Decision Report 201304173

Summary

Mrs C complained about the medical care and treatment the medical practice gave to her late husband (Mr C). In particular, she was unhappy that he was not referred to hospital earlier.

During our investigation, we obtained independent advice from one of our medical advisers, who is a GP. We found that for the most part the treatment provided to Mr C was reasonable and appropriate. The adviser said that, although some GPs might have considered referring him to hospital earlier, the practice had acted within national guidelines and it was not unreasonable that Mr C was not referred earlier than he was. The medical records showed that the practice had been attentive and had managed Mr C's care as best they could.

We were, however, concerned that there was no evidence in the records that the practice had recognised and considered Mr and Mrs C's distress when deciding how best to progress his care. We were also concerned that there was no evidence to support the practice's position that Mr C was involved in the decision-making process. As a result we made a number of recommendations to further improve practice.

Recommendations

We recommended that the practice:

• provide us with evidence demonstrating how the practice involve the patient in the decision-making process; and
• consider this case to see if any further lessons can be learned, and bring the concerns raised by our investigation to the attention of the staff involved.