Decision Report 201400210

Summary

Mrs C complained about the care her late mother (Mrs A) received in Wishaw General Hospital following her hip replacement. Mrs C had been concerned that Mrs A – who had advanced dementia - had become dehydrated while in the hospital, that it had taken too long for her to be discharged and that her urine infection was not treated properly.

Our role was to assess whether the evidence indicated that Mrs A's treatment was reasonable in the circumstances. We took independent medical advice from a geriatrician and a nurse, both of whom felt that clinical staff had been aware of the possibility of dehydration. The medical advice we received was that staff had responded to Mrs C's concerns and had given Mrs A a fluid drip, even though there was no evidence of significant dehydration. Taking everything into account, we did not uphold Mrs C's first complaint.

Both advisers explained that it can take time to make the necessary arrangements to discharge a patient. However, our geriatrician adviser felt that the time taken between the necessary equipment being put in place in Mrs A's home and her being discharged from hospital was too long. We upheld this complaint and made one recommendation. Finally, the medical advice we received explained the difficulty in diagnosing a urinary tract infection. It also outlined the balance to be struck between not over treating somebody with antibiotics and not missing a chance to provide appropriate treatment (the adviser felt that balance had been struck appropriately for Mrs A). While we took account of Mrs C's concerns, we did not uphold her complaint about this.

Recommendations

We recommended that the board:

• remind staff, in circumstances where appropriate arrangements have been made for a patient's discharge, of the importance of taking a proactive approach.