Health

Summary
Mrs C complained to the board about aspects of care and communication when her late husband, Mr C, was a patient at Queen Margaret Hospital on three occasions. Mr C had speech difficulities and although he could understand what was being said to him, he had difficulty expressing himself and Mrs C had to assist him. She was concerned about the failure of staff to listen to her concerns that she believed Mr C had contracted clostridium difficile and that he was frequently moved between wards where staff did not know where he was.

We did not uphold the complaint about a delay in diagnosing that Mr C had contracted clostridium difficile, but we upheld a complaint that communication between the staff and Mrs C was inadequate. The board had already accepted there were communication issues and had undertaken to include its importance in staff training.
 

Summary
In August 2009, Ms C had a fall which resulted in an injury to her wrist and foot. She was referred by her GP to the hospital’s casualty department where wrist was x-rayed. Ms C was diagnosed with a fractured wrist and a cast was applied. The following day, she attended the hospital’s fracture clinic where her x-ray was reviewed by a registrar. The registrar questioned the diagnosis of a fracture and subsequently diagnosed a soft tissue injury. Her cast was removed and replaced with a temporary splint.

Over the next two months, Ms C experienced a great deal of pain and discomfort. She attended the casualty department of the hospital in October 2009 with pain. Her wrist was x-rayed a second time and a fracture was diagnosed. A few days later, Ms C attended the fracture clinic where her splint was replaced and a referral made for physiotherapy. Ms C attended the physiotherapy sessions but as her pain persisted over several months she was referred to a consultant hand surgeon who recommended corrective surgery.

Ms C complained that the failure to diagnose her broken wrist prolonged her suffering and led to a need for surgery. We did not uphold this complaint as we found that the diagnosis and subsequent treatment were reasonable.

Ms C also complained that the board delayed in taking action and that she had to wait too long for surgery. We did not uphold this complaint and found that the waiting time Ms C experienced was considered according to the nature of her injury and was within the NHS target for that type of operation.
 

Summary
Mrs C complained that she was removed from the practice list without warning or reasonable explanation. She also complained that the practice failed to give her advice about, or treat, a leg injury. In addition, Mrs C complained that the practice failed to refer her to appropriate specialists for treatment for ongoing health problems.

We did not uphold the complaint about referral to specialists. We found from looking at the practice's records and taking advice from one of our clinical advisers, that Mrs C was referred appropriately. We also found that, as Mrs C went to hospital for her leg injury, the practice were not responsible for treating it. The practice said they gave Mrs C appropriate advice about her leg injury. However, because they did not have a record of this, we upheld the complaint. We also upheld the complaint that Mrs C was removed from the list without warning, as we felt that the practice could have given one. However, we agreed that the practice had given Mrs C a reasonable explanation when they did remove her from the list.

Recommendations
We recommended that the practice:
• review their practice on making records of telephone conversations, with a view to making records where advice is given to a patient to attend a hospital department, or treatment advice is given; and
• review their policy on removal of patients from the list, to incorporate guidance on providing reasonable warning to patients who might be at risk of removal from the list.
 

Summary
Mr C complained about the treatment his adult daughter, Ms A, received at the Glasgow Southern General Hospital and a local Physical Disability Rehabilitation Unit following a diagnosis of thymus cancer. Mr C had numerous concerns in that Ms A was discharged from hospital in February 2010 with an inadequate care package and that in November 2010, Ms A was told she also had Neuromyelitis Optica (NMO) and her medication was altered. Mr C wondered how the NMO was missed in February 2010 and believed that this had resulted in a serious lapse in Ms A's condition.

We found that in general the treatment which Ms A received was of a reasonable standard and although there was a delay in the diagnosis of NMO this did not affect the treatment regime. While we upheld some of the complaint, we did not find that that board had failed to provide Ms A with suitable on-going care and that a comprehensive care package was in place.
 

Summary
Mr C complained that his mother, Mrs A, had received inadequate care and treatment during two accident and emergency admissions and discharges to a hospital that served a rural area. Mr C was also dissatisfied with the facilities in the wards, staff communication and attitude. Mr C also stated that an out-of-hours doctor wrongly diagnosed Mrs A's medical condition.

Our investigations concluded that Mrs A received proper care and treatment from clinical staff at the hospital. We also concluded that the out-of-hours doctor had not wrongly diagnosed Mrs A's condition. We also found that the board had responded reasonably to Mr C’s complaints.

We did not uphold any of the complaints. However, we did make two recommendations, one about about Mr C's participating in a significant events analysis and one about record-keeping. We noted that before Mr C brought this complaint to us the board had apologised to Mr C for the issues he had raised with them on his mother's behalf.

Recommendations
We recommended that the board:
• ensure that the GP reflects on his procedure regarding the assessment of elderly patients and arranges a Significant Events Analysis (SEA) for this issue; and
• ensure that the GP's written records comply with NHS record-keeping guidelines.
 

