Decision report 201201696

Summary

Mrs C complained that the board's rheumatology service (which deals with conditions affecting the musculoskeletal system, including joints, bones and muscles) unreasonably failed to offer an appointment to her mother (Mrs A). Mrs A had slipped at home the previous week, was unable to put weight on her leg, and was in pain and discomfort. Mrs A's GP had diagnosed a 'flare-up' of arthritis. Mrs C phoned the rheumatology service, where her mother had been a long-standing patient, in the hope that they would see her at the regular weekly clinic. Mrs C said that her request was unreasonably refused and that she was told that this was because the service was short staffed and clinics had been cancelled in the unexpected absence of two key members of staff.

The board said that this was not why the request was refused. They said that the specialist rheumatology nurse who spoke to Mrs C refused the request because she did not think that Mrs A's symptoms were consistent with a 'flare-up' of arthritis. The nurse advised Mrs C to take her mother to the accident and emergency department (A&E), or revisit her GP. The board said that, in spite of the lower than usual staffing levels, had Mrs A required a review because of her arthritis, then she would have been offered an appointment at a nurse-led clinic. Five days later Mrs A was admitted to A&E and was discovered to have a fracture.

Although we understood Mrs C's concerns about this, we did not uphold the complaint. This was because it was not possible during our investigation to reconcile the two very different accounts of the same phone call. There was no supportable evidence to suggest that the rheumatology service had unreasonably refused to see Mrs A on the basis of capacity alone, and there were in fact sound clinical reasons for Mrs A to be referred to A&E either directly, or via her GP.