Overview
The complainants (Mrs C and Mrs D) raised a number of concerns about the care and treatment of their late mother (Mrs A) at St Johns Hospital at Howden (the Hospital) between 19 December 2005 and 2 February 2006.
Specific complaints and conclusions
The complaints which have been investigated are that Lothian NHS Board (the Board):
- (a) failed to provide adequate care and treatment to Mrs A (partially upheld); and
- (b) failed to properly plan for Mrs A's discharge (upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) ensure that discussions take place within the clinical team on Ward 9 of the Hospital to agree the appropriate standard of practice with regards to the importance of a) thorough examination of a patient prior to discharge, with particular reference to patients with pre-existing medical problems and multiple medications, and b) recording of medical examination findings and the rational behind any changes to medications;
- (ii) consider the use of fully unified records, i.e. including therapy follow-up records with the joint medical/nursing records;
- (iii) consider regular (at least weekly) multi-disciplinary team meetings where discharge planning for complex cases, particularly for elderly patients, can be discussed, coordinated and recorded;
- (iv) consider that where family conflicts or carer anxieties are raised, case conference meetings are organised when the key disciplines and family and carers can meet to exchange information and plan discharges and that all family meetings are adequately recorded; and
- (v) consider whether current occupational therapist staffing levels in this area are sufficient to avoid the delays experienced by Mrs A.
The Board have accepted the recommendations and will act on them accordingly.