Not upheld, no recommendations

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.

Summary

Mrs C complained to the Commissioner for Ethical Standards in Public Life in Scotland (CESPLS) about a member of a public body. CESPLS decided not to investigate, and she complained to us about their handling of her complaint.

CESPLS have broad discretion under the Ethical Standards in Public Life etc. (Scotland) Act 2000 to decide whether, when and how to carry out an investigation.

We found that CESPLS' investigation procedures allowed them to carry out an initial assessment to decide if a complaint was relevant and admissible. In Mrs  C's case, CESPLS decided that her complaint was neither relevant nor admissible. CESPLS' communication with Mrs C explained their intentions and decisions clearly. We considered that CESPLS acted in line with their investigation procedures, and we did not uphold Mrs C's complaint.

Summary

Mrs C complained about the council's policy on kinship care allowances. She and her husband are kinship carers for their granddaughter and previously obtained a residency order. The council pays approved/formal kinship carers the same additional four week holiday allowance that is paid to foster carers. However, they do not pay this to previously approved/informal kinship carers, which is the category that Mrs C falls into. Mrs C feels that a council committee report proves that she should be paid the four week allowance, as it states that approved/informal kinship carers should not be disadvantaged by obtaining a residence order (now known as a kinship care order).

We made a number of enquiries to both the council and the Scottish Government. Although we were not satisfied by the council's initial response, they eventually provided a more robust justification for why they reached their decision within the existing legal framework. The Scottish Government also provided a far clearer explanation of their intentions than was contained in the letter detailing the funding agreement which led to the changes to kinship care allowances. They stated that the funding agreement only applied to regular weekly allowances and was intended to bring allowances for eligible kinship carers in line with foster carers. Therefore, local authorities had discretion to make additional payments as they saw fit. In addition to this, we saw no evidence to support the statement in the council's committee report which stated that kinship carers should not be disadvantaged by obtaining a residence or kinship care order. On this basis, we did not uphold Mrs C's complaint. However, we did provide feedback to the Scottish Government as they are currently carrying out a national review into kinship and foster care payment arrangements.

Summary

Mr and Mrs C's child (child A) was a pupil in a primary school. Child A started to show signs of difficulty with reading and writing, which became more apparent when they moved into the next school year. Mr and Mrs C removed child A from the school as they believed that the school had told them that they could no longer support their child. Mr and Mrs C complained that the school failed to assess their child for dyslexia and to provide the appropriate support.

We found that the school had acted appropriately in line with the council's "Dyslexia Guidelines". The evidence we received showed that the school assessed child A's needs as they progressed through the school years and that support was provided. We found no evidence to corroborate Mr and Mrs C's view that the school stated that they could no longer support child A. We did not uphold the complaint.

Summary

Mrs C complained to the association about problems with insects in her home and the water quality, after it was confirmed by the provider that there were high levels of lead in the water. The association responded to the complaint about insects by instructing specialists, who reported that there was no infestation but carried out preventative treatments. With respect to water quality, the association said that they checked internal pipework and confirmed there was no lead present. They also contacted the water provider and, following a re-test of the water supply, it was confirmed that the levels of lead were now at safe levels. The association considered that there was nothing else they could do on the matter. Mrs C was unhappy with this response and brought her complaint to us.

We found that the association had acted reasonably in instructing proper inspections of her property which confirmed that there was no insect infestation. There was a delay with respect to organising preventative treatments, however, these were not the fault of the association. Therefore, we did not uphold this aspect of Mrs C's complaint.

In relation to the problems with respect to the water quality, the association had taken appropriate steps to liaise with the water provider and had undertaken checks with respect to the pipework which was their responsibility. The association made reasonable enquiries with respect to the cause of the initial high lead readings and acted on the advice of the water provider. We found the actions of the association were reasonable and did not uphold this aspect of Mrs  C's complaint.

Mrs C also complained about how the associaton handled her complaint. We found that there had been a small delay in responding to her complaint, however, the association's reponse provided a detailed account of the actions they were taking to understand and address the complaint. Therefore, we did not uphold this aspect of Mrs C's complaint.

Summary

Ms C has an adult son with autism and she is his main carer and financial welfare guardian. Ms C complained that the partnership did not respond reasonably to a complaint she made about various elements of her son's care and her position as carer and guardian.

We found that the partnership had issued a lengthy stage two complaints response. Whilst we noted that this response was quite strongly worded and that this tone may have been upsetting to Ms C, we found that the content of the response was reasonable. We considered that it adequately answered all of the issues Ms C had raised, including evidence of the efforts that had been made to work with Ms C regarding various elements of her son's care. We did not consider the partnership's position on any of these issues to be unreasonable. We did not uphold Ms C's complaint.