Not upheld, no recommendations

Summary

Mr C complained about a number of aspects of the authority's handling of a planning application, their discharge of various conditions on the planning application, and their failure to take enforcement actions on breaches of planning conditions.

We took independent planning advice on the complaints. We found that the authority had followed the appropriate guidance and legislation in all aspects of the complaints and that there was no evidence of maladministration in the way they had taken various discretionary decisions. We did not uphold Mr C's complaints.

Summary

Mr C complained that the council failed to provide a reasonable level of housing support. Mr C lives in sheltered accommodation and had experienced some significant problems with his property since moving there. Mr C said that the Sheltered Housing Officer (SHO) was not on site enough and felt that he should not have to pay the housing support charge. After we became involved, the council met with Mr C to try to resolve his complaint, and provided apologies for the problems he had experienced with his tenancy.

In their response to our enquiry, the council said that a breakdown of the care and support charges was clearly itemised on the Tenancy Agreement Mr C had signed. They also explained that the SHO was not on site all of the time but should be available to respond on the telephone if called upon. They also said that when Mr C moved into sheltered housing he requested not to have contact with a SHO. Based on the available evidence, we did not uphold this aspect of Mr C's complaint.

Mr C had also complained about the tone of some of the council's complaint correspondence. While we acknowledged that Mr C was upset by some of the content of the correspondence, we noted that the council are entitled to seek to limit communication where a matter has already exhausted their complaints process. We found that the council's handling of the complaint had been reasonable and therefore, did not uphold this aspect of Mr C's complaint. However, we considered that some of their email correspondence with Mr C could have been more sensitively worded and we fed this back to the council.

Summary

Mr C complained that the housing association imposed restrictions on his contact with their services under their unacceptable actions policy. The restrictions stopped Mr C from contacting the association directly and required him to nominate a third party representative to communicate on his behalf. Mr C complained that these restrictions were unreasonable and that the association failed to make reasonable adjustments on account of his specific needs and disability.

We found that there was reasonable evidence to support the housing association's decision to place restrictions on Mr C's communication. They acknowledged that they could have improved their communication with Mr C and they have already taken steps to address this. However, we were satisfied that the housing association responded appropriately to Mr C's requests for reasonable adjustments. We did not uphold the complaint.

Summary

Ms C, an advocate, complained on behalf of her client (Ms A). Ms A contacted the partnership to request a self-directed support assessment. A number of efforts were made to arrange a meeting to complete the assessment, however, after a number of months the partnership expressed concerns about the difficulty in progressing the assessment. They advised Ms A that her case would be suspended until a later date so that the case worker could progress other work. Ms A complained that the partnership failed to make reasonable adjustments in light of her communication needs. Ms A said that she wanted the partnership to fund her preferred interpreter service.

We took independent equalities advice. We found that the partnership made an interpreter available for meetings and made reasonable efforts to accommodate all those that Ms A wished to have in attendance at meetings. We also found that the partnership permitted Ms A to use her own preferred interpreter, however, we did not consider they were required to fund that service as they had already made a service available. We did not uphold the complaint.

Summary

Mr C complained that the board's neurology (the branch of medicine concerned with the diagnosis and treatment of disorders of the nervous system) department had unreasonably delayed in diagnosing his epilepsy (a neurological disorder). Mr C was initially diagnosed with chronic fatigue syndrome (a medical condition of unknown cause, with fever, aching, and prolonged tiredness and depression) and said that he was referred to the neurology department on many occasions over a number of years but stayed with this diagnosis. Several years later, Mr C's diagnosis was changed to functional weakness and, several years after this, it was identified that he had epilepsy. Mr C considered that his epilepsy should have been identified earlier.

We took independent advice from a consultant neurologist. We found that it was unlikely that the symptoms Mr C initially had were due to epilepsy. He subsequently did develop symptoms that fitted epilepsy, but it was reasonable that it took some time to make a diagnosis, as his symptoms were relatively infrequent. We found that the sequence of investigations undertaken were reasonable and that there were no failings in Mr C's care and treatment. Therefore, we did not uphold this complaint.

Summary

Mr C attended the Western General Hospital after he experienced seizures. They carried out scans, which showed a lesion (an abnormal growth) in his brain. Mr C complained that there was a delay in diagnosing that it was brain cancer, as medical staff initially thought that the lesion was an abscess (a collection of infected fluid). We took independent advice from a consultant oncologist (cancer specialist). We found it was reasonable that Mr C's lesion was thought to be an abscess, given the results of the scans and his medical history. We found that it was good practice that they also tested the lesion for cancer. We did not uphold this aspect of the complaint.

