Overview
The complainant (Mr C) considered that his daughter (Ms A)'s GP Practice (the Practice), the Out of Hours Service and Accident & Emergency (A&E) at Victoria Hospital, Kirkcaldy, did not properly diagnose and treat her illness.
Specific complaints and conclusions
The complaints which have been investigated are that:
- (a) the Practice did not properly diagnose and care for Ms A's illness (not upheld); and
- (b) the Out of Hours Service and A&E at Victoria Hospital, Kirkcaldy, did not properly diagnose and care for Ms A's illness (upheld).
Redress and recommendations
The Ombudsman recommends that the Practice:
- (i) review its threshold for considering whether or not a patient might have a subarachnoid haemorrhage, and whether or not early/urgent imaging would be beneficial; and
- (ii) consider recording patients' actual blood pressure when a check is made.
The Ombudsman recommends that (Fife NHS Board) the Board:
- (iii) apologise to Mr C for the failure of medical staff to reach a differential diagnosis of subarachnoid haemorrhage on 22and 23 July 2005;
- (iv) review its locally agreed indications and process for admission, observation and investigation of patients presenting with acute headache in A&E, including ensuring that the teaching and guidance given to A&E junior doctors is based on current research; and
- (v) ensure that Out of Hours records are in line with relevant record-keeping standards, for example as laid down by the General Medical Council.
The Practice have accepted the recommendations. The Board have also accepted the recommendations, and in some respects have already taken action and made procedural changes to address them.