Not upheld, no recommendations

Summary

Mrs C complained that the medical practice failed to provide appropriate care and treatment to her late husband (Mr A), who died in hospital of double pneumonia a few days after last seeing a GP. She said that her husband had seen a GP on two occasions before the hospital admission and that the GP had not carried out appropriate assessments to diagnose the pneumonia or to have referred her husband to hospital for a specialist opinion.

We took independent advice from an adviser in general practice medicine and concluded that the practice had provided a reasonable level of care. The records showed that the GP had carried out appropriate assessments and that, based on the symptoms which Mr A had reported, it was reasonable for the GP to have diagnosed a viral illness. The GP had advised Mr A to rest, take fluids and paracetamol. It was clear that, following the last GP appointment, Mr A's symptoms had changed and that he had deteriorated and at that time a hospital referral was appropriate. We did not uphold the complaint.

Summary

Mrs C complained to us that the medical practice had failed to provide appropriate care and treatment to her son (Mr A) who had attended an appointment with one of the GPs with symptoms of sore lungs and a cough. Ms C said that the GP had failed to listen to Mr A's lungs or chest and did not prescribe an antibiotic for him to take. Mr A was still unwell the following week and was taken to hospital, where he was diagnosed with pneumonia.

We took independent advice from an adviser in general practice medicine and concluded that the GP had provided a reasonable level of care. We found that the GP had examined Mr A's lungs and had found no signs of an infection. We also found that an adequate medical history was recorded and that it was not unreasonable for the GP to have diagnosed a viral infection. As such, it was not unreasonable that the GP did not prescribe antibiotics. We did not uphold the complaint.

Summary

Ms C complained on behalf of her late brother (Mr A) about the treatment he received from the practice in the four months prior to his diagnosis of lung cancer. She complained that the standard of care and treatment provided to her brother was unreasonable.

We took independent advice from a GP adviser who said that the initial symptoms Mr A presented with had led doctors to believe that he had a problem with his hormones, and that doctors had referred him appropriately at that time. When Mr A complained of different symptoms, which could have indicated cancer, his GP then asked him to complete a form to arrange an x-ray. The practice were unable to reach Mr A by phone and Mr A either did not receive the letter sent to him, or did not respond to it. When Mr A re-attended the practice it was noted that the x-ray request had not been returned and he was referred urgently to hospital that day. The adviser said that this was reasonable.

We accepted the advice we received and we did not uphold the complaint.

Summary

Mr C was referred to the orthopaedic department at Glasgow Royal Infirmary after he suffered with osteoarthritis (chronic breakdown of cartilage in the joints leading to pain, stiffness and swelling) in the metatarsal phalangeal joint (the second joint from the end) in a toe on his right foot. Surgery was carried out to fuse the joint, but following this Mr C continued to experience pain in the toe. A further procedure was carried out to fuse the interphalangeal joint (the first joint from the end), however, this was not successful and the bones did not fuse together. Surgery was then carried out to remove a broken metal pin from the interphalangeal joint but Mr C continued to experience pain in the toe. After this the board considered that revision surgery was unlikely to be successful and Mr C agreed to the amputation of the toe.

Mr C complained that the first operation was not carried out appropriately. He also raised concern that the board did not provide him with appropriate treatment when he reported ongoing pain, as it had taken over two years following the first operation to resolve his pain. We took independent advice from a consultant orthopaedic surgeon. We found that the first procedure was carried out to a reasonable standard, and we did not find evidence that the first surgery had contributed to the issues Mr C subsequently experienced. We considered that the management of Mr C's treatment following the first operation was appropriate, and we did not consider that there was evidence of any unreasonable delays in Mr C's treatment. We did not uphold Mr C's complaints.

Summary

Ms C, who is an independent mental health advocate, complained on behalf of her client (Mr A) in relation to community mental health (CMH) nursing care Mr A received after discharge from Dr Gray's Hospital. Mr A took a large overdose of alcohol and prescription drugs two weeks after discharge and said that, without the support of his family, he would have completed suicide. In addition to the complaint about nursing care, Mr A also felt that the introduction of occupational therapy (OT) services prior to his discharge could have benefited him and aided his recovery.

We took independent advice from a mental health nursing adviser. We found that the CMH nursing care offered to Mr A had been reasonable. The CMH nurse had visited Mr A within five days of his discharge, which the adviser considered to be good practice. The nurse had appropriately discussed coping strategies with Mr A and had made sure that he was aware of other sources of support available as they were going on leave for two weeks.

The working relationship with the CMH nurse broke down after they returned from leave. Mr A requested a different CMH nurse, but his psychiatrist referred him instead to OT services. This referral was not successful either, again due to problems in the working relationship. We considered that the aftercare provided by the board was reasonable, although the adviser highlighted some shortcomings in the records, which we fed back to the board. The board confirmed that Mr A was involved in his discharge planning, but there was no evidence to support this. Aside from shortcomings in record-keeping, we considered the CMH nursing care provided to Mr A to have been reasonable and we did not uphold Mr C's complaint.

We considered that OT services would largely have overlapped with the support being offered by the CMH team, and saw no evidence to support the complaint that OT input in hospital would have made a significant difference to how Mr A coped post discharge. We did not uphold this complaint.

