Not upheld, no recommendations

Summary

Mrs C complained on behalf of her late relative (Mrs A) about the information given to Mrs A by doctors prior to her death in hospital. Mrs C was unhappy that Mrs A was told that she was dying, and that she was asked where she wanted to be when she died. We found that on one occasion Mrs A asked for information about her prognosis and she was provided with an honest response. We also found there was evidence of a further discussion with Mrs A regarding her future care when it was disclosed to her that she was dying. The General Medical Council (GMC) guidance states that a doctor must answer patients' questions honestly. It also states that information necessary for making decisions should not be withheld even if another relative asks the doctor to do this, unless the doctor considers that this would cause the patient serious harm. It was recorded that Mrs A had capacity and that she required to be involved in discussions about her future care. We found that the doctors were required to make Mrs A aware of her situation in order to obtain her consent. We did not uphold this aspect of the complaint.

Mrs C also complained about a failure to address her complaint about an item of hers that went missing in the hospital. We did not uphold this complaint on the basis that the board had initially logged the complaint. Although the board delayed in addressing the complaint they proceeded to apologise for the fact that it had not it had been addressed sooner.

Summary

Mr C complained about the antenatal care which his wife (Mrs A) received at the Royal Infirmary of Edinburgh. Mr C felt that Mrs A was not appropriately monitored by the community midwives, that they had been difficult to contact for advice when Mrs A started to suffer from swollen legs, and that she went on to develop pre-eclampsia (a pregnancy-related condition involving a combination of raised blood pressure and protein in the urine) which required an emergency hospital admission.

We took independent advice from a midwife and found that Mrs A's antenatal care was shared between the community midwives and her GP practice. Mrs A was appropriately monitored during the antenatal period although the nursing documentation could have been clearer. We also found that appropriate advice was given that Mrs A should take paracetamol for her swollen legs and to seek further advice if the symptoms did not improve. Appropriate contact details were contained in Mrs A's nursing records. There was also no indication from the nursing records that Mrs A had reported symptoms which were suggestive of pre-eclampsia. We did not uphold the complaint.

Summary

Mrs C complained about the care provided to her late sister (Mrs A) when she attended Raigmore Hospital with gastric symptoms. Investigations were carried out into Mrs A's symptoms over two admissions. During the latter admission, Mrs A was diagnosed with a perforated bowel, thought to be related to cancer. Her condition deteriorated very quickly and she died from her illness.

We took independent advice from a consultant gastroenterologist (a doctor who specialises in the digestive system) and from a registered nurse.

We did not identify any failings in the medical management of Mrs A's condition or in the nursing care provided. We did not uphold this aspect of the complaint. However, we noted that the documentation of her care could have been more detailed and fed this back to the board.

Mrs C was also unhappy that board staff did not contact her regarding Mrs A's discharge from the hospital following her first admission. In response to Mrs C's complaint, the board confirmed that another family member had been told about the discharge and so there was no requirement for duplication of information. We did not uphold this aspect of the complaint.

Summary

Mr and Mrs C complained on behalf of their child (Child A) about the care and treatment they received from the board's children and adolescent mental health services over several years. The concerns related to the stopping of treatment; the lack of support to aid Child A's understanding of a complex system and consenting to it; and lack of transparency regarding a number of matters. The board did not identify any failings in the care and treatment provided and explained this to the family.

We took independent advice from a consultant child and adolescent psychiatrist. We considered that there had been a reasonable amount of input at an appropriate level of seniority in place to make decisions in a complex case. We found that it was a reasonable course of action to stop a type of therapy and not carry out a risk assessment as there was evidence of engagement and future planning and no evidence of a high risk situation at this time. In addition, whilst the therapy was stopped, Child A continued to receive care from psychiatric and psychology services. In terms of consent, there was evidence in the clinical records to support that attempts were made by staff to tailor their approach towards Child A and we did not identify unreasonable practice. However, we did provide feedback to the board regarding ensuring that patients receive relevant information about their clinical condition. We also considered that further opinions were appropriately sought when the family questioned the clinical diagnosis in line with national guidelines. We did not identify any concerns regarding transparency in the clinical records or with the family. We did not uphold the complaint.

Summary

Miss C complained about the clinical and nursing care and treatment given to her late father (Mr A).

