Decision Report 202203587

Summary

C complained about the attitude of a doctor during an inpatient admission. C stated that the doctor had treated them in a dismissive, derogatory and unprofessional manner. C further complained that the doctor removed their diagnosis, stopped their medication and made no arrangements for them to receive support following their discharge. C told us that the actions of the doctor had resulted in them not receiving a reasonable standard of care.

We found that the inpatient doctor's communication and documentation did not meet the required professional standards and impacted on the board's overall communication of C's care and treatment needs. The clinical records evidenced a dismissive and disrespectful attitude towards C. The doctor's documentation lacked a clear clinical rationale for the decisions that they made about C's diagnosis and medication. Therefore, we upheld this part of C's complaint.

In relation to the standard of care C received, we found that board staff had ensured that C's care and treatment needs were met. The decision to discharge C from inpatient care was reasonable and the community-based care that was provided was appropriate to C's identified needs at the time. When it was clinically indicated, the board arranged a further inpatient admission and reviewed C's diagnosis and treatment plan. There was evidence that the doctor did not stop C's medication. Therefore, we did not uphold this part of C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to C for the unprofessional language used by the doctor, the doctor's communication regarding diagnosis and medication, the impact the doctor's communication had on C and not adequately reflecting that the board recognised that the doctor's communication was unreasonable in the complaint response. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
• The board should review the support being provided to C to assess whether the current level of support is appropriate and sufficient; and ensure that C is able to access medical assessment and review from a doctor other than the doctor at the subject of the complaint, if required.

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

• Communication with patients is professional and respectful. Documentation evidences that clinicians work in partnership with patients. Concerns and disagreements are documented using professional, non-judgmental language.
• There should not be a pattern of poor practice.

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.