Health

Summary

A Getting It Right For Every Child meeting (a meeting with multi-agency representatives in attendance to share information and to identify any potential risks or concerns) was held to discuss the welfare of Mr C's children. He complained that it was improperly convened and did not adhere to relevant protocols. He specifically complained about the actions of a health visitor who worked for the board and convened the meeting. He was unhappy that he had been excluded from the meeting.

We investigated the complaint and took independent advice from an experienced health professional. We found that the health visitor concerned (and, accordingly, the board) acted reasonably and that appropriate guidance was followed. We did not uphold Mr C's complaint.

Summary

Mr C complained about the decision taken by the prison health centre to stop his medication for nerve pain. He said he was told that the medication had been stopped because he was on methadone. In response to his complaint, the board said the prison health centre decided to stop his prescription because they did not think he needed the medication.

We sought independent medical advice from a GP adviser. She reviewed the evidence available and confirmed that Mr C had a history of past and current drug misuse including using a combination of drugs. She said the prison doctor had a responsibility to ensure they were prescribing medication to Mr C safely and responsibly. Our adviser considered that in view of Mr C's drug misuse (including misusing the medication for nerve pain) and the increased risk of addiction, it was appropriate for the prison doctor to try less harmful, alternative drugs for him. The adviser noted that Mr C had been started on an appropriate alternative medication. She said the actions taken by the prison health centre were consistent with General Medical Council guidance and, in her view, the care and treatment provided to Mr C was reasonable.

In light of the evidence available, we did not uphold Mr C's complaint.

Summary

Miss C complained to us about the care and treatment she had received when she attended the A&E department at Forth Valley Royal Hospital. Miss C had gone to A&E after injuring her ankle. She said that she also told staff that she had sickness and diarrhoea, and that she had a rash on her forehead.

Miss C returned to the A&E department two days later with shortness of breath, swelling in the right leg, bruising and a rash. She was assessed as requiring immediate attention and was then diagnosed as having myositis (inflammation of the muscles) caused by group A streptococcus (a bacterial infection). She required treatment in the intensive care unit and several emergency operations, including an above-the-knee amputation of her right leg. She also had surgery on her other limbs.

Miss C said that she had not received reasonable care and treatment when she had first attended the A&E department, and had been seen by an emergency nurse practitioner. We took independent advice from one of our nursing advisers, who is an emergency nurse practitioner. The medical records that were completed when Miss C had initially attended the A&E department only referred to an injury to her left ankle. No other symptoms were documented. We found that it had been appropriate for the emergency nurse practitioner to diagnose and treat this minor injury, and that the care and treatment the nurse practitioner had provided had been reasonable and appropriate. As there was no evidence that Miss C had reported sickness, diarrhoea or a rash when she attended the hospital on the first occasion, we did not uphold the complaint.

Summary

Mrs C complained about the care and treatment her late mother (Mrs A) received at Forth Valley Royal Hospital. Mrs A was admitted with kidney failure and, further to treatment, was discharged eight days later. However, she became ill again the following day and required re-admission. She responded well to treatment, this time for heart failure, but subsequently suffered a sudden heart attack and died. Mrs C raised concerns that the board did not take reasonable account of Mrs A's pre-existing heart problems when treating her kidney failure during her first admission. She felt that this led to them overloading her with fluids, thus contributing to her subsequent heart failure and eventual death. She also questioned the appropriateness of the discharge following Mrs A's first admission, raising concerns that her heart failure should have been detected prior to this and noting that Mrs A had been vomiting on the day of discharge.

We took independent advice from one of our medical advisers, with experience in the acute hospital care of elderly patients with multiple illnesses. He explained that the treatment of kidney failure involves fluids being provided, whereas the treatment of heart failure requires fluid restriction. He advised that a careful balancing act was required where a patient has both kidney and heart problems. He considered that the doctors caring for Mrs A were mindful of this and said the treatment provided to her during both admissions was reasonable. He also considered the interim discharge to have been clinically appropriate at the time. He said Mrs A's sudden heart attack could not have been predicted and was not connected to her treatment. We accepted this advice and did not uphold the complaints.

Summary

Mr C complained that, due to a high staff turnover within the practice, he had been seen by a number of different dentists over the years. He said that each dentist changed his treatment plan and, as a result, his gum disease was never treated. In responding, the practice noted that the staff turnover was outwith their control. They confirmed that a treatment plan should continue from one dentist to the next unless there were clinical grounds for changing it. They did not comment specifically on Mr C's treatment plan as they did not have his records to hand.

