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Case ref:201607200
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Date:February 2018
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Body:Fife NHS Board
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Sector:Health
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Outcome:Some upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Ms C was in the early stages of pregnancy when she had a miscarriage. Ms C complained about the care that she received when she contacted the board's early pregnancy service by phone and she was concerned that appropriate testing had not been carried out following the miscarriage. Ms C also complained about the way that staff had communicated both with her and between departments, as she had to explain to a member of staff carrying out a scan that the pregnancy had miscarried.
We took independent advice from a nursing adviser and from a midwifery adviser. We found that the clinical advice Ms C was given was reasonable and that the management of the miscarriage was in line with relevant guidance. We also found that some testing had been carried out following the miscarriage and that further investigations were not required in Ms C's circumstances. We did not uphold Ms C's complaint about the care provided to her by the early pregnancy service.
Regarding communication, we found that, on some occasions, it had been difficult for Ms C to reach someone at the early pregnancy service. We found that the board had identified a programme of enhanced communication training to be implemented as a result of Ms C's concerns. We also found that the board planned to change their process when referring women for scans so that more information was available to the scanning staff. We upheld this aspect of Ms C's complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to Ms C for the failing in communication between staff. The apology should meet the standards set out in the SPSO guidelines on apology available at https://www.spso.org.uk/leaflets-and-guidance.
What we said should change to put things right in future:
- Patients should have a 24 hour contact phone number for the early pregnancy service, in line with national guidance.
We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.