Not upheld, no recommendations

Summary

C complained about the care and treatment provided to their late spouse (A) by the practice. A had reported symptoms of excessive wind, bloating, nausea and loss of appetite. A was later diagnosed with metastatic melanoma (skin cancer that has spread). C complained that the practice delayed in carrying out an appropriate assessment of A's symptoms and that they failed to follow up on A's treatment and referrals. The practice considered that A was seen promptly following triage and that according to the Scottish Referral Guidelines, A did not warrant an urgent referral based on their symptoms at the time.

We took independent advice from a GP. We found that the assessment of A's symptoms was appropriate and the relevant guidelines for suspected cancer were followed appropriately by the practice. We also found that the referral for an urgent endoscopy (a procedure whereby a flexible tube with a camera is used to view the organs inside the body) was timely and appropriate. We did not uphold the complaint.

Summary

The board carried out a significant adverse event review (SAER) into the care provided to Mr C's family, following the death of their baby. The SAER identified various issues in the care provided to Mr C's family and it identified actions to address them. Mr C raised concerns with us that the board might not have carried out all of those actions appropriately and he wanted us to independently assess this.

We took independent advice from a midwife and from a consultant obstetrician (a doctor who specialises in pregnancy and childbirth). We found that the actions set out in the SAER were appropriate to address the issues in care and treatment that it identified. We also considered that the board had provided us with sufficient evidence that those actions were carried out appropriately. We did not uphold the complaint.

Summary

Ms C complained about the care and treatment provided to her by the board in relation to breast cancer screening. Ms C had attended the breast clinic where a mammogram (an x-ray test which can detect breast cancer) noted some microcalcifications (tiny abnormal deposit of calcium salts) in the left breast. These were compared with a previous screening and it was decided that no further investigation was needed. Some months later, Ms C had a further screening and on this occasion it was decided to biopsy the calcifications. The biopsy showed some abnormal features and Ms C was later found to have invasive disease (when germs invade parts of the body that are normally free from them). Ms C complained that pre-cancerous cells were not detected at her screening and there was no follow-up or further investigation at this time.

We took independent advice from a consultant in breast radiology (use of medical imaging techniques such as x-rays and other scans to diagnose and treat disease in the body). We found that based on the comparison of the mammogram images from a previous and the most recent scan, there was no indication to carry out a biopsy and it was appropriate not to take further action at this point. Therefore, we did not uphold the complaint.

Summary

Ms C was admitted to hospital due to increased suicidal ideation and an overdose. She remained there for a period of around three weeks where she underwent electroconvulsive therapy (ECT, a type of brain stimulation sometimes used to treat depression) as a treatment.

In her complaint to the board, Ms C was particularly concerned about whether she had capacity to consent to the ECT treatment given her presentation at her time of admission to hospital and during her stay. Ms C was also unhappy that the hospital did not involve her sister in decision-making. The board explained that whilst Ms C was experiencing moderately severe depressive illness at the time of her admission to hospital, she was assessed as having capacity to consent which was taken by the hospital in an appropriately informed manner. The board agreed that they could be more active in offering patients who are unwell the opportunity to include family members in discussions about significant treatment decisions and took steps to implement this. Ms C was unhappy with this response and brought her complaint to us.

We took independent advice from a mental health adviser. We noted that although Ms C experienced undesirable after-affects from the treatment, they were not uncommon or out of the ordinary. There was nothing to indicate a potential loss of capacity to make decisions regarding medical treatment in Ms C's case. We considered that Ms C was properly assessed as having capacity to make treatment decisions and she was provided with appropriate information in relation to the risks and benefits of the ECT treatment to enable her to make an informed decision. The evidence showed consent was re-checked prior to each of the treatments. When Ms C clearly withdrew consent, her treatment was stopped. We concluded that the issue of consent was handled appropriately by the board in Ms C's case. We did not uphold this complaint.

Summary

Ms C had a hysterectomy (surgical removal of the uterus) a number of years ago and recently accessed the records held by the hospital that performed it. She noted a report had been prepared post-surgery with advice to be followed in the event Ms C sought Hormone Replacement Therapy in the future. Ms C complained that this report was not sent to her former GP. We found that it was not possible to state the report was not sent to Ms C's former GP. Therefore, we did not uphold this complaint.

Ms C also complained about a failure to maintain an adequate record of when the hysterectomy report was sent to Ms C's former GP. We found that the procedure in place for the transfer and recording of information was standard practice at the time in question. We noted that since that time, the board's method of sending and recording this information had changed to an electronic method, and this removed the uncertainty around the transfer of information which had previously existed. Therefore, we did not uphold this complaint.

