Not upheld, no recommendations

Summary

Mr C complained to the council as he was not happy with their response to his repair request relating to damp in his property. Mr C had previously experienced damp in the property and the council had attended and made repairs. The problem returned approximately six weeks later and Mr C had reported it again to the council. They attended the property and it was found that the cavity wall insulation had deteriorated. The council arranged to have this replaced.

Mr C was of the view that the poor quality of the cavity wall insulation was the main cause of damp in the property, and he believed this should have been identified and remedied by the council sooner. Mr C complained to us that the council had failed to respond reasonably to his requests for repair, and that they had dealt unreasonably with his subsequent complaint.

We found that the council had responded to the repairs within reasonable timescales, and that the options they had explored to treat the damp before having the cavity wall insulation replaced were reasonable. We did not uphold this aspect of Mr C's complaint.

With regards to complaints handling, whilst we found that the council's response to Mr C's stage one complaint had been late and they had not apologised for this, we found that the complaints handling was reasonable overall. We did not uphold this aspect of the complaint, but we did offer feedback to the council to stress that, if a complaints response is going to be outwith the timescale, then complainants should be notified where possible, and apologies for this should be provided.

Summary

Mr C complained about rechargeable repairs he was billed for after he vacated his tenancy. Under the terms of his tenancy agreement he was responsible for any damage caused and any items left in the property. He was charged for removal of items, repairs to doors and cleaning and redecoration throughout.

We found that Mr C had been properly advised of his responsibilities. We further found that the condition of the property was beyond what could be considered fair wear and tear. We did not uphold the complaint.

Summary

Mr C complained about the care and treatment he received from the board in relation to his mental health whilst he was in prison. We took independent advice on the complaint from a consultant psychiatrist. We found that the care and treatment provided to Mr C had been reasonable. He had received mental health nursing reviews, a full psychiatric assessment and had also seen a number of other healthcare staff. The management of his medication had also been reasonable. Whilst there had been a delay in arranging for Mr C to see a psychiatrist, we found that this was not unreasonable. He saw other healthcare staff during this period and they discussed his care with the psychiatrist and put interim measures in place. We did not uphold this aspect of Mr C's complaint.

Mr C also complained that staff in the prison health centre failed to provide appropriate treatment in relation to his cellulitis (an infection of the deeper layers of skin and the underlying tissue). We took independent advice on this aspect of his complaint from a GP adviser. There was no evidence in Mr C's medical records that he had cellulitis, although the records showed that he had been treated for scabies. We found that the care and medication provided by the board in relation to scabies had been reasonable and we did not uphold this complaint.

Finally, Mr C complained that the board had failed to respond appropriately to his complaints. We found that Mr C had made a large number of complaints. Whilst there had been some delays by the board in responding to these complaints, these delays had not been unreasonable. We considered that the board had issued a reasonable response to the issues Mr C had raised and did not uphold this aspect of the complaint.

Summary

Ms C complained about the medical practice on behalf of her five-year-old son. Ms C complained that the GP failed to diagnose her son's tonsillitis over the course of two appointments. Ms C told us that the GP should have diagnosed tonsillitis rather than referring her son to the paediatric team at a hospital in the board's area. The practice advised that, at the first appointment, the GP had been able to examine Ms C's son, despite him being upset. The GP did not observe any infection, and based on his symptoms, diagnosed Ms C's son with hand and mouth disease. At a second appointment, the GP examined Ms C's son. At this appointment the GP had not been able to take all of the measurements they had wanted to during the consultation. As a result, the GP felt that the diagnosis was unclear and referred Ms C's son to the paediatric team at the hospital. Ms C also complained that the GP refused to arrange an ambulance to transport her son to the hospital. The GP offered patient transport, however Ms C felt that this was not suitable as it would have taken too long.

We took independent GP advice. The adviser examined the records and confirmed that the GP examined Ms C's son in line with General Medical Council (GMC) guidance. The adviser confirmed that it was appropriate for the GP to refer Ms C's son to the hospital given that he was presenting with persistent symptoms. The adviser also confirmed that the GP's actions regarding transport to the hospital were appropriate as ambulances should only be used in an emergency. We found no evidence that the GP had failed to provide the appropriate clinical treatment. We did not uphold this complaint.

Summary

Mr C complained to us that staff at the dental practice unreasonably informed him that he was exempt from NHS charges for dental treatment. Mr C said that, when he started a course of dental treatment at the practice, he told the staff that he was in receipt of carer's allowance and they completed a form and said that he would be exempt from NHS treatment costs. He was subsequently contacted by NHS Counter Fraud Services who said that he had fraudulently claimed exemption as he had completed the form stating that he was in receipt of income-based Jobseeker's Allowance, which was not the case. Mr C was asked to pay the costs of the NHS treatment along with a penalty charge. He maintained that while he had signed the form, he had not ticked the box which stated that he was in receipt of income-based Jobseeker's Allowance.

We took independent advice from an adviser in general dentistry and concluded that there would have been a discussion with staff about whether Mr C was exempt from charges. There was reference in his dental records that Mr C thought he was exempt from charges as he was a full time carer. We were unable to establish who had ticked the box to indicate that Mr C was in receipt of income-based Jobseeker's Allowance, but the form did contain Mr C's signature. The staff maintained that they would not have ticked the box as they do not know the patient's financial situation and that the onus was on the patient to ensure that they were signing a form which was accurate. It was noted that following Mr C's representations, NHS Counter Fraud Services had waived the penalty charge aspect and therefore he was only liable to pay the costs of the dental treatment. We did not uphold the complaint.

