Investigation Report 200500951

  • Report no:
    200500951
  • Date:
    November 2007
  • Body:
    Grampian NHS Board
  • Sector:
    Health

Overview

Ms C raised a number of concerns on behalf of her mother (Mrs A) that she had not received proper or adequate treatment from Grampian NHS Board (the Board) whilst in Woodend Hospital (Hospital 1) for a knee operation.  She was transferred to Aberdeen Royal Infirmary (Hospital 2) on 11 December 2004.  

Specific complaints and conclusions

The complaints which have been investigated are that the Board failed to:

  • (a) the Board failed to provide proper or adequate nursing and medical care to Mrs A (upheld);
  • (b) the Board failed to identify a small bowel obstruction (upheld); and
  • (c) the Board failed to communicate effectively with Mrs A’'s family (upheld).

Redress and recommendations

The Ombudsman recommends that the Board:

  • (i) review medical and nursing documentation and advise the Ombudsman of the outcome of the review;
  • (ii) introduce a system for the audit of clinical documentation, for example pulling five files on a monthly basis, and advise the Ombudsman of the proposed action; and
  • (iii) consider if there are training needs for staff in relation to communication with patients and relatives/friends.

The Board have accepted the recommendations and will act on them accordingly.

Updated: December 11, 2018