Summary

Mrs C complained about the care and treatment her husband (Mr A) received during an admission to St Andrew's Community Hospital for a period of rehabilitation. She complained that Mr A's suspected urinary tract infection and delirium were not treated appropriately and with sufficient urgency, thus prolonging his admission unnecessarily. She also raised concerns that he was inappropriately sedated over the weekend prior to discharge.

We took independent advice from a GP adviser who considered that Mr A received appropriate treatment for his infection symptoms and delirium. They noted in particular that his blood results were negative for infection when Mrs C first requested more aggressive antibiotic treatment. The adviser also considered it clinically reasonable to prescribe a sleeping tablet as a trial to treat restlessness at night, although they said that it would have been good practice for staff to have discussed this with Mrs C in advance. The board had already acknowledged that it would have been helpful for this to have been discussed with Mrs C. We accepted the advice received and concluded that the medical care provided to Mr A was reasonable. We did not uphold the complaint.

Summary

Mr C complained that staff at the dental practice had failed to deal appropriately with his concerns that his gums continued to bleed after having four teeth extracted. He was on warfarin medication (a medication to prevent blood clots) which meant that he was at high risk of bleeding. He reported this to the dentist, who said that it would be alright and he could leave the practice. When Mr C got home, the bleeding continued and he contacted the practice again and was asked to attend. He saw a second dentist who also said that he was not to worry and that the bleeding would stop. However, the bleeding continued that evening and Mr C had to attend hospital, where the bleeding eventually stopped and he was sent home.

We took independent advice from an adviser in general dentistry and concluded that the second dentist was aware that Mr C was on warfarin medication and that they had repeated the advice given earlier by the first dentist about what Mr C should do in the event of bleeding from his gums. We considered this to be reasonable and we did not uphold the complaint.

Summary

Mr C complained that dental staff at the practice had failed to deal appropriately with his concerns that his gums continued to bleed after having four teeth extracted. He was on warfarin medication (a medication to prevent blood clots) which meant that he was at high risk of bleeding. He reported this to a dentist, who said that it would be alright and he could leave the practice. When Mr C got home, the bleeding continued and he contacted the practice again and was asked to attend. He saw a different dentist, who also said that he was not to worry and the bleeding would stop. However, the bleeding continued that evening and Mr C had to attend hospital where the bleeding eventually stopped and he was sent home.

We took independent advice from an adviser in general dentistry and concluded that the first dentist was aware that Mr C was on warfarin medication, that they had checked his clotting status prior to the extractions and that they had stitched and packed the tooth sockets following the extractions. The first dentist had also provided Mr C with a detailed post-operative instruction sheet, which provided advice on action which should be taken regarding any bleeding. We did not uphold the complaint.

Summary

Mr C is a mature student who suffers from anxiety. Mr C complained that the college unreasonably failed to provide reasonable adjustments and take seriously his concerns about age and anxiety issues. He also complained the college failed to address his concerns about bullying. Mr C said that his anxiety reached unmanageable levels due to the lack of empathy shown by the college staff. Mr C believes that his college tutor did not properly make the other lecturers aware of his anxiety issues.

We found that, where possible, the college did offer reasonable adjustments to Mr C. Mr C was offered counselling, and the option of moving class was discussed. It was also confirmed that students are offered the opportunity to disclose information about their disability at the point of registering on the course, and we did not see any evidence to suggest that Mr C was unaware of this. We found no evidence that the college tutor did not inform the other lecturers of Mr C's anxiety and we did not find any evidence of bullying. We did not uphold Mr C's complaints.

Summary

Mr C was a student on a placement at an organisation outside the university. He felt that he was bullied by staff at the organisation where he was on placement and complained to the external organisation. They investigated, and found that Mr C had been mistreated while on placement. Mr C was unhappy with the university's role in what happened and complained to them. Mr C remained unhappy and brought his complaints to us. He complained to us that the university had failed to follow their Dignity at Work & Study Policy and Procedure during his placement, that they had unreasonably provided incorrect information to the external organisation about his reports of mistreatment during placement, and that the university had handed his complaint in an unreasonable way.

We found that the university's Dignity at Work & Study Policy and Procedure outlined what a student or university staff member should do if they thought they were being subjected to bullying by students, members of university staff, or contractors and suppliers. It did not include a specific provision for students on placement who thought they were being subjected to bullying by a member of staff employed by the placement provider. Given this, we found that the policy did not apply in Mr C's circumstances and we did not uphold this part of the complaint.

We found that information about Mr C's reports of mistreatment was provided by the university to the external organisation in a phone call. Given this, we could not prove exactly what was discussed and whether the information was incorrect. Therefore, we did not uphold the complaint.

We found that the university's investigation report on Mr C's complaint was a reasonable reflection of the relevant evidence from him, university staff, and the external organisation. The report responded to each of the main points of Mr C's complaint and reached reasonable conclusions on them. We therefore considered that the university had handled Mr C's complaint in a reasonable way and we did not uphold this part of the complaint. However, in their investigation report about the complaint, the university had made a number of recommendations. Given the importance of the university learning from complaints to improve their service, we requested that they send us evidence that these recommendations had been implemented.