Not upheld, no recommendations

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.

Summary

Mr C complained that, following his discharge from hospital, his medical practice unreasonably failed to contact him for more than 48 hours, and unreasonably failed to carry out a home visit despite his request for one. The practice responded to his complaint by apologising for any lack of care which Mr C felt he had received, but explained that the discharging unit at the hospital usually take responsibility for co-ordinating with community care and district nursing teams. They also noted that where there was a medical need for immediate post-discharge medical input, hospital clinicians would usually communicate this directly to the practice. We noted that Mr C requested a home visit when on the way home from hospital by visiting the practice and dropping off a letter.

We took independent advice from a GP adviser. The adviser reviewed Mr C's medical records and said there was no indication that a house visit was necessary, as it appeared that Mr C was able to attend the practice for an appointment. The adviser also noted that the decision whether or not to offer a home visit lies with the clinician, and should be based on clinical need. The adviser confirmed that it is not routine practice for GPs to contact patients who have been discharged from hospital once they have returned home, although they may do so following a review of the patient's discharge medication and history. The adviser noted that in this case the practice had reviewed Mr C's medication and history and contacted him by phone within 48 hours of his request and considered this reasonable.

The adviser also commented that if there was a clinical need for contact from the GP, this would have been detailed on the discharge letter from the hospital. There was no request for contact in Mr C's discharge letter. It was unfortunate that reception staff at the practice did not make clear to Mr C that home visits would only be carried out on the basis of clinical need, and by phone request on the day. However, we were satisfied that the evidence suggested that a home visit was not required, and that the time taken by the practice to contact Mr C following discharge was reasonable. We did not uphold this complaint.

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Mrs A) about the care provided by the practice following a phone consultation. The day following her discharge from hospital for heart bypass surgery, Mrs A called the practice for advice. A GP called her back a short time later and discussed medication with her. At this time, Mrs A reported a clicking sensation in her chest. The GP reassured her about this sensation and advised her to contact the practice again if she became more unwell. Mrs A's condition deteriorated later that day and she was admitted to hospital, where she was treated for an infection.

Ms C raised concern that the GP did not identify that Mrs A had an infection and felt that a home visit should have been carried out. We took independent advice from a GP adviser. Whilst they noted that the GP's clinical record of the consultation was brief, on balance, the adviser considered that the assessment and care provided was reasonable. We accepted this advice and we did not uphold this complaint.

Summary

Mr C complained that the Scottish Prison Service (SPS) failed to appropriately handle his request to have his legal agent's phone number added to his prison phone account. He also complained that the SPS failed to respond appropriately to his complaint about this.

Mr C said that he submitted the appropriate form with details of his request but that the SPS did not have any record of having received it. The SPS said that they only became aware of Mr C's request after an officer, who received a complaint from Mr C, called the business support team to notify them. Mr C said the officer who responded to his complaint indicated that he could call his lawyer, and Mr C said he felt this response indicated that any calls made would be confidential. However, the business support team added Mr C's legal agent's phone number to his account, but because the details could not be verified in the normal way, the number was added as allowed but not private. This meant that any calls made by Mr C to his legal agent could be recorded. The SPS said that they told Mr C that the number would only be added as private when sufficient evidence was provided by him to confirm that the phone number was in fact for his legal agent.

We found that the SPS had handled Mr C's request appropriately and in line with the normal process. We were also satisfied that the SPS had responded appropriately to Mr C's complaint. Therefore, we did not uphold his complaints.

Summary

Miss C complained about the way the council dealt with her complaint to them. She was also was unhappy that the council had issued warnings following an investigation into allegations of anti-social behaviour.

We were satisfied that the council demonstrated that a fair and balanced investigation into complaints of anti-social behaviour had taken place and that their discretionary decision to issue warnings was in line with their procedures.

We were also satisfied that the council could demonstrate that a full investigation of Miss C's subsequent complaint had taken place and that their letter explaining their decision was reasonable. As a result of our findings, we did not uphold Miss C's complaints.

Summary

Mr C complained about a planning application for a residential development of houses close to his own. He was concerned about the way the council considered, and then approved, the application. Mr C said that insufficient information was made available to allow the public to make informed objections and that his privacy had been overlooked to the benefit of the developer. Mr C also said that the council did not give proper consideration to their existing policies. During the build, the developer constructed a site office without the benefit of planning permission, and they advertised properties for sale. Mr C brought this to the council's attention but said that they failed to take appropriate action and did not require the developer to stop works. Mr C said that council officers allowed the developer to make a retrospective planning application for the site office, which Mr C felt was to his disadvantage. Mr C also complained about the way the council dealt with his subsequent complaints.

The council took the view that they had provided sufficient information about the planning application for the residential development and that, in deciding it, had taken into account Mr C's objections. The council said that they had noted and looked into Mr C's concerns about the site office. They had contacted the developer about a number of issues and made a site visit. Following this, it was decided that a retrospective planning application was to be submitted and Mr C would be kept updated. It was also agreed that council officers would continue to monitor the site office. Mr C remained dissatisfied and complained to us.

We took independent planning advice and we found that, in accordance with relevant guidance, the council had provided sufficient information for the application for the residential development to be considered reasonably and appropriately. We found that, after Mr C had reported concerns about the unauthorised building of the site office and the use of this site to advertise properties for sale, the council had looked into the matter to ensure that an appropriate planning application was submitted. They did not take enforcement action, but the decision whether or not to do so was a matter for their professional judgement. We considered the council's handling of Mr C's complaints to have been reasonable overall. We did not uphold Mr C's complaints.