Not upheld, no recommendations

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.

Summary

C fell and injured their head, requiring emergency surgery and the removal and replacement of part of their skull. Tayside NHS board carried out the surgeries and provided rehabilitative care. C complained that the board failed to properly insert the ceramic bone replacing the portion of skull taken out, causing disfigurement. C was also not satisfied with the explanations given by the board in relation to the care provided.

We took independent advice from a consultant neurosurgeon (a surgeon specialising in surgery of the brain and nervous system). We found that the board provided reasonable treatment to C. C’s injuries required two emergency operations, both of which were reasonably carried out. The board provided a custom-made plate to replace the portion of the skull lost due to the head injury. The surgeries and follow-up care provided to C were of an extremely high standard. While there was a complication with one of the surgeries, this was a known complication for cranial surgery which the board accepted and apologised for. After the operations were completed, the board provided rehabilitation to C through multiple rehabilitation schemes. This was reasonable. As such, we did not uphold this aspect of C's complaint.

We also considered C’s complaints that the board had failed to provide a reasonable explanation about the treatment they received. We found the board provided reasonable explanations to C about the treatment they provided. Clinicians spoke with C on multiple occasions to discuss the outcomes of the surgeries. The board took account of C’s cognitive difficulties when communicating with them and exceeded the level of standard care required in terms of communication. The board’s response to C’s complaint explained the outcome of C’s surgeries including the impact on C’s facial appearance. This was reasonable. As such we did not uphold this aspect of the complaint.

Summary

C complained about the treatment their late spouse (A) received from Tayside NHS board. Following a fall, A required emergency hip replacement surgery. A developed a severe infection in their wound following the surgery and later died as a result of this infections. C complained that the board inappropriately ignored issues with A’s stomach when prescribing antibiotics. C also considered that A was required to attend hospital appointments unnecessarily when their condition became untreatable. C stated that at a meeting to discuss their complaint after A’s death the board told them that A had not been expected to live. C said they were shocked and had not been told this before.

The board stated A’s treatment had been reasonable. Staff had responded appropriately to A’s serious infection. Although every step had been taken to avoid infection, these did occur. A’s condition had been regularly reviewed and advice taken from microbiology specialists to try and optimise A’s treatment.

We took independent medical advice from a orthopaedic surgeon (a specialist in the treatment of diseases and injuries of the musculoskeletal system). We found A’s treatment was reasonable. They were regularly reviewed and their antibiotics were changed in order to try and improve their outcome. In addition, we noted that A’s condition was such that it was not unreasonable for them to have their wound dressed as an out-patient. Therefore, we did not uphold C’s complaints.

Summary

C’s child (A) was referred to have a tonsillectomy (surgical removal of the tonsils) and grommets (a small tube inserted in the eardrum to drain fluid) inserted as they had been experiencing seizures and recurrent ear infections. On the day of surgery, the surgeon decided not to insert grommets as A's ears were healthy and there was potential for an unnecessary intervention. C complained that the surgeon failed to carry out the agreed surgery.

We took independent advice from an ear, nose and throat consultant. We found that it was appropriate for the surgeon to make a clinical judgement on the day of surgery based on the clinical presentation of the child. We noted that the clinical decision was supported by clinical research and it was therefore reasonable. As such, we did not uphold the complaint.

Summary

C, an advocate, complained on behalf of their client (A). The complaint related to an incident that occurred when A was a patient in hospital. After receiving treatment in hospital, A was taken to a single room to recover. Another patient entered A’s room several times in an erratic and alarming manner before being removed by nursing staff. However, during the night, the other patient entered A’s room again and sexually assaulted them. When nursing staff became aware of A shouting, they removed the other patient from the room. After this, the other patient did not interact with A again and A later reported the incident to the police.

C complained as A felt that not enough was done to prevent the other patient from interacting with A and ultimately sexually assaulting them. In addition to this, C complained about the board's handling of A’s complaint.

We took independent advice from a nurse. We found that nursing staff acted reasonably, both before and after the incident. We acknowledged that A had been through an extremely distressing experience, however, based on the circumstances at the time, and in the context of a hospital environment, we concluded that there was no indication that nursing staff failed to carry out any actions that they should have done. As such, we did not uphold this aspect of the complaint.

In respect of how the board handled A’s complaint, we were satisfied that this was done in a reasonable and appropriate manner. From our review of the evidence, it appeared that the board did not receive documentation from A’s advocate. This meant that the board communicated directly with A and appeared to have been genuinely unaware that an advocacy service was assisting A. The board had also arranged to provide the stage 2 response to A at a home visit. While we appreciated that it would have been helpful for A to have sight of the board’s stage 2 response before the visit took place, we did not consider this amounted to a significant failing on the board’s part. Overall, we considered the evidence suggested that the board took this complaint very seriously and that they made a genuine attempt to handle it in a sensitive and person-centred manner. As such, we did not uphold this aspect of the complaint.

Summary

C complained about the care their partner (A) received at an orthopaedic clinic in Inverclyde Royal Hospital. A was assessed for knee pain by an advanced physiotherapy practitioner (APP). C complained that the APP incorrectly diagnosed A as having a degenerative lateral meniscal tear (torn cartilage between the thigh bone and shin bone) and mild osteoarthritis (chronic breakdown of cartilage in the joints leading to pain, stiffness and swelling) and unreasonably decided to manage the condition by avoiding invasive measures as opposed to surgically. An orthopaedic review and scan the following year found no evidence of a tear. A ultimately required partial knee replacement surgery. C complained that the initial misdiagnosis and management plan contributed to the subsequent deterioration.

In responding to the complaint, the board said that the APP gave appropriate advice and treatment in keeping with the clinical picture at the time. They noted there was a subsequent deterioration of A’s knee over the following year.

We took advice from a consultant physiotherapist (a person qualified to treat disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise), who considered that the APP carried out an appropriate examination and reached a reasonable conclusion as to the cause of A’s knee pain. There could have been a tear that did not show up on the MRI scan. We also noted the x-ray evidence showed that A had some arthritic change in their knee. There wasn’t sufficient evidence to say what the primary cause of A’s knee pain was, however, the treatment plan would have been the same regardless. We found that the decision to recommend conservative management was reasonable and in keeping with relevant guidelines. We did not uphold this complaint.