Not upheld, no recommendations

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.

Summary

Mr C, a lawyer, complained on behalf of his client (Ms A) regarding the university's handling of complaints she had made about an extra curricular programme provided by them. Mr C raised a number of concerns, the main points being that, Ms A had not been adequately consulted during the university's investigation, that the university had failed to disclose critical information, and that the university had failed to follow their complaints handling procedure.

We found that the university had reasonably followed their complaints handling procedure and had reasonably consulted Ms A during their investigation. Therefore, we did not uphold the complaints.

Summary

Mr C complained that an approved extension to a neighbouring property was in breach of the relevant planning guidance. Mr C considered that the height of the rooflights were too low and that the privacy and amenity of his garden would be compromised. Mr C also argued the development was inappropriate in size and scale and would be overbearing when compared with other properties. In addition, Mr C believed that the reduction in garden ground would be excessive as much of the front garden was taken up by parking and hardstanding.

We found that there had been no procedural errors on the part of the council when handling the application. Mr C's objections had been considered by the planning committee as part of the report. We considered that there were no grounds for this office to question the professional judgement the planning officers had exercised when compiling the report considered by the planning committee. Mr C subsequently contacted us raising further questions about the planning guidance which might apply. Whilst this was noted, we explained to Mr C that planning guidance is not binding and that a planning officer is entitled to take into account the circumstances of each individual application when deciding the extent to which the planning guidance needed to be applied. We found that the council's report to the planning committee set out in some detail how the application had been amended to bring it into line with planning guidance. Therefore, we did not uphold the complaint.

Summary

Mr C complained that the council did not reasonably respond to reports of bullying against his child (Child A).

We found that the school had appropriately followed both their own, and the council's anti-bullying policy in approaching the issues raised by Mr C. Therefore, we did not uphold the complaint.

Summary

Mr C complained about the care and treatment he was given for addiction issues while in prison. We took independent advice from a mental health nurse with experience in addictions. We found that the treatment and support offered to Mr C was reasonable. In particular, the decision not to offer Mr C alternative medications to methadone was reasonable given that he admitted to the ongoing use of heroin and other illicit medications in prison, and would therefore have been at risk of an overdose. We also noted that with alternative medications to methadone there is a risk of them being covertly diverted in the prison environment. We did not uphold Mr C's complaint.

Summary

Ms C complained on behalf of her late mother (Mrs A) who died during her admission at a community hospital. Ms C's complaints were that:

the partnership did not provide reasonable care and treatment to Mrs A;

there was a lack of reasonable communication with Ms C about Mrs A's care and treatment, and the behaviour of staff towards Ms C was unreasonable;

the partnership unreasonably obtained a second clinical opinion on Mrs A's eligibility for hospital based NHS continuing healthcare;

the decision to discharge Mrs A from hospital, on the grounds that her healthcare needs - did not meet the eligibility criteria for hospital based NHS continuing healthcare was unreasonable;

and that the partnership's handling of and their response to Ms C's complaints was unreasonable.

We took independent advice from a consultant in geriatric (elderly) and general medicine, and from a senior nurse. We found that, overall, the care and treatment provided to Mrs A was reasonable. We were unable to find evidence of a lack of reasonable communication with Ms C about Mrs A's care and treatment, and that the behaviour of staff towards Ms C was unreasonable.

We were satisfied that, in terms of the NHS continuing healthcare guidance which was in place at the time, the partnership were entitled to carry out regular formal reviews of Mrs A's health care needs and to reassess her eligibility for NHS continuing health care. We found that the partnership were entitled to carry out the two clinical assessments of Mrs A's current healthcare needs at the time; that they agreed with the decisions reached that Mrs A did not require the provision of NHS continuing healthcare in line with the relevant guidance and that the decision to discharge Mrs A from hospital was reasonable. We were also satisfied that the partnership appropriately informed Ms C of her right of appeal and of her right to complain to this office. Therefore, we did not uphold these aspects of the complaint.

We also considered that the partnership took reasonable steps to try and address Ms C's concerns and complaints, both informally in the ward setting and at meetings with her, and also more formally by the patient experience team. A review highlighted no overall system failings but did identify areas for improvement which concurred with all of the review findings made. Given this, we did not uphold this complaint.