Decision Report 201507774

Summary

Mr C complained about a delay in being referred for psychology treatment. He was referred to the community mental health team and was seen initially by a consultant psychiatrist and a community psychiatric nurse (CPN). He continued to see the CPN over the following months but it was deemed that no psychiatric follow-up was necessary. However, the CPN subsequently discussed Mr C with the psychiatrist when the Mr C had reported experiencing vivid dreams, and the psychiatrist recommended a referral to psychology. Mr C raised concerns that he was not seen by a psychologist until several months later, when he considered that he should have been referred directly after his initial appointment.

We obtained independent advice from a senior mental health nurse, who did not consider that there was any indication for a psychology referral initially and deemed it reasonable for this to have been proposed when it was. However, the adviser noted that the CPN did not make the referral until almost three months later, despite having indicated that she would progress this. While Mr C was seen by a psychologist within the national 18 week waiting target from referral to treatment, the adviser considered that the delay in making the referral was unreasonable. We were critical that the board did not identify the delay when investigating this complaint and their response inaccurately indicated that the referral had been made around the time it was first proposed. We upheld this complaint.

Mr C also raised concerns about the contribution of a medical secretary at a meeting he attended with the psychiatrist and clinical director to discuss his complaint. He complained that the secretary inappropriately intervened to speak on the psychiatrist's behalf. The minutes of the meeting and the board's response to the complaint confirmed that this happened, although not to the extent described by Mr C. Nonetheless, the adviser considered that the secretary's documented input was inappropriate, noting that she was at the meeting solely as minute taker and should have left any explanations and/or apologies about care and treatment to the professional clinicians in attendance. We also upheld this complaint.

Recommendations

We recommended that the board:

• apologise to Mr C for the delay in referring him to psychology;
• ask the staff involved in Mr C's care to reflect on the findings of this investigation and take steps to ensure that psychology referrals, once deemed appropriate, are progressed without any avoidable delay;
• highlight to complaints handling staff the importance of establishing the facts and accurately reflecting them in complaint responses;
• apologise to Mr C for the psychiatry secretary's inappropriate contributions at his complaint review meeting; and
• ensure clear directions are given to administrative staff taking on the role of minute takers at meetings, setting out the limitations of their role in this regard.