Not upheld, no recommendations

Summary

Mrs C brought her nephew to live with her following a mutual agreement with his mother. Mrs C approached the partnership to enquire about kinship care assistance, however, she was advised that she was not eligible as she did not have a kinship care order in place. A few years later, Mrs C enquired again about kinship care assistance and she was advised that her nephew was not considered an eligible child as he was not at risk of becoming looked after (a  looked after child is a child under the care of the council). Mrs C complained that the partnership did not reasonably consider her request for kinship care assistance.

We took independent social work advice. We found that there were a number of family members providing support to Mrs C's nephew and his mother, and the child's father was also playing an active role in caring for him. We were satisfied that the partnership carried out an appropriate assessment and their decision that Mrs C was not eligible for kinship care assistance was reasonable. We did not uphold Mrs C's complaint.

Summary

Ms C complained that NHS 24 failed to provide appropriate assistance when she called them to raise concerns that her mother (Mrs A) had been discharged from hospital too early following a suicide attempt. She said that she had not received any advice or assistance and complained that she had only been able to speak to a call handler and not a clinician.

We took independent advice from a practitioner experienced in out-of-hours services. We found that NHS 24's handling of the call had been reasonable. The call handler contacted Mrs A, who had told them that she had been seen by psychiatry that day and had psychiatric follow-up arranged. The call handler also spoke to a senior nurse. We found that the advice provided to Ms C had been appropriate and it had been reasonable to advise her to contact Mrs A's GP practice at that time. We did not uphold the complaint.

Ms C also complained about NHS 24's handling of her complaint. We found that this had been reasonable and did not uphold this aspect of the complaint.

Summary

Mr C complained about the treatment which he received when he attended the Western General Hospital for reported left upper abdomen pain. He said he had advised staff that he was allergic to aspirin and penicillin but was prescribed diclofenac medication (pain relief) on discharge. When he returned home, Mr C took two further diclofenac tablets and experienced breathing difficulties. He attended his GP the following day who prescribed alternative pain relief. Given his allergies, he felt that the diclofenac should not have been prescribed.

We took independent medical advice from a consultant. We found that although diclofenac would not normally be prescribed for a patient allergic to aspirin it was not absolutely contraindicated and should be used with caution. We also found that diclofenac was a non-steroidal anti-inflammatory medication (NSAID) and Mr  C had advised the staff that he was able to tolerate some NSAIDs. We noted that Mr C had been given diclofenac whilst in hospital and that it had a good effect on his reported abdomen pain and he was given advice to seek further medical attention should his condition deteriorate following discharge. On balance, we found that it was reasonable for the doctor to have prescribed the diclofenac. We did not uphold Mr C's complaint.

Summary

Mr C complained about the lack of treatment which he received at St John's hospital. He had been referred to the mental health service by his GP for an assessment. Mr C complained that the board failed to carry out appropriate mental health assessments. He was also dissatisfied that the board would not arrange a further medical opinion.

We took independent advice from a consultant psychiatrist (a specialist in the diagnoses and treatment of mental illness). We found that Mr C was seen on two occasions by a doctor in training who discussed Mr C with a supervising consultant psychiatrist. There was evidence that thorough assessments were carried out on both occasions which resulted in a reasonable management plan. Mr C was then assessed by another consultant psychiatrist, who again carried out an appropriate assessment in view of Mr C's reported symptoms. The clinicians reasonably concluded that Mr C was not suffering from a diagnosable mental health disorder. We considered the assessments to be reasonable and did not uphold this aspect of Mr C's complaint.

In relation to a further medical opinion, we noted that Mr C had been assessed twice by a trainee doctor, under supervision of a consultant psychiatrist, and also by an additional consultant psychiatrist. Therefore, we found that it was not unreasonable that the board did not offer Mr C a further medical opinion. We did not uphold this aspect of Mr C's complaint.

Summary

Mr C complained about the care provided to his late mother (Mrs A) by staff at Wishaw General Hospital. Mrs A had attended the emergency department following a fall at home. She was observed for a few hours and discharged home. Mrs A fell again at home that evening and had to be readmitted to hospital where it was established that she had problems with the blood supply to her left leg. Mrs A was told that no further treatment could be given and she was commenced on palliative care. Mr C believed that the seriousness of his mother's condition should have been identified on the first attendance to hospital.

We took independent advice from a consultant in emergency medicine. We found that on the first attendance the staff carried out a thorough assessment, made appropriate investigations and reasonably concluded that Mrs A could be discharged home with follow-up by the hospital at home team. When Mrs A re- attended hospital, her observations were mostly normal and it was only after a further period of review that issues were identified which revealed a lack of blood supply to her left leg. We found that the staff could not reasonably have predicted that Mrs A would go on to have subsequent problems. We did not uphold the complaint.

Summary

Miss C complained about the treatment which her late child (Child A) received at Wishaw General Hospital. Child A had recently had a vaccination and had developed a temperature and a rash. Miss C asked the staff if Child A could have Kawasaki Disease (heart disease) and was told that they did not meet the criteria. Instead Child A was treated for a viral infection and then discharged home after a period of observation. Although Child A showed some signs of improvement, over two weeks later they were admitted to hospital where they died. The post mortem report showed findings in keeping with Kawasaki Disease. Miss C felt that staff should have carried out additional investigations when Child A was originally at the hospital and the disease would have been identified sooner.

