Not upheld, no recommendations

Summary

Mr C complained about the care and treatment he received in relation to a suspected hernia (a condition where an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall) whilst he was in prison. In particular, that there were delays in being seen by his GP, being referred for an ultrasound scan (a scan that uses sound waves to create images of organs and structures inside the body), being referred for surgery and concerns over his prescribed medication. Mr C also complained that he was not given a long-term sick line after an initial sick line expired.

We took independent advice from a GP. We found that the time Mr C had to wait for appointments with his GP was reasonable. We also found that he was referred for an ultrasound scan and surgery within a reasonable amount of time and that his medication was reviewed appropriately. Therefore, we did not uphold this aspect of Mr C's complaint.

In relation to Mr C's sick line, we found that it would be reasonable to expect that he would be able to attend classes and carry out light duties whilst waiting for surgery and, therefore, we considered that the GP's decision to refuse a sick line was appropriate. We did not uphold this aspect of Mr C's complaint.

Summary

Ms C complained about the treatment she received at Wishaw General Hospital when she attended the emergency department (ED) after a road traffic accident.

We took independent advice from a consultant in emergency medicine. We found that Ms C had been correctly triaged (a process in which things are ranked in terms of importance or priority) when she attended the ED, that the history taking had been of a good standard, the examination carried out was thorough and of a good standard and the treatment was reasonable. Therefore, we did not uphold Ms C's complaint.

Summary

Mr C attended the prison health service on a number of occasions with chest infections and high blood pressure. He complained that he did not receive appropriate medication and that there were delays in being referred to specialists.

We took independent advice from a GP adviser. We found that Mr C had been assessed and treated appropriately. We also considered that appropriate referrals had been made, and that the waiting times for appointments were normal. We noted that there had been a delay in discussing x-ray results with Mr C, but the board had apologised for this and had provided evidence of improvements in their recording and checking system, to prevent this from happening again.

We did not uphold this complaint.

Summary

Miss C raised a complaint about the care and treatment she had received from her dentist over an extended period of time. Miss C had suffered from pain in one of her lower teeth and was advised she would require root canal treatment. Miss C continued to be in pain; the treatment had to be repeated and also caused problems with an adjacent tooth. Miss C said she was told the tooth required extraction and was referred to the dental hospital for further treatment. Miss C was dissatisfied with the way the dentist managed her dental care.

We took independent advice from a dentist. We found that the dental treatment which Miss C received was appropriate and in accordance with usual practice. The symptoms which Miss C had reported were uncertain, therefore a period of monitoring was required. The suggestion by the dentist for root canal treatment or extraction was reasonable in view of the dental records and x-rays which were taken. We did not uphold the complaint.

Summary

Ms C complained that the board had refused her request for a genital cosmetic surgery procedure.

We took independent advice from a consultant gynaecologist (a specialist in the health of the female reproductive systems). We found that the board had appropriate guidelines in place for consideration of such requests and that Ms C did not meet the criteria for surgery. We did not uphold the complaint.

Summary

Mr C complained that the practice refused to register himself and other members of his family as new patients. He also said that the practice failed to make reasonable adjustments to accommodate the needs of disabled family members.

We found that the practice had followed their policy in relation to Mr C's registration. The practice declined to register Mr C on the basis of being unable to form a doctor / patient relationship with him because of his conduct which they are entitled to do. Therefore, we did not uphold this part of Mr C's complaint.

Mr C also wanted to register other members of his family as new patients. The practice said that they could not do so unless they came to the practice so that their identification could be verified. This was in line with the practice policy. The practice made this clear to Mr C, however, we found that some later communication was not appropriate. The practice appeared to link the decision to not register Mr C's family to Mr C's behaviour in their communication. However, we noted that the practice acknowledged this mistake and confirmed that members of Mr C's family could still register as new patients, provided that they comply with the registration policy. On balance, we did not uphold this part of Mr C's complaint.

In relation to the practice failing to make reasonable adjustments, we found that Mr C had declined to provide sufficient information about the disabilities of members of his family. Therefore, we considered that the practice did not have enough information to assess whether the adjustment requested was reasonable, or not. We did not uphold this part of Mr C's complaint.

Summary

Mr C complained on behalf of his late wife (Mrs A) about a decision by staff at the Golden Jubilee National Hospital not to perform a heart transplant on her. Mr C highlighted that Mrs A had been working to lose weight so she could potentially receive a heart transplant. Mr C was concerned that Mrs A was not given the opportunity to be included in the major decision made not to allow her a transplant.

