Decision Report 201704607

Summary

Mrs C complained about the care and treatment that her child (Child A) received from the orthopaedic department (the branch of medicine that deals with diseases and injuries of the musculoskeletal system) and the rheumatology department (the branch of medicine that deals with rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments) at the Royal Hospital for Sick Children, Yorkhill.

We took independent advice from a consultant spinal surgeon and a rheumatologist. We found that:

Mrs C was not informed that the possibility of a spinal x-ray had been discussed following Child A's appointment with the orthopaedic department.

there was no record of the referral that the orthopaedic department made to physiotherapy.

there was no record of the discussions within the orthopaedic department about the risk of doing an x-ray on Child A's spine.

there was no record of the referral that physiotherapy made to rheumatology.

the plan to watch Child A's back for changes did not happen.

We upheld Mrs C's complaints about the care and treatment provided following Child A's referral to the orthopaedic department and the rheumatology department.

Mrs C also complained about the way the board handled her complaint. We found that the board failed to acknowledge Mrs C's complaints in writing within three working days and failed to keep Mrs C updated about the reason for the delay in responding to her complaints and provide a revised timescale for a response. We upheld this aspect of Mrs C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mrs C and Child A for failing to provide Child A with reasonable care and treatment following their referral to the orthopaedic department and the rheumatology department, for failing to communicate reasonably with Mrs C and for failing to handle Mrs C's complaint reasonably. 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:

• Patients and/or their parent/guardian should be informed when an x-ray is being considered following the identification of scoliosis (abnormal lateral curvature of the spine).
• Clear records of inter-disciplinary referrals and discussions should be kept.
• Clear records should be kept of discussions about the risk of performing an x-ray on a child's spine.
• Clear records of inter-disciplinary referrals and discussions should be kept.

In relation to complaints handling, we recommended:

• Complaints should be handled in line with the model complaints handling procedure. The model complaints handling procedure and guidance can be found here: www.valuingcomplaints.org.uk/handling-complaints/complaints-procedures/nhs.