We took independent advice from one of our dental advisers. He said the treatment carried out by the various dentists appeared consistent in that the primary aim was to address Mr C's chronic gum disease. He explained that this was a longstanding condition which progressed to the position where loss of the teeth was inevitable, despite the treatment carried out. He concluded that the treatment provided by the practice was reasonable. We accepted this advice and did not uphold the complaint.

We were concerned, however, that the practice had responded to Mr C's complaint about his dental treatment without specifically referring to his dental records. We also noted that their response had not told Mr C that he could complain to us in the event that he remained dissatisfied. In addition, we noted that the practice sent Mr C's original dental records to us and did not use a secure postal method. In light of these observations, we made some recommendations.

Recommendations

We recommended that the practice:

• apologise to Mr C for the identified shortcomings in their handling of his complaint;
• review their handling of Mr C's complaint with a view to making improvements for future complaints handling. In particular, they should ensure that all available information relevant to the complaint is considered as part of their investigation and all complaint issues raised are fully responded to. They should also ensure that the complaint response includes information about the right to refer a complaint to us and our contact details; and
• review their process for handling secure data with a view to avoiding a repeat occurence of the issues raised during the course of this investigation.

Summary

Mrs C complained about the dental treatment she received for a swelling in her mouth, which was subsequently found to be cancerous, and about the delay in referring her to a specialist for further investigation.

When we investigated Mrs C's complaint, we found that she had received the treatment as a private patient, rather than under the NHS. Under our legislation, we are not able to consider complaints about private dental treatment, and we closed our investigation of this complaint.

Summary

Mr C complained that, when his wife (Mrs C) phoned the GP practice for a home visit, the GP should have phoned for an ambulance instead. He also complained that the GP did not arrive at their home for just over an hour.

We took independent advice from one of our GP advisers. They considered that it was clear from the medical records, and from a discussion the GP had with the district nurse who had made a routine visit to Mrs C earlier that day, that there was no reason for an ambulance to have been called on the basis of Mrs C's phone call. We noted that the medical records recorded the call as taking place about half an hour later than Mr C had indicated. However, regardless of the exact time, the adviser considered that the GP had arrived very promptly. When the GP saw and examined Mrs C, the GP felt that Mrs C had a significant infection. In line with relevant medical guidelines, she arranged hospital admission at that time. However, that decision was based on a physical examination, not the phone call. We did not uphold Mr C's complaint.

Summary

Ms C is the mother of a young child who was born with a number of health issues. She complained that when her child was being assessed for support needs, the community paediatric consultant (the consultant) told her, incorrectly, that her child suffered from a particular genetic syndrome. Ms C said that this information was then relayed to other health and social care professionals causing her distress and upset.

We took independent advice from a consultant community paediatrician. We found that there was no evidence to show that the consultant had provided incorrect information and that, as soon as the consultant discovered that incorrect information was being repeated, she took steps to correct it and to advise all concerned. The child was promptly referred to a consultant in clinical genetics to establish a diagnosis. The complaint was not upheld.

Summary

Mr C complained to the board that a health centre providing physiotherapy treatment delayed in referring him for a scan of his spine and in referring him to a special clinic for managing pain (the pain clinic).

In responding to the complaint, the board found that Mr C's GP could have referred him directly for a scan, saving a three-month delay. The board also felt that the time taken for Mr C to be referred to the pain clinic was acceptable.

We took independent advice from two of our medical advisers who reviewed the care and treatment Mr C had received. Our physiotherapy adviser considered that there was evidence that Mr C's treatment was reasonable and that there was no undue delay in him being referred to the pain clinic (given that further investigations and decisions about any surgery needed to take place in the first instance). Our GP adviser also considered that the GP records showed Mr C did not meet the national criteria for direct access to receive a scan. He considered that it was appropriate Mr C was instead referred to a specialist who subsequently made the decision for a scan to be performed. We concluded that Mr C received appropriate care and treatment for his back pain.

Summary

Mrs C complained about one of her mother (Mrs A)'s GPs. Mrs C said the GP should have sent Mrs A to hospital after seeing her at a home visit. Several days later another GP admitted Mrs A to hospital, where she died.

We looked at Mrs A's medical notes and the GP's file on Mrs C's complaint. We also took independent advice from one of our GP advisers. We found that the GP provided appropriate treatment to Mrs A at the home visit, and there were no indications at the visit that Mrs A should have been admitted to hospital as an emergency. We also found that, in the circumstances, Mrs A's deterioration several days later could not have been foreseen at the home visit.

We concluded that the care provided to Mrs A at the home visit was reasonable in the circumstances, and that the GP did not unreasonably fail to send Mrs A to hospital on that day. We did not uphold Mrs C's complaint.