Not upheld, no recommendations

Summary

Mr C complained about the care and treatment his wife (Mrs A) received at Dunbar Hospital. Mr C and Mrs A had just moved to the area and had not yet registered with a local GP practice when Mrs A became unwell with flu-like symptoms. NHS 24 advised her to attend Dunbar Hospital, where she was diagnosed with a respiratory infection and prescribed antibiotics. Mrs A had two further attendances and phone contact with the hospital, before registering with a local GP. The GP diagnosed pneumonia, prescribed a new course of antibiotics and subsequently arranged an emergency admission to a different hospital for treatment.

Mr C complained that the doctor who initially assessed Mrs A at Dunbar Hospital failed to diagnose her pneumonia. He also complained that Mrs A was assessed by nursing staff on her subsequent attendances at the hospital and not a doctor, despite his understanding that the plan was for further medical review. In addition, he complained that the nurse Mrs A spoke to when she phoned Dunbar Hospital did not make appropriate arrangements for her to be seen by a doctor and simply advised her to register with a local GP.

We took independent advice from both a GP and a nurse. Both advisers considered that the respective assessments of Mrs A were reasonable and they considered it appropriate for her to have been advised to register with a local GP. They noted that the out-of-hours service at Dunbar Hospital is for emergency care when GP surgeries are closed. They also noted that routine follow-up and the arrangements of tests is usually carried out by the GP. The GP adviser considered that Mrs A's initial diagnosis and treatment were appropriate and noted that the treatment would have been the same if pneumonia had been suspected initially. We did not uphold this aspect of the complaint.

Mr C also raised concerns that the board's response to his complaint contained a number of inaccurate and misleading statements. In particular, he considered that it inappropriately contained continual reference to the GP registration issue and that the response did not justify the poor quality of care that he considered was provided by Dunbar Hospital. We reiterated that we found the advice to register with a GP to have been appropriate and we found no evidence to support Mr C's concerns that the detail of the board's response was inaccurate or misleading. We did not uphold this aspect of the complaint.

Summary

Ms C complained on behalf of her mother (Mrs A) about the way her medical practice managed the medication for her thyroid condition. Mrs A had a condition called hypothyroidism (where the thyroid gland is underactive and does not produce enough thyroxine hormone) and had received treatment for this for a number of years. Mrs A had attended the practice for a blood test to measure her levels of thyroxine. When the test results showed that her thyroxine level was too high, a GP at the practice advised Mrs A to stop taking her thyroxine replacement medication and to attend the practice in six weeks to have the levels checked again.

Shortly before Mrs A was due to return to the practice, she had a seizure and was hospitalised. Doctors at the hospital concluded that the seizure was caused by profound hypothyroidism following the withdrawal of thyroxine medication. Ms C complained that the medication should have been reduced more gradually and that follow-up tests should have been arranged sooner than they were. She also complained that Mrs A was not informed of the side effects of withdrawing the medication.

We took independent advice from a GP adviser who said that there were a number of risks associated with high thyroxine levels. In view of this, they considered that the GP's decision to cease thyroxine medication and review Mrs A in six weeks was reasonable. They did not consider that Mrs A's rapid development of hypothyroidism followed by a seizure was predictable, and noted this was a rare complication of her condition. While there was no evidence that discussion of side effects had taken place, the adviser did not think it was unreasonable had the GP not discussed the rare complications of a seizure in the circumstances of this case. We did not uphold this complaint.

Summary

Ms C made a number of complaints to us about the care and treatment she received from the board's community psychiatric nurse (CPN) service. Her complaints included concerns about the allocation of a CPN and discharge arrangements. She also complained about the board's handling of her complaint.

We took independent advice from a mental health nurse and from a consultant psychiatrist. Ms C complained that the board had arranged a meeting without her consent after she made a complaint about a support worker. We found that the board's records indicated that Ms C had agreed to the meeting and we did not uphold the complaint.

Ms C also complained that the board had unreasonably allocated her a CPN that she could not work with. We found that it had been reasonable for the board to appoint this member of staff as Ms C's CPN. We did not uphold this aspect of her complaint.

Ms C complained that the board refused her support from a CPN that had previously been agreed. We found that staff had met Ms C to discuss the support she needed from CPNs. They then arranged to speak to her consultant psychiatrist to clarify what had been agreed. The psychiatrist said that this matter should be discussed at her next review meeting. We considered this had been reasonable and did not uphold this aspect of her complaint.

Ms C complained that she had then been discharged from the CPN service. We found that given the support she was receiving from other agencies at that time, there was no need for CPN involvement in her care. We did not uphold this complaint.

Finally, Ms C complained to us about the board's handling of her complaint. She said that she considered that the board should have contacted her mental health officer to discuss her complaints. We found that it had not been necessary for the board to do so to investigate the complaints. We did not uphold this aspect of Ms C's complaint.

Summary

Mr C complained to us that the practice had failed to manage his medication in an appropriate manner. He had been on pramipexole medication (used as treatment for Parkinson's disease and restless legs syndrome) for four years and he said that during that period the practice had not reviewed the medication. Mr C said that the practice had also increased the medication dosage without telling him and that he had experienced severe side effects. Mr C felt that the practice should have kept the medication under review and informed him of the change in dosage.

We took independent advice from a GP adviser. We found that, during the period in question, Mr C had not reported to the practice that he was having side effects from the medication. The practice had invited Mr C to attend for a review of his medication on five occasions, but he had not responded. Mr C was also reviewed on two occasions when he attended the practice to discuss other clinical matters. We also found that it was appropriate for a pharmacist to advise Mr C of the increase in the dosage of the medication, rather than have him make an appointment with a GP. We did not uphold Mr C's complaint.

