Overview
The complainants, a firm of solicitors (the Solicitors) raised a concern on behalf of their client, Mrs C, that her late husband, Mr C, had not been properly assessed by Fife NHS Board (the Board) and consequently had ceased to receive funding for NHS Continuing Care (Continuing Care). Mrs C was also concerned that during her appeal against the decision not to fund Mr C's care she had been subjected to undue pressure from the Board.
Specific complaints and conclusions
The complaints which have been investigated are that the Board:
- (a) failed to properly assess Mr C's ongoing eligibility for Continuing Care (partially upheld); and
- (b) exerted undue pressure on Mrs C by supporting the local authority in making an application to the Sheriff Court to be appointed Mr C's welfare guardian (not upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) make a formal, evidenced record of decisions to discharge and that this record is provided to the patient and/or family in a timely manner;
- (ii) ensure that when a decision to discharge is reached such a decision is made known to the patient and/or family at the time the decision is taken and that where objections are presented the process for appealing against such a decision is clearly and fully explained;
- (iii) act on the recommendation of the Fife report to produce written information on ongoing eligibility for patients assessed as eligible for NHS funded Continuing Care. The Board should ensure that there is a single approach to such funding and that this is commonly understood by all relevant staff; and
- (iv) make a written apology to Mrs C that the lack of clarity among staff about eligibility for Continuing Care led to miscommunication to Mrs C of Mr C's status and caused unnecessary distress.
Further Action
This and other complaints to the Ombudsman indicate an urgent need to review the guidance on NHS Funded Continuing Care which was issued more than 11 years ago. This is not a matter which an individual Health Board is able to address so cannot be resolved within this report. The Ombudsman will instead draw this matter to the attention of the Scottish Executive Health Department.
The Board have accepted the recommendations and will act on them accordingly.