Decision Report 201808206

Summary

Mr C complained about the treatment his mother (Mrs A) received at the practice. Mrs A suffered from chest pain and breathlessness and had concerns she had angina (a heart condition). Mr C complained that appropriate treatment and investigations were not carried out in a reasonable time-frame.

We took independent medical advice from a GP. We found that the practice unreasonably failed to carry out appropriate physical assessments during appointments. While the practice did not consider angina was a likely cause for Mrs A's health concerns, at the point where it was agreed to refer her, the practice used the incorrect referral pathway. They arranged for an electrocardiograph (ECG - test that records the electrical activity of the heart) followed by a routine referral to cardiology (the branch of medicine that deals with diseases and abnormalities of the heart), instead of the appropriate action of an urgent exercise tolerance test (or if the patient was not physically capable of doing this test then an urgent cardiology referral). We upheld this complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mr C for failing to follow the correct referral pathway for investigation of angina. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/informationleaflets.

What we said should change to put things right in future:

• The GP should be familiar with the appropriate referral pathway when investigating angina.

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.