Not upheld, no recommendations

Summary

Mr C complained about the care and treatment the board provided to his late wife (Mrs A). In particular, he was concerned that there had been a delay in diagnosing an occurrence of cancer. In response to Mr C's complaint, the board did not identify any delay in the diagnosis.

Mrs A was initially diagnosed with bowel cancer. Surgery was performed to remove part of Mrs A's bowel, and she also received chemotherapy treatment. Mrs A received follow-up care from the colorectal (conditions of the colon, rectum and anus) and oncology (cancer) teams. In this period, she continued to experience abdominal symptoms. Following an annual surveillance scan, peritoneal cancer (a cancer that develops in a thin layer of tissue that lines the abdomen) was diagnosed. Mrs A received palliative treatment until she later died from her illness.

We received independent advice from a colorectal surgeon and a radiologist (a doctor who specialises in diagnosing and treating disease and injury through the use of medical imaging techniques such as x-rays and other scans). We found that the abdominal symptoms Mrs A experienced were associated with the treatment she received for bowel cancer. We also noted that development of primary peritoneal cancer was very rare. Therefore, we concluded that there was no failing by the board to have identified peritoneal cancer at an earlier stage. We did not uphold this complaint.

Summary

Mr C complained about the care which he received from the practice when he reported urinary problems. In particular, he had attended four consultations at the practice to report his symptoms, and despite them carrying out investigations it turned out that he had suffered a prostatic abscess. By the time Mr C was admitted to hospital the abscess had grown to 4cm, and he believed that the GPs involved in his care should have noted the abscess at an earlier stage when it would not have been as large.

We took independent advice from a GP. We found that initially Mr C's symptoms were indicative of a urine infection, and when Mr C attended hospital, a subsequent diagnosis of prostatitis was made. Again, the GPs managed this appropriately. It was only when Mr C's clinical condition deteriorated that it was appropriate to refer him to hospital where the final diagnosis was made. We found no evidence of failings or delays by the treating GPs. We did not uphold the complaint.

Summary

Mr C complained about the treatment which he received at A&E of University Hospital Monklands. Mr C had injured his foot and a doctor diagnosed him as having a sprained ankle. Mr C continued to suffer discomfort and attended his GP several weeks later who referred him back to the hospital. Further investigation revealed he had suffered a ruptured Achilles tendon. Mr C believed that the rupture should have been diagnosed at his initial attendance at A&E.

We took independent advice from an A&E consultant. We found that the records indicated that the doctor had carried out an appropriate examination and reached a reasonable diagnosis of a badly sprained ankle. Although it turned out that Mr C had possibly suffered a partial rupture of the Achilles tendon at the time of the attendance, the actions of the doctor in wrongly diagnosing a sprained ankle was not unreasonable in the circumstances. We did not uphold the complaint.

Summary

Mr C complained about the care and treatment his sister (Miss A) received after she was admitted to Hairmyres Hospital, specifically about the medication prescribed, the standard of communication and the discharge planning. Mr C also complained about the community care, mainly the lack of care plan and the actions of a staff member.

We took independent advice from a consultant psychiatrist and from a mental health nurse. In terms of the hospital care, we found that the medication changes made during Miss A’s hospital admission were both appropriate and consistent, with established and agreed treatment protocols, and that the approach taken was reasonable. We also found that there was evidence to support a reasonable level of communication, and that the discharge planning was appropriate, as Miss A discharged herself voluntarily, and staff had no power to stop this or to detain her. Therefore, we did not uphold this aspect of the complaint.

In terms of the community care, we found that the records did not show that Miss A's risk to herself was underestimated by staff and that the incident which caused her admission to hospital was not predictable. We found that the care planning was reasonable, noting specifically that staff identified Miss A’s health and social-care needs, her goals for care and interventions, and that these were evaluated and updated. Importantly, there was also clear evidence that Miss A was involved in this process. Therefore, we did not uphold this aspect of the complaint.

Summary

Mrs C manages a direct payment (a cash payment paid under self-directed support in order to purchase care at home) on behalf of her disabled son (Mr A). The board contacted Mrs C to progress a review of the direct payment and to review the decision that Mrs C should be permitted to be employed as a Personal Assistant (PA) for Mr A. The direct payment included funding for two carers to provide two-to-one support to Mr A. Following the review, the board decided the funding should be reduced to only pay for one PA until a second PA was recruited to provide the two-to-one support. The board also decided that Mrs C should no longer be employed as a PA,and they advised that a second PA needed to be recruited.

Mrs C complained that the board acted unreasonably in respect of the review of the direct payment. Mrs C felt that the board unfairly blamed her for the failure to complete the review and that their decision to reduce the funding was unreasonable. Mrs C also complained that the board's decision regarding her employment as a PA was not in accordance with self-directed support legislation.

We took independent advice from a social worker. We found that the board acted reasonably in respect of both complaints. We identified that the local authority's decision to reduce the funding until a second PA was recruited was reasonable as the funding should only be used to meet the agreed outcomes detailed in the support plan. We also identified that the board acted reasonably by providing Mrs C adequate notice to recruit an alternative PA. Therefore, we did not uphold the complaints.

