Decision report 201100360

Summary
Mr C, an advice worker, made several complaints on behalf of Mr A. He complained about a delay to remedial hip surgery; that Mr A’s proposed surgery by hospital 1 was blocked by the board; and that misleading and/or inaccurate information about tests resulted in an unnecessary referral to London.

Mr A underwent hip replacement surgery in January 2009 at hospital 1. He later developed a fracture of the neck of the femur and underwent revision surgery at hospital 2. This was known as a ‘metal on metal’ (MOM) hip replacement procedure. Mr A then developed pain in the hip and following a national alert in April 2010 concerning MOM hip replacements, his consultant surgeon referred Mr A to hospital 3 in London for tests to be carried out.

When Mr A was next reviewed by his consultant and informed he required surgery he requested a second opinion. Mr A was then referred to hospital 4 where the board have a service level agreement to provide a number of routine procedures and to assist with waiting times. Hospital 4 was prepared to carry out the necessary surgery. However, the board informed Mr A that due to the nature of the MOM hip replacement procedure his care should, for clinical reasons, remain within their system because hospital 4 is only used for routine procedures and this procedure did not fall into this category. Mr A eventually had further remedial surgery at hospital 2 in April 2011.

We obtained advice from our medical adviser which was that, from a clinical perspective, the timescale within which the surgery was carried out would not have had any clinical bearings on the outcome of the surgery. Therefore, there was no undue delay in Mr A undergoing revision surgery. Therefore, we did not uphold the first complaint.

We upheld the second complaint because our medical adviser considered that Mr A’s surgery was blocked from going ahead at hospital 4 on financial and administrative grounds. Although this was reasonable, the advice we received was that there was no clinical reason for the surgery to have been carried out by one of the board’s hospitals rather than hospital 4.

We also upheld complaint 3 because while we did not doubt that Mr A’s consultant acted with the best of intentions in referring Mr A to a centre of excellence in London, there was no evidence that he was given the alternative option of having his case dealt with in Glasgow, which would have avoided him having to travel to London. We recommended that the board apologise to Mr A for this.

Recommendation
We recommended that the board:
• issue Mr A with an apology for the failure to inform him of an alternative option of having the necessary investigations carried out in Glasgow.