Overview
In early 2008, Ms A was diagnosed with osteomyelitis of the maxilla, following investigation at a private hospital. This is a condition where the main bone of the upper jaw (maxilla) has become inflamed and damaged by infection. Ms A had suffered from symptoms since at least 2004 and previously attended at both Borders NHS Board (Board 1) and Lothian NHS Board (Board 2) hospitals. She complained that, despite this, she had not been correctly diagnosed by the NHS and that, as a result, she had had to pay for private treatment. Ms A's complaint was brought to the Ombudsman's office by her MSP (Mr C).
Specific complaint and conclusion
The complaint which has been investigated is that Ms A was not investigated properly and that the diagnosis could have been made sooner by the NHS (upheld).
Redress and recommendations
The Ombudsman recommends that Board 1:
- (i) review their procedures for monitoring and auditing the referral process in light of the problems identified;
- (ii) remind clinicians involved of the need to consider carefully the information provided as part of the referral process;
- (iii) consider the best practice advice made by the Adviser to the Ombudsman; and
- (iv) provide him with reassurance that there has been an improvement in the time taken to review CT scans and discuss them with patients. He also asks that Board 1notify him when the recommendations have been implemented.
The Ombudsman recommends that Board 2:
- (i) review their procedures for monitoring and auditing the referral process in light of the problems identified;
- (ii) remind clinicians involved of the need to consider carefully the information provided as part of the referral process;
- (iii) consider the best practice advice made by the Adviser to the Ombudsman;
- (iv) undertake a short, focussed audit of record-keeping in the Ear Nose and Throat clinic and the Dental Institute and put in place an action plan to deal with any problems identified; and
- (v) reimburse Ms A for the costs of the private treatment required to identify her condition.
Board 1 have accepted the recommendations and will act on them accordingly.