Overview
The complainant (Mrs C) raised a number of concerns that her husband (Mr C) had been wrongly diagnosed as having Bells Palsy by an NHS24 Nurse Adviser (the NHS24 Adviser) after he contacted NHS24 complaining of numbness in his face and index finger, slurred speech and a headache. Mrs C also complained that Mr C had been informed of the diagnosis inappropriately by the NHS24 Adviser and that he should have arranged for an ambulance for Mr C and treated him as a medical emergency. Instead, Mr C was advised by the NHS24 Adviser to attend the Primary Care Emergency Centre (PCEC) and an appointment made for him there.
Mr C drove to the PCEC himself and was seen by a GP (GP 1), who made a diagnosis of Transient Ischaemic Attack (TIA). After this consultation, he was allowed home and advised to see his own GP if he did not begin to feel better. Mr C then waited in the PCEC car park until Mrs C arrived. He re-attended the PCEC where, after a 30 minute wait, he was seen by a second GP (GP 2). Mr C was then admitted to hospital and found to have suffered a stroke. Mrs C complained about the consultation with GP 1 and the care offered to Mr C by the PCEC and Lanarkshire NHS Board (the Board).
Specific complaints and conclusions
The complaints which have been investigated are that:
- (a) Mr C was wrongly diagnosed and informed inappropriately of the diagnosis over the telephone by the NHS24 Adviser (upheld);
- (b) the NHS24 Adviser failed to treat Mr C as a medical emergency and should have arranged an ambulance, instead of sending Mr C to an out-of-hours GP practice (upheld);
- (c) GP 1 diagnosed Mr C wrongly and, therefore, treated him inappropriately (upheld);
- (d) GP 1 did not offer to admit Mr C to hospital (no finding);
- (e) GP 1 failed to record sufficient data about his consultation with Mr C (upheld);
- (f) GP 1 rushed his consultation with Mr C (not upheld) and;
- (g) Mr C waited an unreasonably long time on re-attending the PCEC (not upheld).
Redress and recommendations
The Ombudsman had no recommendations to make in relation to NHS24.
The Ombudsman recommends that the Board:
- (i) ensure that GP 1 shares this report with his appraiser at annual review and that he reflects on the comments made in this report regarding the diagnosis of a TIA;
- (ii) review GP 1’s record-keeping to ensure it meets the required standards of the regulatory bodies; and
- (iii) write to Mr C with an apology for the failures which have been identified in this report.
The Board have accepted the recommendations and will act on them accordingly.