Summary

Mrs C complained on behalf of her daughter (Mrs A) about the care and treatment provided to Mrs A at Raigmore Hospital. In particular, she complained that the board had failed to provide reasonable care and treatment when Mrs A had first attended the breast clinic at Raigmore Hospital and that Mrs A's breast cancer, which was diagnosed a few years later, may have been present at the initial consultation. Mrs C also complained that the board had unreasonably delayed in carrying out genetic testing.

We took independent advice from a consultant breast surgeon. We found that the care and treatment provided to Mrs A had been reasonable and that there had been no delay in diagnosing Mrs A's breast cancer. We also found that there had been no missed opportunities by the board to have diagnosed the cancer earlier. We did not uphold this aspect of Mrs C's complaint.

We also found that there had been no indication for genetic testing when Mrs A first attended the breast clinic and that there had been no red flag criteria to prompt genetic testing at that time. As such, we did not uphold this part of Mrs C's complaint.

Summary

Mr C complained on behalf of his wife (Mrs A) about the behaviour of a consultant psychiatrist towards Mrs A at an appointment at Braeside Day Centre. Mr C also complained about the way the board had handled complaints that Mrs A had raised.

We found that the psychiatrist's account of what happened at the appointment differed from Mr C and Mrs A's account. There were no independent parties present at the appointment. In the absence of any independent evidence, we could not prove what was said at the appointment. This meant that we could not reach a finding on this part of Mr C's complaint and, therefore, we did not uphold this aspect of the complaint.

We found that the board's handling of Mrs A's complaints was reasonable, and that their response letter to Mrs A was also reasonable. We did not uphold this part of Mr C's complaint.

Summary

Mr C was unhappy that the doctor in the prison health centre decided that his prescription for pregabalin medication (medication used to treat pain from damaged nerves) would be reduced. He was also unhappy that, shortly after this, the decision was made to stop the medication entirely as a result of a failed spot check. The following month the medication was restarted, but on a supervised, reduced dosage. Mr C was concerned about this as he said that this medication was very important in helping him manage pain. He complained to us that the board unreasonably reduced his dose of pregabalin.

We took independent advice from a GP. The adviser explained that the decision to prescribe this medication is a clinical one based on the patient's need and the medical assessment. It is not prescribed based on a patient's request and, in this case, the adviser considered that there had been no clinical failings. The adviser also noted that the decisions had been in line with the relevant policy and were also in line Mr C's medication contract, which said that medication would be stopped if a spot check was failed. We did not uphold this complaint.

Summary

Mrs C complained about the care and treatment provided to her late husband (Mr A) at Queen Elizabeth University Hospital.

Mr A attended the board's respiratory clinic over the course of a number of months. The board's consultant respiratory physicians were concerned that Mr A was suffering from mesothelioma (a rare type of cancer that is linked to asbestos exposure). The board arranged for blood tests, a scan, and a biopsy. The results showed no evidence of cancer. However, the consultant remained concerned about this. Mr A's condition deteriorated over the course of the following months, and the consultant said that while a diagnosis of mesothelioma was not proven, it was very likely. The board made arrangements for oxygen therapy for Mr A, however his condition deteriorated and he suffered a cardiac arrest and died.

Mrs C complained that the board failed to give Mr A a firm diagnosis of mesothelioma within a reasonable timeframe. She also raised concerns about a nurse failing to visit after the oxygen for oxygen therapy was delivered to Mrs C and Mr A's house. Mrs C also complained that the board did not communicate the severity of Mr A's illness to his family.

We took independent advice from a consultant respiratory physician and from a nurse. We found that there are recognised difficulties with diagnosing mesothelioma. We found that the board conducted appropriate investigations, but also balanced their concerns about mesothelioma with the possibility that Mr A was suffering from a different condition. We found this to be reasonable. Regarding Mrs C's concerns about nursing staff, we found that there were limited records available to suggest that staff had advised that they would attend. We found that whether nursing staff will follow up in these circumstances is dependent on local arrangements, and that it was reasonable not to arrange a follow-up. In relation to Mrs C's concerns about communication, we found that there were records which suggested that staff had attempted to explain the situation to Mrs C and Mr A. We did not uphold Mrs C's complaints.

Summary

Ms C, who is an advocacy and support worker, complained on behalf of her client (Mr A) regarding the care and treatment he received at the medical practice. In particular, she complained that the practice did not do more to assist Mr A in obtaining a clear diagnosis and appropriate treatment for his mental health difficulties. This included concerns that Mr A's repeated requests for cognitive behavioural therapy (CBT) were not actioned.

We took independent medical advice from a GP, who considered that the practice arranged appropriate referrals for Mr A to mental health services. They noted that the specialists involved in these clinics had shown reluctance to give a specific diagnosis. They observed from one of the clinic letters that a psychiatrist had suggested a CBT approach and, while this did not appear to have progressed, they said it was not the role of a GP to follow up treatment plans arranged by a separate specialty. The adviser concluded that the care provided to Mr A by the practice was reasonable. We accepted this advice and did not uphold this aspect of complaint.

As Mr A had moved to a new GP practice, the practice were only able to access his electronic records and not any older paper records. Ms C also raised concerns that the complaint was not fully investigated as all medical records were not accessed. The practice considered that they had enough information to respond to the complaint and the adviser agreed that sufficient records were accessible to enable a response to the concerns and queries raised. We concluded that the practice's investigation was reasonable and proportionate to the issues raised and we did not uphold this aspect of the complaint. We noted that the practice had failed to provide details of our office in their complaint response, but they acknowledged this and we were satisfied that this had since been appropriately addressed through the revision of their complaints handling procedure.