Health

Overview

The complainant (Mrs C) raised a number of concerns about the way her late mother, Mrs A, had been assessed and treated on three occasions at the Accident and Emergency Department (the Department) at Ninewells Hospital in March and April 2004.

Specific complaint and conclusion

The complaint which has been investigated is that Mrs A was inadequately assessed and had been inappropriately discharged from the Department on three occasions (upheld).

Redress and recommendations

The Ombudsman recommends that, as a matter of urgency, the Board undertake an audit of all of the Departmental nursing documentation including observation charts in use in the Department and conduct a review of the chest pain protocol and advise her of the outcome.

The Board have accepted the recommendations and will act on them accordingly.

Overview

The complainant (Mrs C) raised a number of issues regarding her treatment and care following an ankle fracture.

Specific complaints and conclusions

The complaints which have been investigated are:

• (a) failure by the Consultant to align properly Mrs C’s broken ankle (upheld);
• (b) Mrs C’s concerns about the alignment had been dismissed by medical staff at the time (upheld); and
• (c) failure by medical staff to provide appropriate advice to Mrs C on managing her injury (upheld).

Redress and recommendations

The Ombudsman recommends that:

• (i) the case be discussed at the Consultant's next annual appraisal;
• (ii) the Board provide evidence that their records have been submitted to scrutiny, via audit, and address the problems identified in this report in record-keeping; and
• (iii) the Board introduce a protocol on providing advice to patients on managing plaster cast injuries.

Overview

Mrs C was concerned that her late husband, Mr C, was only diagnosed as suffering from non-Hodgkins Lymphoma shortly before his death.

Specific complaint and conclusion

The complaint which has been investigated is that there was a delay in the diagnosis of Mr C's non-Hodgkins Lymphoma (not upheld).

Redress and recommendations

The Ombudsman has no recommendations to make.

Overview

The complainant raised a concern that her mother (Mrs A) had been refused NHS Continuing Care Funding by Lothian NHS Board.

Specific complaint and conclusion

The complaint which has been investigated is that Mrs A was unreasonably refused NHS Continuing Care Funding (not upheld).

Redress and Recommendations

The Ombudsman has no recommendation to make.

Further Action

This and other complaints to the Ombudsman indicated an urgent need to review the guidance on NHS Continuing Care Funding which was issued more than 11 years ago.  This is not a matter which an individual Health Board is able to address so cannot be resolved within this report.  The Ombudsman has previously drawn this matter to the attention of the (then) Scottish Executive Health Department and has now been informed that a review of this policy is underway with the intention that it will report in January 2008.  In light of this action this office has formally suspended consideration of any further complaints raised with us on this matter pending the outcome of the review by the Scottish Government Department of Health and Wellbeing.

Overview

The complainant, Mr C, raised a number of concerns about the podiatry treatment he received while he was recovering from a stroke.

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a) staff at Liberton Hospital did not take his speech and mobility problems into account before giving him treatment and pain relief was not discussed with him, as a consequence of which he suffered extreme discomfort (upheld);
• (b) pain relief was not offered at the local podiatry clinic, where he was referred for further treatment (not upheld); and
• (c) reception staff were unhelpful (no finding).

Redress and recommendations

The Ombudsman recommends that for stroke patients like Mr C who are receiving podiatry treatment, the Board discuss, and record, the situation with regard to pain relief.  Furthermore, that they emphasise to reception staff the importance of good communication and, if information is required when attending for appointment (however that appointment is made), to be clear with patients about this.

The Board have accepted the Ombudsman's recommendations and will act on them accordingly.

Overview

The complainant (Mrs C) raised a number of concerns about the care and treatment of her late husband (Mr C) and the handling of his complaint about that care and treatment by Lothian NHS Board (the Board).

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a) Mr C was prematurely discharged from the Royal Infirmary of Edinburgh (Hospital 1) on 16 September 2005 (upheld);
• (b) the Board failed to provide Mr C with appropriate and timely care and treatment between 27 September 2005 and 6 October 2005 (upheld); and
• (c) the Board failed to make an adequate response to Mrs C's complaint (upheld).

Redress and recommendations

The Ombudsman recommends that the Board:

• (i) inform her of progress towards achieving the objectives set out in paragraph 16 of this Report; and
• (ii) make a written apology to Mrs C for the failure to maintain proper records and the additional distress this has caused to Mr C's family in pursuing this matter.

The Board have accepted the recommendations and agreed to act on them accordingly.

Overview

The complainant (Ms C) raised a number of concerns about her mother (Mrs A)'s care and treatment at Aberdeen Royal Infirmary (the Hospital).  In particular, she wondered whether Mrs A's cancer could have been diagnosed a few months earlier and whether this would have affected the sad outcome for her mother, who died, aged 60, in October 2005, the day after being temporarily discharged whilst waiting for the result of a biopsy.

Specific complaint and conclusion

The complaint which has been investigated is that Mrs A's care and treatment at the Hospital from July 2005 to October 2005 were inappropriate (not upheld).

Redress and recommendations

The Ombudsman has no recommendations to make.

Overview

The complainant (Miss C) raised a number of concerns about her late uncle (Mr A)'s care at Ninewells Hospital (the Hospital), to which he was admitted on 20 December 2005 and where he died on 25 December 2005, aged 62.

Specific complaint and conclusion

The complaint which has been investigated is that Mr A's care in December 2005 fell below a reasonable standard (upheld).

Redress and recommendations

The Ombudsman recommends that Tayside NHS Board (the Board):

• (i) put in place a policy, protocol or guidance in relation to infective exacerbations of chronic lung disease;
• (ii) advise urgent contact from clinical staff to carers in particularly grave situations and, more generally, encourage proactive communication from clinical staff to patients and their carers;
• (iii) provide evidence of the systems in place to monitor and audit nursing records; and
• (iv) provide evidence of the main improvements which they have made in the standard of care as part of their 'safer patient' initiatives.

The Board have accepted the recommendations and will act on them accordingly.

Overview

The complainant (Ms C) raised concerns about her care and treatment by a consultant (Consultant 1), information that was included in a letter and subsequent effect on her medical care as a result.

Specific complaints and conclusions

The complaints which have been investigated are that:

• (a) Consultant 1's medical treatment of Ms C was inadequate (not upheld);
• (b) Consultant 1 wrote a letter to Ms C's GP containing information Ms C had advised was incorrect (upheld); and
• (c) Consultant 1's comments had a negative influence on other medical practitioners involved with Ms C's case (not upheld).

Redress and recommendations

The Ombudsman has no recommendations to make.

Overview

The complainant (Mr C) considered that his GP Practice (the Practice) failed to diagnose and treat his illness and he was unhappy that the Practice decided to no longer provide medical treatment to him, his brother and his father.

Specific complaints and conclusions

The complaints which have been investigated are:

• (a) the alleged failure to diagnose and treat Mr C's illness (not upheld); and
• (b) that the decision by the Practice to remove Mr C and his family from their list was wrongly taken (upheld).

Redress and recommendations

The Ombudsman recommends that the Practice:

• (i) apologise in writing to Mr C, his brother and his father for the failure to follow the appropriate procedures when taking the decision to remove them from the Practice list; and
• (ii) review how it takes such decisions in light of The National Health Service (General Medical Services Contracts) (Scotland) Regulations 2004, and ensure that Practice policy and actions are compliant with this Statutory Instrument.

The Practice have accepted the recommendations and will act on them accordingly.  The Ombudsman asks that the Practice notify her when the recommendations have been implemented.