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Case ref:201703051
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Date:September 2018
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Body:Greater Glasgow and Clyde NHS Board - Acute Services Division
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Ms C complained that the Royal Hospital for Sick Children Glasgow unreasonably failed to accept a referral from her daughter (Miss A)'s GP. The GP had made the referral to endocrinology (a branch of medicine dealing with hormones) for Miss A to be assessed for her diagnosis of hypothyroidism (under active thyroid). Miss A's thyroid function tests had been reported as normal and the board rejected the referral. Ms C felt that it was wrong that the board refused to see Miss A as she was reporting symptoms which needed to be addressed.
We took independent advice from a consultant endocrinologist. We found that, although the thyroid function tests were normal, Miss A was still showing symptoms relating to hypothyroidism. It would have been reasonable for the board to have seen Miss A and her family, where they could have discussed the symptoms in more detail and explored potential explanations as to why Miss A was feeling the way she did. Alternatively, if they remained of the view that a consultation was not required, then they could have provided the GP with suggestions of what further investigations or assessments could be arranged through the primary care setting. This may have led to additional diagnoses being discovered. We considered that the board could have been more proactive when considering the GP referral. Therefore, we upheld Ms C's complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to Ms C for the failure to see Miss A at a consultation or to have provided advice to her GP about alternative treatment or investigations. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/leaflets-and-guidance.
What we said should change to put things right in future:
- In cases where staff do not consider that a GP referral warrants a consultation, they should consider providing the GP with information about alternative treatments or investigations if appropriate.
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.