Summary

Ms C, an advocacy and support worker, raised a complaint on behalf of her client (Mr A) about the care and treatment he received for a bunion from Golden Jubilee National Hospital. Specifically, she complained that appropriate surgery was not carried out, that the cause of infection following surgery was not properly investigated and that Mr A had not been advised of the problems which could occur with the surgery.

We took independent advice from a consultant orthopaedic trauma surgeon and found that there was evidence to support that discussion had taken place with Mr A about the recognised complications associated with the bunion surgery. Some of these included the possible risk of non-healing and a need for further surgery. We considered that the surgery was appropriate and that, whilst there was no clear evidence of infection post-surgery, it was appropriate to consider the possibility of infection when Mr A experienced problems following his surgery. We noted that the board had apologised to Mr A regarding the lack of communication about this. We concluded that there was no evidence of unreasonable treatment and that delayed healing had been the likely reason for Mr A's protracted recovery. We did not uphold the complaint.

Summary

Mr C attended his GP practice because he was concerned that he may have Lyme disease (an infection transmitted by ticks). He said that the practice failed to follow reasonable process in diagnosing him with Lyme disease. He was prescribed antibiotics on two occasions, some months apart. Mr C said that a GP had failed to note in his medical records that he had a reaction eight days into the second course of antibiotics, which Mr C said was crucial evidence that he had the disease. As a result of the practice's failure to recognise Mr C had Lyme disease, he said that he was concerned for his future health. Mr C also complained that the practice had failed to provide reasonable explanations in their response to his complaint.

We took independent advice from a GP adviser. We found that the treatment decisions and investigations carried out by the practice were reasonable in light of the symptoms Mr C presented with. We found that it was reasonable that the practice referred Mr C to several specialists, who did not confirm that Mr C had Lyme disease. We were satisfied that the standard of medical care and treatment was reasonable and we did not uphold the complaint.

In relation to complaints handling, we found that the practice properly explained the rationale behind the decision-making on treatment and managing Mr C's symptoms, and that the responses were fair and appropriate. We did not uphold the complaint.

Summary

Mr C, who works for an energy management company, complained on behalf of his client about their premises. Mr C complained that Thames Water had unreasonably rejected his request to amend the rateable value (RV) of his client's premises. Mr C maintained the RV should be lower than that being applied by Thames Water. Mr C stated that the RV being used was contrary to the Scottish Water wholesale scheme of charges.

We took independent advice from a water adviser. We found that while there had been errors in maintaining the RV of the premises prior to Thames Water taking over as supplier of water services, the correct RV of the premises was being used by Thames Water. We found no evidence to support Mr C's position that the RV should be set at a lower rate than it was. We did not uphold the complaint.

Summary

Mr C complained about Disclosure Scotland after they issued a disclosure certificate showing him to have a criminal conviction. He complained that Disclosure Scotland unreasonably associated his details with those of another person with a conviction.

Disclosure Scotland apologised and rectified the certificate, but the error had resulted in Mr C losing his job and struggling to find employment. They maintained that they had followed their procedures correctly and had not made any error in processing his application.

We found that Disclosure Scotland had correctly checked the information provided by Mr C against the Police National Computer, and that his details had been correctly associated with someone with a criminal conviction. Their disputes process is set out in the Police Act 1997, and requires applicants to provide fingerprints to dissociate themselves from the person with a conviction where there is a dispute regarding identity. Mr C refused to provide his fingerprints, which meant the dispute was unnecessarily protracted.

We found there had been no maladministration by Disclosure Scotland and did not uphold the complaints.

Summary

Ms C complained to the council about her neighbour's dog barking. Ms C believes her neighbour is keeping more dogs at their home than they have permission for. She told us she felt the council did not take her concerns seriously and they did not follow the procedure they advertise on their website. The council responded to her complaint and told her that the Safer Neighbourhood Team does not deal with dog barking. The council advised Ms C that she has the option to pursue private legal action.

Our investigation found no evidence that the council failed to take the appropriate action in line with their policies. The council were not able to take further action as they required independent evidence of the dog barking. We did not uphold this complaint. Our investigation did find the information provided on the council's website was out of date. They informed us that they had already made some changes, but we found that there was still come incorrect information on the website and we asked that they send us evidence that they have corrected all of the conflicting information.

Summary

Mr C complained that the council had advised him to submit a building warrant application without first reviewing information he had previously submitted. He also complained that the council accepted his building warrant application before ensuring that all necessary information had been submitted. He was also concerned that, once the building warrant application had been submitted, it took the council a considerable time to issue his building warrant. He felt this delay was unreasonable.

The council responded to Mr C's complaint and explained that, because his plans included a drainage system which was untested in the UK, the council were unable to assess this aspect of the application at the pre-warrant stage and this was why Mr C was encouraged to submit his application for a building warrant. They acknowledged that following the submission of the application it took a considerable time for the building warrant to be issued. However, they explained that this was because they had to consult with other external agencies to seek opinions on the suitability of the drainage system. As soon as they obtained responses from these consultees, they approved the building warrant. Mr C was unhappy with this response and brought his complaint to us.

We considered the information provided by both parties. We noted that the drainage system proposed was new and untested, and we noted the considerable work undertaken by the council to seek approval for this system. We were satisfied that it was reasonable for the council to advise Mr C to submit his warrant application to allow the drainage issues to be considered in more detail and we noted the time taken for the council to obtain responses from consultees. We did not find evidence of administrative failure in the way the council dealt with this matter and, as a result, we did not uphold Mr C's complaints.