Not upheld, no recommendations

Summary

C complained that their concerns about changes in their breast had not been investigated adequately by the board. As a consequence, there had been a delay in diagnosing C's breast cancer. C was also unhappy with the treatment that had been proposed for them. C believed that the board was unreasonably denying them breast surgery and was proposing to keep C on potentially harmful chemotherapy indefinitely. C sought a second opinion and did undergo breast surgery shortly afterwards. C believed this demonstrated the treatment proposed by the board was unreasonable.

We took independent advice from an appropriately qualified adviser. We found that the investigations carried out were reasonable. It had not been reasonable to inform C that their breast cancer was inoperable on the basis of the investigations that the board had carried out at that point. However, the treatment provided to C was reasonable and it was appropriate for the initial treatment to be chemotherapy, rather than proceeding directly to surgery. We did not uphold C's complaint.

Summary

C complained to us about the care and treatment their spouse (A) received at the Golden Jubilee National Hospital. A was referred to the hospital after being diagnosed with aortic stenosis (where a valve has narrowed and is restricting blood flow).

We took independent advice from advisers both in cardiology (studies of diseases and abnormalities of the heart) and in cardiology nursing.

C raised concern that A's angiogram (a type of x-ray that uses dye to look at blood vessels) was not carried out reasonably, including the aftercare. We found that A's angiogram was carried out in a reasonable manner and the aftercare was appropriate. We did not uphold this aspect of C's complaint.

C also raised concern about an unreasonable delay in arranging A's heart surgery. We found that the hospital carried out appropriate tests to decide whether to list A for heart surgery. We also found that the hospital's decision not to proceed with heart surgery was reasonable, due to the risks involved from A's other health conditions. We did not uphold this aspect of the complaint.

Summary

C, an advice and support worker, complained on behalf of their client (A) in relation to the care and treatment provided to A by the board.

A attended Forth Valley Royal Hospital as they had suffered a myocardial infarction (heart attack - when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle) the previous week. A presented to the hospital complaining of pain and swelling affecting their wrist. A was examined and treated for this.

A said that the board failed to provide reasonable care and treatment to them as they were not treated appropriately and questioned whether alternative treatments could have been offered. A also said that it took several visits to A&E to be treated appropriately and that they were not referred to a specialist following that first visit.

We took independent advice from an appropriately qualified adviser with expertise in emergency medicine. We did not observe any concerns with the care and treatment that A received and concluded that assessment, treatment and advice given were reasonable. Therefore, we did not uphold C's complaint.

Summary

C complained on behalf of their spouse (A) about the treatment provided to them. A had a history of cancer and attended the practice with urinary symptoms. A was later diagnosed with bowel cancer which had metastasised (spread to other parts of the body). C complained that the practice's response to A's symptoms, and the length of time it took for A's cancer to be diagnosed, were unreasonable.

We took independent advice from a GP. We considered that A's symptoms were reasonably investigated, with appropriately prioritised referrals being actioned in a timely manner. A's history of cancer was considered when assessing their symptoms. A's symptoms initially aligned with a benign (non-cancerous) condition. When A's presentation changed, appropriate steps were taken, with further investigation and referrals to secondary care. A's pain was reasonably managed. Therefore, we did not uphold the complaint.

Summary

C suffers from severe joint and musculoskeletal (relating to the muscles and skeleton) pain throughout their body. C complained that the board did not reasonably test C to establish the appropriate level of pain treatment they required. C wanted medication for pain to be administered by an intrathecal pump (a medical device used to deliver very small quantities of medications to the spinal fluid) and by trigger-point injections (a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax). The board did not consider this to be appropriate.

We considered that the board was aware of the level of pain experienced by C and that the pain management had been reasonable. We found that an intrathecal pump is usually used to target pain in a specific area for cancer patients or in palliative care, rather than where pain is benign (not directly linked to another medical condition) and widespread. We found that an implant can cause infection and that this increases over time and therefore the risk of use is lower for those in receipt of palliative care. We also found that if pain is not responsive to opioids (a type of pain relief) then delivery of opioids by this method is not likely to be effective. We also found that trigger point injections offer short-term relief and their effectiveness reduces when repeated. We therefore agreed with the board that these treatments were not appropriate for C. We did not uphold this complaint.

