation. We noted that there was a delay in the process for arranging a hysteroscopy (a procedure that allows a surgeon to look inside the womb using a narrow tube-like telescopic camera) and the board apologised to Mrs C and explained the action that they had been taken to prevent a repeat occurrence before she complained to us. Although, therefore, we understood why Mrs C was concerned that a chance to diagnose the cancer may have been missed, we took the view that the care she received was appropriate in the circumstances.

Summary

Mrs C complained on behalf of her mother (Mrs A) about the care and treatment Mrs A received from her dentist. Mrs A attended the dentist in pain after a filling fell out. The dentist took an x-ray and removed a nerve. He made an appointment for a couple of weeks later to extract some teeth. Unfortunately, the pain did not get any better and Mrs A had to go back a further three times for treatment. However, before the date on which the extractions were scheduled, she was admitted to hospital, where it was found that her windpipe was obstructed by a large abscess. Mrs A had emergency surgery, and needed a tracheotomy (an operation to insert a tube into the windpipe) to assist with her breathing.

Mrs C complained that the dentist did not treat her mother appropriately and that had he done so she would not have deteriorated to such an extent. After taking advice from two of our dental advisers, however, our investigation found that the dentist's decisions about prescribing antibiotics to Mrs A were reasonable, as was the care and treatment provided.