Mr C also complained that when cancer treatment options were discussed with him, he was not given appropriate support. In addition, he complained that there was a delay in telling him about fertility options before he started his cancer treatment. We found that Mr C had appropriate support from the multidisciplinary team and his family when treatment options were discussed with him. We also found that he was given appropriate written information about fertility options. Therefore, we did not uphold these aspects of the complaint.

Summary

Mrs C complained about the treatment provided to her husband (Mr A). Mrs C said that the board unreasonably removed Mr A's right kidney and ureter (the duct by which urine passes from the kidney to the bladder) on the basis of a diagnosis of cancer.

We took independent advice from consultants in urology (the medical specialism that deals with the male and female urinary tract, and the male reproductive organs) and pathology (the study of disease). We found that there were failings in relation to record-keeping which we drew to the board's attention. We also found that there had been a delay in the surgery being carried out which the board had apologised for. However, we found the investigations carried out which led to the diagnosis of cancer were reasonable. We also found that the biopsies (tissue samples) taken in this case were appropriately interpreted at the time and that a mistake had not been made. Therefore, we did not uphold the complaint.

Mrs C also raised concerns about the Significant Adverse Event Review (SAER) which had been carried out. We found that the SAER carried out was reasonable. We found that a comprehensive review of the case was carried out, and failings in the consenting process were recognised. We also found that there had been a thorough external review of the pathology slides and recommendations made for improvements. We did not uphold the complaint.

Summary

Ms C complained about the care and treatment that her mother (Ms A) received at University Hospital Hairmyres. Ms A attended the hospital with back and chest pain, and her blood count was found to be low. The cause of Ms A's low blood count was suspected to be an internal bleed. Ms C was concerned about the investigations carried out to identify the cause of Ms A's low blood count and that Ms A was discharged home without a final diagnosis.

We took independent advice from a consultant hepatologist (specialist treating the liver, gallbladder and pancreas) & gastroenterologist (treatment of the stomach and intestines). We found that the clinical approach used to identify the source of Ms A's bleeding was reasonable. In particular, plans were made for Ms A to have an endoscopy (procedure using an instrument to give a view of the body's internal parts) and a colonoscopy (procedure where a flexible fibre-optic instrument is inserted through the anus in order to examine the colon) on an

out-patient basis. We found that it was reasonable for the board to discharge Ms A and that it would not have been possible for the board to make a final diagnosis during Ms A's admission. We did not uphold Ms C's complaint.

Summary

Mr C complained about the care and treatment provided to him by the board in relation to a pacemaker implantation (a device that generates electrical impulses delivered by electrodes to contract the heart muscles and regulate the heart). After Mr C had his pacemaker implanted, he attended hospital on several occasions as he was aware of having palpitations (noticeably rapid, strong or irregular heartbeat). Some months after implantation, it was found that Mr C had a heart failure as a result of the pacemaker. Mr C raised concern that it took several months to detect the heart failure and take action on this.

We took independent advice from a cardiologist (a medical specialist who diagnoses and treats disorders of the heart). We found that the monitoring of Mr C's pacemaker was reasonable, and that no problems were identified during this monitoring. We found that Mr C was not experiencing any symptoms of heart failure and therefore there would have been no reason for the board to suspect this. We determined that the finding of heart failure was incidental, and when identified it was acted upon in a timely and appropriate manner.

We noted that the risk of heart failure was not outlined on the consent form for Mr C's pacemaker implantation and that this was technically a failing. However, we found that national practice does not currently reflect that this risk is not routinely included anywhere on consent forms in the NHS at this point. Therefore, while we considered that it may be good practice to raise the risk of heart failure when taking consent for pacemaker implantation, as the risk is not one that is nationally recognised or currently reflected in practice and guidance, we did not consider this to be a failing of the board with regards to required actions and reasonableness. We did not uphold this aspect of Mr C's complaint.

Mr C also complained about the board's communication with him regarding his pacemaker and heart failure. We found that communication was prompt and covered all issues reasonably. We did not uphold this aspect of Mr C's complaint.

Summary

Miss C complained that the board failed to recognise and treat problems with her nose. Miss C was seen by consultants at both Wishaw General Hospital and Monklands Hospital but felt that her problems were ignored.

We took independent advice from an ear, nose and throat surgeon. We found that the assessments and conclusions reached by the consultants who reviewed Miss C were reasonable, and took into account her concerns. We considered that the treatment provided was in line with the findings of the assessments carried out. Therefore, we did not uphold the complaint.