Overview
The complainants, a firm of solicitors (the Solicitors) raised a concern on behalf of their clients, the family of Mr A, that Mr A had not been properly assessed by Fife NHS Board (the Board) and consequently was not receiving funding for NHS Continuing Care. The family were also concerned that they had not been able to appeal against the decision not to fund Mr A's care.
Specific complaints and conclusions
The complaints which have been investigated are that the Board failed to:
- (a) properly assess Mr A for his continuing health needs and to provide details of the criteria used in deciding to discharge Mr A from in-patient care (not upheld); and
- (b) consider an appeal against the decision to refuse funding (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; and
- (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.
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