Ms C also complained about a failure to offer a follow-up appointment after her hysterectomy. We found that the decision not to arrange a follow-up appointment following surgery was standard practice at the board and that this was reasonable based on the surgery undertaken. We did not uphold this complaint.

Summary

C complained about the care and treatment provided by the ear nose and throat (ENT) clinic. C had been referred to the ENT clinic to have a nasal polyp (a painless soft growth in the nose) removed as they had been suffering sinus congestion. Prior to the procedure, C contacted the ENT clinic to advise they were suffering with severe tinnitus (ringing or buzzing in the ears) and cluster headaches. C complained that their concerns regarding tinnitus were not taken seriously and that there was a lack of follow-up once treatment had been provided.

We took independent advice from an ENT consultant. We found that appropriate referrals to neurology (the area of medicine that deals with disorders of the nervous system) and audiology (the area of medicine that treats those with hearing problems balance and related disorders) had been made and that there were no significant failings in the care and treatment provided to C in respect of their concerns. We did not uphold the complaint.

Summary

Miss C attended the Maternity Assessment Unit (MAU) at Crosshouse Hospital after suffering a bleed at home. Miss C had had a caesarean section at the same hospital a few weeks earlier. Miss C was reviewed by staff and an ultrasound scan was taken. Staff concluded the bleeding was likely related to Miss C's period starting and she was discharged home. Miss C was readmitted to the same hospital days later after she collapsed at home and was transferred to the Maternity High Dependency Unit where a further scan revealed a blood clot in the uterus. Miss C complained that she had received poor care at the MAU and that it was wrong to send her home only to be readmitted at a later date.

We took independent advice from a consultant. We found that staff performed appropriate investigations when Miss C attended the MAU, that it appeared her symptoms were improving and that there was no clinical reason for a hospital admission at that time. We did not uphold the complaint.

Summary

Mr C complained on behalf of Mr A, who owned a business. Mr C complained that Clear Business Water failed to bill the business appropriately. Mr A believed that his water bills were too high and he had extensive contact with Clear Business Water over a number of months whilst efforts were made to establish a reason for this.

After agreement with Mr A, Clear Business Water arranged for Scottish Water to conduct a site visit and the engineer identified that a valve close to the meter was the cause of the issue. This valve was fixed and meter readings were subsequently obtained in order to calculate a 'burst allowance' credit. A credit for a limited period was applied to Mr A's account, whilst non-payment charges were also cancelled. Mr A remained unhappy with Clear Business Water's response to his complaint and Mr C brought the complaint to us.

We found that, although it took a number of months to identify the issue with the water supply, Clear Business Water communicated with Mr A appropriately and they did not significantly contribute to the delay. We also noted that Clear Business Water had offered a goodwill payment to Mr A and subsequently extended the period for which the burst allowance credit was applied.

We concluded that there were no failings in the service provided to Mr A and we did not uphold the complaint.

Summary

C complained on behalf of A regarding a bill for water usage at a business premises which was unusually high. After the water meter was removed and tested, it was found to be faulty, in that it was under-recording water usage. C was dissatisfied that these tests results were only representative of the meter performance at the time of it being tested and not at the time of the spike in usage. C also highlighted that the area was subject to historic flooding.

We did not identify evidence that the spike in water usage was supported by historic flooding in the area. The evidence available showed that the meter was under-recording the volume of water usage and did not explain the increased usage. Therefore, we did not uphold the complaint.

Summary

Mr C complained that the university had unreasonably withdrawn him from his course of study. He considered that, contrary to the findings of the university's appeal process, he had appropriately corresponded with the university and engaged with his studies. He was removed for not responding to correspondence and not adhering to obligations of his visa with respect to attendance, particularly that he missed a number of face-to-face meetings.

We found that the university had corresponded with Mr C with respect to his studies, and a progress report for a number of months identified that he had failed to attend organised meetings. However, the university had not communicated with Mr C directly regarding his attendance or to remind him about the obligations in this regard, which was required under the university policy on student engagement.

We found that whilst the university should have issued additional communications to Mr C regarding his attendance, overall, the communication was reasonable as the progress reports correctly recorded that he had not attended as he should have. Mr C should have been aware of his obligations to attend, and there was an expectation on him to raise the very difficult circumstances which had impacted on his ability to attend meetings.

Overall, the communication was reasonable, Mr C confirmed he understood his obligations with respect to attendance at the subsequent hearing regarding his appeal, and the decision to remove him from his studies was reasonable. We did not uphold the complaint.