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Case ref:201400591
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Date:August 2014
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Body:Lanarkshire NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:appointments / admissions (delay / cancellation / waiting lists)
Summary
Ms C complained that after her GP referred her to orthopaedics (the specialty for conditions of the musculoskeletal system) at Wishaw General Hospital, she was inappropriately allocated to podiatry (specialising in disorders of the foot, ankle and lower limb). She had previously attended private podiatry appointments with no improvement to her condition, and thought she should have been referred to an orthopaedic surgeon. She thought that this would have resulted in quicker treatment and would have meant that she did not need to obtain a private referral to an orthopaedic surgeon. She also said that the board should have told her that she was being allocated to a podiatrist, to allow her to decide whether to request further private referrals and avoid delays in treatment.
We considered the information she provided and that from the board. We found that Ms C's GP gave her a routine referral to orthopaedics and was initially triaged (deciding where patients should be treated, based on their condition) by an extended scope practitioner (ESP) podiatrist in the orthopaedic team. This person can give an onward referral to podiatry or other specialisms, and can also request specialist investigations, such as radiology and scans. Triage could include a further review by other ESPs and surgical staff. We noted that the review by the ESP podiatrist was in line with the board's protocols. Although the board had not told Ms C or her GP that she would be triaged this way, this did not disadvantage her as this is what happens to all routine orthopaedic referrals. The board explained, and we accepted, that it would be impractical to tell all patients and GPs who would carry out the triage. As the board had clearly followed their protocols, we did not uphold Ms C's complaints.