We took independent advice from a consultant geriatrician (a doctor who specialises in medicine of the elderly) and from a nursing adviser.

In relation to the clinical care and treatment, we found that the clinical records evidenced that an appropriate assessment of Mr A was carried out and that reasonable efforts were made by clinical staff to treat Mr A's condition. We found that, overall, the clinical care and treatment given to Mr A was reasonable and we did not uphold this aspect of the complaint.

In relation to the nursing care and treatment given to Mr A, we found that the nursing records were of a reasonable standard and that they demonstrated that there had been a risk-based assessment of Mr A. There was also evidence of care planning related to the level of risk and ongoing documentation around delivery of daily care for Mr A. However, we found that the documentation around the injury to Mr A's foot could have been better and we drew this to the board's attention. On balance, we found that the nursing care and treatment was reasonable and did not uphold this aspect of the complaint.

Lastly, Miss C complained about the communication from the hospital with her and her family. We found that the clinical records demonstrated an appropriate level of communication and we did not uphold the complaint.

Summary

Ms C complained that the university did not carry out a reasonable investigation into her complaints. In particular, Ms C was concerned that the university did not take all the relevant evidence into account, did not interview all the relevant parties and did not follow the right policies/procedures.

We found that the university had reasonably followed their complaints handling procedure, considered all the relevant evidence and made reasonable attempts to interview the witnesses specified by Ms C. While we appreciated that Ms C disagreed with the university's decisions regarding her complaints, her disagreement with their interpretation of matters and their decisions is not, of itself, evidence of an administrative failing on their part. We considered that the university's investigations into Ms C's complaints were reasonable and did not uphold Ms C's complaint.

Summary

Mrs C complained that the council had handled a planning application unreasonably. She noted that there were a number of admitted errors, which she said materially affected the conclusion reached by the planning officer.

We took independent planning advice and found that although the council had acknowledged these errors, they were not sufficient to consider the council acted inappropriately or unreasonably. The council had provided detailed explanations for their decision and had been able to demonstrate that they were made on appropriate planning grounds. In addition we found some of the issues being raised by Mrs C, such as a boundary dispute with the developer, were in fact civil matters and could not be decided through the planning process. We did not uphold the complaint.

Summary

Mr C complained about the support provided to him by the council following his release on licence from prison. Mr C also complained about the content of a report that the council submitted to the Parole Board, requesting consideration of Mr C being recalled to prison. We took independent advice from a social worker. We did not find evidence that the council's decision-making or the support provided to Mr C was unreasonable. We did not uphold Mr C's complaints.

Summary

Mrs C complained that she and her family were unreasonably removed from the practice list of patients. Mrs C said that she had no trust in the service provided by the practice and that she had never received explanations about what diagnoses had been reached about her numerous medical conditions.

We took independent advice from a GP. We found that prior to removing Mrs C and her family from the patient list, the practice had repeatedly made an offer of a meeting with Mrs C to discuss her concerns. When Mrs C failed to accept the offers, the practice viewed the doctor/patient relationship had irretrievably broken down and that it was in Mrs C's best interests to register with another medical practice. The hope was that she could build up a good doctor/patient relationship with her new practice. We did not uphold the complaint.

Mrs C also complained that it was unreasonable to have her family removed from the patient list as well. Guidance suggests that members of a patient's family should not be removed automatically from the practice list where there is a breakdown in the doctor/patient relationship. However, in instances where children and/or carers are involved, it is appropriate to remove the whole family, as this will allow better communication and the sharing of information where all family members are registered with the same practice. Therefore, we did not uphold this complaint.

Summary

Mr C complained about the treatment which he received from the practice. He reported stomach and bowel problems to a number of GPs. They treated him for irritable bowel syndrome but they failed to diagnose that he had a bowel obstruction and that resulted in him having to have a colostomy (an operation to divert part of the bowel through an opening in the tummy) and undergo chemotherapy.

We took independent medical advice from a GP. We found that the GPs who treated Mr C carried out appropriate investigations in view of the stomach and bowel symptoms which he presented with. When Mr C reported passing blood the GPs made a referral for a colonoscopy (examination of the bowel with a camera on a flexible tube). However, before the colonoscopy could take place, Mr C was admitted to hospital as an emergency and was diagnosed with a bowel obstruction. We did not uphold the complaint.