We took independent advice from a consultant cardiologist. We found that there was evidence to support that much consideration had been given to the heart transplant and that Mr C and Mrs A had been reasonably involved in the decision making. We did not uphold the complaint.

Summary

Mr C complained to us about the decision making of his GP practice. Mr C had received annual checks for prostate cancer for several years. However, the practice decided to change this to every two years. When Mr C's PSA levels were next checked, they had risen considerably and Mr C was found to have developed prostate cancer. Mr C complained that the practice unreasonably changed the frequency of his prostate checks. In addition to this, he complained about a number of administrative and communication issues relating to his prescriptions and treatment following his diagnosis.

We took independent advice from a GP. We found that there is currently no national guidance relating to prostate screening but noted that it was important to discuss the pros and cons with the patient so they could make an informed decision. The practice told us that a discussion had taken place but Mr C recalled that it was more a case of the practice stating a firm position and taking the decision. We were unable to confirm that a discussion had taken place. However, the records did state that Mr C should be monitored based on symptoms rather than testing and that he should be seen as required. In addition to this, an International Prostatic Symptoms Score (IPSS, a tool used to screen for, rapidly diagnose and track the symptoms of prostate enlargement) taken after the consultation showed a lower score. In light of the known information at the time of the consultation, and the fact that there is no national policy regarding screening for prostate cancer, we considered that the practice's decision was reasonable. Therefore, we did not uphold this aspect of Mr C's complaint.

In respect of the administration and communication issues, there appeared to have been some minor failings which were partly acknowledged in the practice's response to Mr C's complaint. However, we considered that the administration of prescriptions and paperwork had been largely adequate. Therefore, we did not uphold this aspect of Mr C's complaint.

Summary

Mr C complained about the care and treatment his late wife (Mrs A) received from Dumfries and Galloway Royal Infirmary in relation to the decision and communication about de-activating her implantable cardioverter defibrillator (ICD - a device designed to treat abnormal heart rhythms). Mr C also raised concerns that no discussions took place with Mrs A about a 'do not attempt cardiopulmonary resuscitation' (DNACPR - a decision taken that means a healthcare professional is not required to resuscitate the patient if their heart or breathing stops) order being put in place until after the decision had been taken by medical staff. In addition, he was dissatisfied that staff had not clearly communicated that Mrs A's condition had worsened to the point that she was in the end of life stage.

We took independent advice from a consultant cardiologist. We found that there was sufficient evidence to show that discussions had taken place about the DNACPR order on two separate occasions. We also considered that it was appropriate clinical practice to de-activate Mrs C's ICD given that her condition had significantly deteriorated and there were no other treatment options possible. Whilst we did not uphold these aspects of Mr C's complaint, we welcomed that the board have taken steps to improve how conversations about de-activating ICDs are carried out.

In terms of Mr C's concerns about communication regarding end of life, we found that there was evidence to demonstrate that conversations took place about the reasons why there were no treatment options possible, and that palliative (end of life) care was Mrs A's only option. Whilst palliative care had been started, we found that there was no indication at the time of discharge from hospital that Mrs A would die as soon as she did afterwards. We, therefore, did not uphold this part of the complaint.

Summary

Miss C, who was a postgraduate student, was required to resit a coursework assessment. Her second submission was unsuccessful and she was withdrawn from her course. She appealed the university's decision, but her appeal was not upheld.

Miss C complained to us that she had not received appropriate support during her postgraduate studies. We found that she had met with her supervisor on two occasions for assessment feedback and that the supervisor had referred her to revision guidelines and a resit session. Although Miss C provided an email trail showing her attempt to arrange a further meeting with the supervisor, she provided no evidence of having told the supervisor that she was struggling with the work, or of having persevered with trying to arrange a meeting after the supervisor declined. We did not uphold this aspect of the complaint.

Miss C further complained that the university had failed to take her health issues into account when considering her appeal. We found that the Appeal Committee had taken Miss C's medical evidence into account when considering her appeal, but had not considered it sufficient for justification of submission of a late Extenuating Circumstances Statement. She also complained that the university had failed to follow their procedures before withdrawing her from her course. We found that procedures had been followed appropriately and we did not uphold these two aspects of the complaint.