Not upheld, no recommendations

Summary

C complained in relation to their late sibling (A) who was admitted to Glasgow Royal Infirmary following a fall. During their time in hospital, they contracted various infections (latterly pneumonia) and was diagnosed with dementia. A's health deteriorated during their time in hospital and they died.

C said that medical staff failed to take adequate steps to ensure that A received sufficient nutrients to fight the infections they acquired whilst in hospital and this was a contributory factor in their death.

We took independent advice from an appropriately qualified adviser on the care and treatment, specifically the feeding aspect, and found that the care and treatment provided to A was reasonable. We did not uphold the complaint.

Summary

C complained that the board unreasonably carried out a biopsy after a mass was identified in C’s chest. C said due to the type of tumour it shouldn’t have been biopsied.

We took independent advice from a consultant physician and rheumatologist (a specialist in rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments) and a consultant radiologist (a specialist in diagnosing and treating disease and injury through the use of medical imaging techniques such as x-rays and other scans).

We found that while the type of tumour should not have been biopsied, it was not identified as that type of tumour until after the biopsy and that was reasonable. We found that the decision to perform a biopsy was reasonable based on the information available at the time. As such, we did not uphold this complaint.

Summary

C complained to us about the care and treatment their adult child (A) received from the board regarding their mental health over a one-year period. A was an in-patient for part of this time and C complained that it was inappropriate to allow A to make decisions about their care, including time out of the ward. C raised concerns about A’s diagnosis and the medication they were prescribed, as well as the level of support in place for A.

We took independent advice from a psychiatrist. We found that the care and treatment provided to A in relation to their mental health was reasonable and in line with relevant guidance. We also found that the symptoms exhibited by A were consistent with their diagnosis and that the medication put in place for A was reasonable. We did not uphold this complaint.

C also complained that the care and treatment A received regarding their physical health whilst an in-patient had been unreasonable. We found that the approach taken during A’s admission to hospital was reasonable and in line with the expected approach. The focus of clinicians was on A’s psychiatric symptoms and their physical health was treated in line with the arrangements already in place for them in the community. It was reasonable for the referral to rheumatology (specialists in rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments) to be passed to A’s GP on discharge. We did not uphold this complaint.

In addition, C complained that the communication and engagement with them with regards to input into A’s care and treatment had been unreasonable. We found that the communications recorded in A’s medical notes were of an appropriate standard and well recorded. We did not uphold this complaint.

Summary

C complained that the care and treatment they received from the practice was unreasonable. C said that they had developed an intolerance to a number of medications, some of which they had previously tolerated. C sought a referral to pharmacology (the branch of medicine concerned with the uses, effects, and modes of action of drugs) through the practice but complained that they unreasonably failed to facilitate this.

C complained that the GPs at the practice were dismissive of C’s symptoms without reasonable investigations being carried out. C said that their symptoms were inappropriately attributed to anxiety or panic attacks and that GPs provided misleading information in referrals that suited their own presumptions about C’s diagnosis.

We took independent advice from a GP. We found that, whilst the GPs and C disagreed about the likely cause of C’s symptoms, the GPs did not rule out C’s opinion or block their access to specialist investigations. We were satisfied that the practice’s GPs made referrals based on their assessments of C’s symptoms, but put forward C’s opinion for consideration by the receiving specialists.

We were satisfied that the practice’s GPs made appropriate referrals and did not promote their own ideas about C’s likely diagnosis. Whilst we considered that one of the GPs could have communicated more clearly with C about the reasons behind one of the referrals, overall, we found the care and treatment provided by the practice to be reasonable. We did not uphold this complaint.

Summary

C complained on behalf of their child (A). A, who has additional support needs, transferred to a new school. C complained about one of A’s National 5 grades, unhappy at the level of the award submitted by the school to the Scottish Qualifications Agency. C believed the decision on the level of award was made using incomplete or inaccurate information. C was also concerned about how the school shared information with staff concerning the additional support needs for A. C was also unhappy at the level of communication received from the school in relation to A.

C complained to the council but was unhappy at their response and brought their complaint to this office. The council said that A’s needs were communicated to all staff with an enhanced provision of support in place, that the school regularly communicated with C including highlighting a risk of a non-award in a National 5 subject and that there was a range of evidence used by staff in conjunction with moderation of standards against the National 5 assessment criteria to make a professional judgement.

