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Case ref:201302480
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Date:December 2014
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Body:A Medical Practice in the Greater Glasgow and Clyde NHS Board area
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C complained that a GP at her medical practice failed to deal with her mental health problems in an appropriate manner. She said that over a two-year period they failed to provide her with a reasonable service for her mental health problems and refer her for specialist support. Mrs C said she asked the GP to refer her to a psychiatrist on a number of occasions and that her counsellor had also made a request for this on her behalf, but no referral was made. Mrs C also complained about how the GP handled the reduction of her sleep medication.
We took independent advice from one of our medical advisers, who is also a GP. We found no evidence that the GP failed to consider Mrs C's requests for referral for specialist support, or failed to refer Mrs C to a psychiatrist in response to her counsellor's request. However, the evidence showed that the practice were copied into a letter from a consultant psychiatrist to Mrs C's counsellor indicating that an appointment would be arranged for Mrs C in the 'near future'. Our adviser said that as the GP continued to see Mrs C for over a year after the letter was sent, and as Mrs C was still having mental health problems and no appointment with the psychiatrist had been forthcoming, it would have been reasonable for the GP to have enquired about this. Our adviser also expressed some concerns about the tone and content of the GP's letter in response to Mrs C's complaint. We were particularly concerned that they referred to Mrs C in the letter as 'patient', which was inappropriate. We were also concerned that the GP took nearly two months to respond to the complaint and that no updates appeared to be sent to her during this time.
On the matter of the sleep medication, it was clear that the guidance in this area was that such medication should be for short-term use and that the doctor was correct to explore the reduction in Mrs C's dosage.
On balance, however, we upheld Mrs C's complaint as we concluded that the GP failed to deal with her mental health problems in an appropriate manner.
Recommendations
We recommended that the practice:
- feed back the failings identified to the GP to ensure that a similar situation does not happen in future; and
- provide Mrs C with a written apology for the failings identified.