Decision Report 201304590

Summary

Ms C was the carer for her late employer (Ms A). When Ms A became unwell late at night with nausea, diarrhoea and abdominal (stomach) pains, Ms C requested an ambulance. She was referred to NHS 24 and a nurse called back and arranged for an out-of-hours (OOH) GP visit. About an hour and a half later, Ms C called NHS 24 again as Ms A's pain was worsening, at which point the OOH doctors arrived. They examined Ms A, provided medication and advised Ms C and Ms A to call back should Ms A's condition worsen. When Ms C's colleague took over caring for Ms A in the morning, she contacted NHS 24 and was told to call Ms A's medical practice. Ms A's GP visited, after which Ms A was admitted to hospital, where she later died.

Ms C complained about the care and treatment that Ms A received from both the OOH GP service and NHS 24. Ms C was of the view that if Ms A had been taken to hospital sooner, the outcome might have been better. She also thought that the OOH doctors provided inadequate pain relief, and was unhappy that she had to contact NHS 24 again (rather than being able to contact the doctor directly).

Our role was to consider whether – on the basis of the available evidence - the care provided to Ms A was reasonable. We took independent advice on the case from one of our medical advisers, who is a GP. The adviser reviewed the evidence, and explained that NHS 24 had not acted unreasonably in arranging for the OOH GPs to attend. He said that the records showed that the doctors examined Ms A and appeared to have discussed a possible hospital admission with her. The adviser was also satisfied that the OOH doctor gave appropriate advice by advising Ms A to call back should her condition worsen. His overall view was that the care provided was of a reasonable standard. Although we recognised how difficult and distressing this had been for Ms C, in the light of the advice we received we did not uphold her complaints.