We took independent advice from a consultant paediatrician. We found that the staff carried out appropriate assessments when Child A attended the hospital and that it was reasonable to have arrived at a working diagnosis of viral infection based on their reported symptoms. Child A did not meet the criteria for Kawasaki Disease at that time and there was no clinical indication that a hospital admission or referral to other hospital specialist was required. We did not uphold Miss C's complaint.

Summary

Mrs C complained about the care which she received from the practice. She said that the practice unreasonably refused to prescribe her pethidine (painkiller) medication and removed it from her list of repeat medications. Mrs C said that she had been on the medication for a number of years and that no alternative painkillers were prescribed and she was at risk of withdrawal symptoms.

We took independent advice from a GP. We found that the clinical records indicated that Mrs C had agreed to stop pethidine, she had also said it was her intention to try ibuprofen (anti-inflammatory pain relief medication) and that she still had a stock of pethidine at home. We found that the GP correctly did not prescribe additional painkilling medication in the meantime and also that Mrs C had not been taking pethidine on a regular basis and as such it was unlikely she would have suffered from withdrawal symptoms. Therefore, we did not uphold Mrs C's complaint.

Summary

Miss C complained about the antenatal care she received from the community midwifery team when she was pregnant. Miss C was informed she was on the "red pathway care" for her pregnancy which meant her antenatal care would be led by a consultant obstetrician (a doctor who specialises in pregnancy and childbirth) and supported by the community midwifery team.

Miss C complained that she was told by her midwife at her first appointment that she would not need to have future appointments with her midwife and would only see her consultant. Miss C also complained that she missed out on vital check ups and she did not receive her relevant maternity forms on time. The board apologised that the consultant did not provide Miss C with the appropriate forms.

We took independent advice from a midwife. We found that when Miss C contacted the community midwifery team, the midwife acted appropriately and offered to meet with Miss C to provide her with the necessary forms and information, however, Miss C refused this offer and did not engage in the service. We found at this point, Miss C was still within the required timescale for submitting her forms, therefore, she did not suffer any significant injustice as a result. We did not find any evidence that Miss C was advised at her first appointment that she was not required to see her midwife again. We did not uphold Miss C's complaint.

Summary

Ms C has complex Post-Traumatic Stress Disorder (a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma) and had been receiving Comprehensive Resource Model (CRM - a holistic therapeutic approach to help people re-process and release the effects of traumatic events) treatment under the care of her psychiatrist. Ms C heard that her psychiatrist had left the practice and that she was to be offered a six week course of Cognitive Behavioural Therapy (CBT - a talking therapy aiming to help manage problems by changing the way people think and behave) in place of CRM treatment. Ms C had tried this before and found it of little benefit. Ms C complained that the board had failed to consult her on the decision to withdraw CRM treatment, and had failed to put in place an appropriate support plan for her.

The board explained that the removal of this treatment was a result of a review of all adult psychiatry services, stating that there was no evidence base for CRM and it did not appear on the Matrix for Psychotherapy Treatments (a guide to planning and delivering evidence-based psychological therapies within NHS boards in Scotland).

We took independent advice from a consultant psychiatrist. We found that Ms C had been discharged from the service on clinical grounds and would only have been informed of the decision to withdraw the treatment when she requested a new appointment. We were satisfied that the board did not have a specific duty to consult with Ms C before deciding to withdraw from providing CRM treatment and we, therefore, did not uphold this complaint.

In relation to the support plan put in place following the board's decision to withdraw CRM treatment, the board said that the psychiatrist had wanted to find out the wishes of their patients in care provision. They had discussed the future care of all their patients and had agreed to refer them to their Community Health Team for an assessment of their needs. We found that the board's approach in offering individual appointments to assess ongoing needs for future treatment was reasonable. Therefore, we did not uphold this complaint. However, we did find shortcomings in the board's communication with Ms C in relation to the matters she complained about and fed this back to the board.

Summary

Mrs C made a complaint on behalf of Mrs B about the care and treatment her late husband (Mr A) received at his GP practice. Mr A had a number of health issues including epilepsy for which he had been prescribed medication for many years. Mr A had attended the surgery for worsening upper abdominal pain following a two day history of vomiting. Mr A was admitted to hospital where he died several days later. Pancreatitis (inflammation of the pancreas) was recorded as one of the causes of Mr A's death. Mrs C complained that the practice had failed to provide Mr A with reasonable care and treatment. In particular, that Mr A's GP had failed to recognise that Mr A's epilepsy medication could cause pancreatitis.

We took independent advice from a GP. We found that the care and treatment provided to Mr A by the practice was reasonable. Mr A's health concerns were appropriately investigated and blood tests and referrals were made as appropriate and in a timely manner. We also noted that pancreatitis is a very rare side effect of the medication Mr A was taking for his epilepsy. We considered that the care provided to Mr A by the practice was of a reasonable standard and in line with good medical practice. Therefore, we did not uphold Mrs C's complaint.