Decision Report 201306095

Summary

Mr C, who is a prisoner, fell and injured his hand. He complained that, after seeing the doctor the following day, he had to wait a further five days to be taken for an x-ray. In responding to his complaint, the board advised that his referral was treated as non-urgent, and that an appointment was made for him at the earliest opportunity.

We took independent advice on this complaint from one of our medical advisers, who is a GP. He noted that Mr C had a suspected scaphoid fracture (a fracture of one of the wrist bones that sits at the base of the thumb). He explained that this can often be difficult to diagnose. However, he considered it highly unusual for an initial x-ray to be delayed for five days. Most NHS users would have been x-rayed on the day of the injury or the day after. He said that it appeared that the delay in Mr C's case might have been to allow the prison to make arrangements to escort him to hospital. Although the injury was correctly managed by ensuring that Mr C had pain relief and ordering the x-ray, our adviser considered the delay in taking him for the x-ray to be unreasonable, as in his view it appeared to have been purely for operational reasons. We accepted this advice and upheld the complaint.

Recommendations

We recommended that the board:

• apologise to Mr C for the delay in arranging for him to receive an x-ray; and
• inform us of the steps they intend to take to ensure that patients with possible fractures are assessed in good time in future.