Overview
The complainant, Mrs C, raised a number of concerns about the care and treatment which her late mother, Mrs A, received at the Royal Infirmary of Edinburgh (the Hospital) in August 2007. Mrs C complained that there were delays in carrying out a CT scan and for Mrs A to be seen by a dietician. She also complained that there were communication problems with the staff.
Specific complaints and conclusions
The complaints which have been investigated are that:
- (a) there was a delay in carrying out a CT scan following Mrs A’s admission to the Hospital (upheld);
- (b) it was inappropriate for staff to assume Mrs A was suffering from bowel cancer and this compromised her treatment plan (not upheld);
- (c) there was a delay in Mrs A being seen by a dietician and to ensure she received an adequate level of nutrition (upheld); and
- (d) the level of communication with Mrs A’s family was inadequate (upheld).
Redress and recommendations
The Ombudsman recommends that Lothian NHS Board (the Board):
- (i) give consideration to whether communication links between clinical and radiology staff require review in view of the findings in this report;
- (ii) conduct a review of the current procedures for requesting a CT scan at the weekend, to ensure that patient care is not compromised, should the status of the request be downgraded;
- (iii) conduct an audit of the clinical and nursing records in the ward, to ensure that they are completed in accordance with the guidance issued by the regulatory bodies such as the General Medical Council and the Nursing and Midwifery Council;
- (iv) reflect on Adviser 1’s comments about the lack of urgency in the clinical investigation and consider whether the degree of patient orientation or clinical leadership at ward level is appropriate;
- (v) review their policies for nutritional assessments and dietetic referrals and consider whether nursing staff would benefit from the implementation of a robust education programme related to meeting the nutritional needs of older people in hospital, with clear links to Food, Fluid and Nutritional Care Standards (NHS Quality Improvement, Scotland NHS Scotland September 2003);
- (vi) should provide evidence of clinical benchmarking of ‘Communication’, which is clearly linked to Standard 8 Clinical standards for older people in acute care (Clinical Standards Board for Scotland October 2002), to ensure that this aspect of practice is audited and there is demonstrable evidence of improvement in this aspect of care delivery; and
- (vii) issue Mrs C an apology for the failings which have been identified in this report.
The Board have accepted the recommendations and will act on them accordingly.