Summary
Mr C, an advocate, complained that the board failed to provide reasonable care and treatment to Mr A from March until June 2009 and, as a result, Mr A became increasingly vulnerable and was forced to move to another health board for alternative treatment. Mr A accessed mental health services for treatment when he became mentally unwell in March 2009. Mr C said that the board had failed to diagnose Mr A's psychotic depression and provide appropriate treatment. He also complained about the board's decisions to discharge Mr A on four occasions and that the communication between the board and Mr A and his wife was inadequate. Finally, he complained about a psychiatrist's assessment of Mr A as fit to plead in court and the follow-up arrangements following his final discharge in June 2009. Mr A said that he had moved to another health board who diagnosed psychotic depression and treated him with electroconvulsive therapy. Mr A said the treatment was successful.

We did not uphold the complaint because we found that all the board's actions in managing Mr A's mental illness were reasonable.
 

Summary
Ms C suffers from Graves or Thyroid Eye Disease which is a complex and devastating condition. She complained that after 2007 her care and treatment was poor and likened it to a ‘production line’. She alleged that she had been examined and discharged without comment from either medical or nursing staff and that her condition has never been discussed with her. She maintained that there was no proper appreciation of her condition and its consequences and that little information has ever been made available to her. She also complained that she was incorrectly diagnosed with dry age related macular degeneration but this since turned out to be incorrect. She did not receive an apology. She also complained that when she submitted a complaint to the board, they failed to adhere to her request to keep some information confidential and delayed in responding.

While we did not uphold most of Ms C's complaints, we did find that she was misdiagnosed with age related macular degeneration and she was not adequately supported in relation to this. We made one recommendation to redress this failing.

Recommendation
We recommended that the board:
• apologise to the complainant for the confusion surrounding her diagnosis of dry age related macular degeneration.
 

Summary
Mr C's father, Mr A, was admitted to the Victoria and Queen Margaret Hospitals for treatment of cancer of the oesophagus. The board assessed Mr A as being unfit for surgery. As a result, Mr C arranged for his father to travel abroad for a second opinion and he subsequently underwent successful surgery.

As Mr C complained to both the General Medical Council and Nursing and Midwifery Council regarding his father's treatment, this office did not duplicate their efforts and reconsider any clinical aspects. Our role was focussed on the board's handling of Mr C's complaint.

Mr C complained that the board failed to take promised follow-up action to consider implementing a policy for assessing patients' fitness for surgery. We asked the board to clarify what action had been taken following Mr C's complaint. They confirmed that the matter had been referred to their Managed Clinical Network and subsequently discussed at their annual meeting. The board concluded that the current systems in place were reasonable and that a formal policy was not required. As it appeared that the matter was duly considered by the board, we did not uphold the complaint.

Mr C also complained that the board had delayed in responding to his complaint. The board acknowledged that their investigation was delayed and they offered their apologies to Mr C. They also accepted that they delayed in issuing a holding letter to Mr C and that the holding letter should have provided fuller information. They advised us that they had taken steps to raise these matters with the relevant staff. In the circumstances, we upheld this complaint. However, as the board had already taken what we considered to be reasonable remedial action, we did not make any recommendations.

Summary
Ms C complained about the treatment provided to her late father, Mr A. Mr had a history of heart attacks and strokes, and he also suffered from dementia. His wife had a poor memory. Mr A was prescribed warfarin following a heart attack and when a blood clot had developed on the inner wall of his heart. However, on many occasions, he failed to take the appropriate dosage and did not attend the appointments made to monitor his blood. In August 2010, a decision was taken to stop his warfarin prescription. One month later Mr A suffered a stroke and died.

Ms C believed that the GP concerned did not do enough to ensure that her father took his warfarin, or that he attended all his appointments. She said that more information should have been to her family so that they could have taken appropriate action.

Our investigation determined that by summer 2009, the family were aware of Mr A's erratic ingestion of warfarin and his non attendance at appointments. We also found that the medical practice had reminded him on many occasions to attend and demonstrated that they did everything they could. Confidentiality prevented them from discussing matters directly with the family.

Ms C also believed that some warfarin was better than none and that her father should have been weaned from his prescription. She also said that the GP had not referred her father to a consultant cardiologist as he should. We did not uphold either of these complaints.
 

Summary
Miss C complained that the board had deliberately, and inaccurately, diagnosed her with cancer and were pretending to give her medicine (so-called placebo injections and pills). Her medical records showed much evidence of testing and decision-making by a number of different healthcare professionals in order to reach a diagnosis of cancer. Likewise, the records indicated that actual medication was being administered. There was no evidence to support Miss C's views and we, therefore, did not uphold the complaint.