Summary

Mrs C complained that the board's decision to not provide her child (Child A) with an emergency appointment was unreasonable. Child A had been receiving treatment from the board's Child and Adolescent Mental Health Services (CAMHS). Mrs C's husband, and Child A's teacher and doctor, raised concerns with the clinical nurse specialist who was responsible for Child A, about an escalation in their behaviour and thought they should be assessed urgently. However, the decision was taken to wait until Child A's scheduled appointment a week later. Prior to that appointment, Child A's condition worsened and they were admitted to Stobhill Hospital. Mrs C also complained about the treatment Child A received over the course of a few years.

On reflection, the board said that they should have offered Child A an urgent appointment. They apologised for this and explained the steps they had taken to improve practice. With respect to the overall care, they considered that the records demonstrated appropriate assessments and care throughout. Mrs C was not satisfied with this response and brought her complaint to us.

We took independent advice from a registered nurse experienced in child and adolescent mental health. We found that, on the basis of the records existing at the time, the actions of the clinical nurse specialist in not arranging an urgent appointment, were reasonable. The expressions of concern made by Child A's family and teacher, whilst in hindsight could be reflected on and improvements made to the board's service, would not have suggested to a reasonable clinician that Child A was experiencing a psychotic crisis. We considered that the concerns expressed could have supported the existing understanding of their mental health. Therefore, we did not uphold this aspect of Mrs C's complaint. With respect to Child A's treatment and diagnosis, we found that the level of support offered was reasonable and the tools used to assess Child A were reasonable. We did not uphold this aspect of Mrs C's complaint.

Summary

Ms C complained that the board unreasonably administered morphine to her during her admission to Woodend Hospital. Ms C complained that during her operation she was administered morphine by an anaesthetist despite being severely allergic to the drug and this being known to board staff. Ms C said this caused her to become very unwell and her admission to be extended.

We took independent advice from a specialist in acute and internal medicine. We found that it was reasonable for the board to have administered morphine to Ms C, and there was no evidence to support it was known that Ms C was allergic to the drug prior to it being administered. We did not uphold this aspect of the complaint.

Ms C also complained that the board unreasonably failed to obtain all relevant information before determining her complaint. Ms C said that when she submitted the complaint to the board, she referred to the attending consultant being aware of her allergy, and the doctor's views were not sought by the board before they issued their response.

We found that the board took reasonable steps to seek comments from the clinician directly involved in the complaint as well as to consider the contemporaneous record from the events complained about before they issued their response. We did not uphold this aspect of the complaint.

Summary

Mr C complained about a number of concerns about the service and treatment he received while in the Golden Jubilee National Hospital. He was admitted to hospital in preparation for receiving a heart transplant.

Firstly, Mr C complained about the behaviour and attitude of hospital staff towards him during a grand ward round. He stated that they spoke to him in an aggressive and threatening manner. Although there was no evidence of what members of staff the board spoke to as part of their complaint investigation, we noted that Mr C's medical records contained an entry written by a member of staff not named in the complaint. This case note provided a different account from the one Mr C provided. We did not take a view on which account was the definitive one but concluded that there was not sufficient evidence to confirm Mr C's account. Therefore, we did not uphold this aspect of the complaint.

Mr C's second complaint was about the fact that all his teeth were removed in preparation for the transplant surgery. We took independent advice from a consultant cardiologist (a doctor who specialises in the heart and blood vessels). We found that, based on the medical records, it was appropriate for Mr C's teeth to be removed. This was because Mr C's records showed he had significant dental and gum disease. Following transplant, Mr C would have to take long-term immunosuppressant medication. As a result, such dental issues would present an on-going risk of potentially life-threatening infection. Therefore, the hospital's actions were appropriate, and we did not uphold this aspect of the complaint.

Mr C's third complaint was that the board did not investigate and respond to his complaint appropriately or reasonably. We found that there were some areas where the board's investigation and response to Mr C's complaint could have been improved. In particular, we highlighted a lack of records of who was spoken with as part of the complaint investigation. However, we did not consider there to be significant failings that would lead us to conclude that the board did not investigate Mr C's complaint reasonably or appropriately. Therefore, we did not uphold this aspect of the complaint.

Mr C's final complaint related to the board's decision to discontinue his treatment and to refer him elsewhere. This was done as the clinical team concluded that they could no longer provide safe and effective treatment to Mr C. We considered that the clinical team and the board acted appropriately and in line with relevant guidance. We also found that the clinical team's decision had been appropriately documented and justified. We recognised that this caused great upset and difficulty for Mr C. However, we did not consider their actions to be unreasonable. Therefore, we did not uphold this aspect of the complaint.

Summary

Mr C complained about the psychiatric care andtreatment he received from the board, specifically that he disagreed with thediagnosis given to him and also that prescribed medication had caused unwanted psychological and physical problems . Mr C also had concerns that his medical recordsdid not hold an accurate account of his views in relation to his treatment anddiagnosis. We found his records did hold this information. We tookadvice from a psychiatric adviser and found that the care and treatmentprovided to Mr C had been appropriate and reasonable. We did not uphold Mr C'scomplaint.

Summary

Mr C, a solicitor, complained on behalf of his client (Mr A) about the university's handling of an academic appeal. Mr A was withdrawn from his degree programme because of inadequate attendance. Mr A appealed against this decision. The university did not uphold his appeal and concluded that the withdrawal decision should stand.

Mr C complained to us about whether the committee who considered Mr A's appeal considered his special circumstances and the documents he submitted. We concluded that it was more likely than not that the committee considered all of the evidence provided. We did not find evidence of procedural failing and we did not uphold Mr C's complaint.