Summary

C, a solicitor, complained on behalf of their client (A) who was formerly an international student at the university. A had a history of health issues, which had impacted on their exam performance. A was excluded from the university as they had reached the exam attempt limit (under the UK Visas and Immigration Tier 4 Regulations) and the university did not consider that there were exceptional circumstances to grant a concession. A submitted an appeal against the university’s decision; however, the university did not uphold the appeal. A remained dissatisfied with the decision to exclude them and C complained to SPSO.

C raised concerns about a number of aspects of the process followed by the university. These concerns related to the university’s consideration of the medical evidence and immigration advice; the failure to offer A an interview during the exclusion process; and failure by the university to provide adequate reasons for their decision.

We did not find evidence of maladministration or service failure in the way the university reached their decision to exclude A. We did not uphold C’s complaint.

Summary

C and their family applied to West Dunbartonshire Council for housing. The council assessed C’s application and awarded 115 points. They said that C qualified for a four-bedroom property.

C said the council had not properly assessed their housing application. They said they required a five-bedroom property and the council had not properly assessed their medical needs.

We found that the points allocated to C were in line with the council’s policy. The allocation of medical points was based on the assessment of an occupational therapist (a method of helping people who have been ill or injured to develop skills or get skills back by giving them certain activities to do - OT) and their assessed was reviewed by a second OT. We therefore did not uphold C's complaint.

Summary

C complained about the council's handling of a Statutory Nuisance under the Environmental Protection Act 1990 (the Act), which was affecting their home. They had a number of concerns regarding the procedures followed by the council and the abatement notices served under the Act to reduce the nuisance.

In addition, the council had restricted C’s contact to them through a single point of contact, which C considered was unreasonable in the circumstances. C also held concerns regarding the council’s handling of their subsequent complaints about these matters.

We took independent advice from an environmental health adviser. We found that the council’s handling of the nuisance had overall been reasonable, although they identified some minor procedural issues in the way this had been handled. The procedural irregularities did not result in any practical impact, and the handling was, overall, reasonable. In addition, we considered that the council had acted reasonably within their discretion when restricting C’s contact and in responding to their complaints. For these reasons, we did not uphold C’s complaints.

Summary

C raised a number of concerns about the council’s handling of a planning application. C considered that the planning service failed to provide an appropriate opportunity for the community to comment on changes made by the applicant after the application was submitted. C also considered that the council failed to ensure that the application referred to the correct class use.

We took independent advice from a planning adviser. We found hat the council had acted reasonably at all stages with regard to the processing of the planning application in the lead up to determination of the planning application in question. We did not uphold this aspect of C’s complaint.

C was also concerned that the council’s response to their complaint contained inaccurate information. Having considered the relevant documentation, we did not identify an inaccuracy in the council’s response. Accordingly, we did not uphold this aspect of C’s complaint.

Summary

C complained about the care and treatment provided to their late adult child (A) during an out-of-hours (OOH) GP visit. A had been experiencing symptoms including exhaustion, vomiting, and lack of appetite. A was examined and given anti-sickness medication, and advised that they should contact their own GP the next day for urgent follow-up review. A died the following day of acute myeloid leukaemia (an aggressive and fast progressing cancer of the white blood cells).

We took independent advice from a GP. We found that, because A was clinically stable (i.e. blood pressure, pulse and oxygen levels were normal), it was reasonable for the OOH service to advise for A to see their normal GP the following day for further investigations, particularly given that the OOH GP service cannot undertake investigations such as blood tests. We did not uphold this aspect of C’s complaint.

However, we noted that the board had undertaken significant review of the events, and although the conclusion was that the OOH GP service did not act unreasonably in their appointment with A, we considered that the board had taken significant steps to ensure that all learning possible has been taken from this case.

C also complained that the board’s handling of their complaint was unreasonable, as they considered that the family should have been more involved before any investigation took place. We considered the board’s actions in relation to complaints handling to have been reasonable and we did not uphold this aspect of C’s complaint.