We found that the school shared information about A’s health and support needs with staff and that there was reasonable proactive communication between the school and C. We found no evidence that A’s projected National 5 grade was based on incomplete or inaccurate information.

We did not uphold C's complaints.

Summary

C was removed from their GP practice patient list. The practice were contacted by Practitioner Services (part of NHS National Services Scotland who support primary care providers) after this and suggested the practice refer C to the board's Challenging Behaviour General Practice (CBGP). The practice referred C to the CBGP.

C complained that the practice had unreasonably referred them to CBGP. C said the practice were not required to refer C to CBGP, did not have a good reason to refer them and did not follow the correct procedure.

We found that once the practice’s request to have C removed from their patient list was actioned, they were not obliged to arrange any future care for C. However, Practitioner Services found themselves unable to place C on a patient list of another GP practice in the area. They went back to C’s most recent practice and asked them to refer C to the board’s CBGP. The referral the practice sent meant C might (if the referral was accepted) have access to primary care services. We decided that the decision to refer C to CGBP was reasonable in the circumstances. As such, we did not uphold this complaint.

However, we found that the processes in place were not helpful to guiding the situation C found themselves in. Understandably C was left confused about why the referral was made and had to contact the practice themselves to find this out. We passed on our feedback to the relevant health board.

Summary

C complained that the board's community mental health team recorded their transgender status in their medical records, without C's knowledge or consent. In their complaint response, the board said that they considered C's gender transition was relevant to their mental health treatment and medical staff would require access to the information when providing C with treatment.

We took independent advice from appropriate clinical specialists. We found from a clinical perspective that, at the time the information was recorded, it had been reasonable for staff to conclude that consent had been given as this information was provided by C, and that the information was relevant to the treatment being provided and, therefore, reasonable to record. We did not uphold this complaint.

However, we did not make a decision on specific points raised about the ongoing and future management of personal data in the records as we considered these were ultimately more appropriate for the Information Commissioner’s Office.

Summary

C underwent re-root canal treatment from the dentist in an attempt to treat an abscess (a painful swelling caused by a build-up of pus) which had formed under one of their teeth. After attempts to resolve the issue were unsuccessful, C was referred to a specialist. C complained that the re-root canal treatment was not carried out by the dentist in a reasonable manner and limited further treatment options for C.

We took independent advice from a specialist in dentistry. We found that the treatment provided was reasonable. While the treatment did not resolve the presence of C’s abscess, it was not unreasonable.

As such, we did not uphold this complaint.

Summary

C, an advice worker, complained on behalf of their client (B) about the treatment which B’s late adult child (A) received from their GP practice. The practice is being managed by the board. A had contacted the practice on a number of occasions over a six-month period reporting problems with their mental health. A was a student studying away from home.

A subsequently completed suicide. B felt that the staff from the practice had failed to take fully into account A’s personal circumstances which all pointed to the fact that A was at increased risk of attempting suicide and that they failed to provide them with appropriate treatment.

We took independent clinical advice from a GP. We found that the GPs involved had formed a good relationship with A. They had recorded A’s mental health symptoms and provided a reasonable level of care and treatment by prescribing appropriate medication and monitoring A’s behaviour. There was also the involvement of a counsellor but there was nothing to indicate that A was going to take their own life. We did not uphold the complaint.

Summary

C attended the Grampian Medical Emergency Department (GMED) out-of-hours service with severe pain in their arms and shoulders. They were referred to the Acute Medical Initial Assessment Unit (AMIA) and then transferred to the Stroke Unit, a unit that has capacity to receive patients with non-stroke problems when the hospital is busy.

C received multiple tests, including multiple electrocardiograms (ECG, test to check a patient’s heart rhythm and electrical activity) in order to diagnose the cause of their symptoms. It was determined to be a trapped nerve in C’s neck and C was discharged from hospital with a prescription for medication for nerve pain and sensitivity.

C complained that there were failings in communication and record-keeping during their admission and that this lead to the unnecessary repetition of ECG tests and a delay in administering pain medication. They also raised concerns that they had been told they had a liver infection requiring antibiotics but this was not recorded, meaning that antibiotics were not prescribed.

We took independent advice from a consultant geriatrician (a doctor who specialises in medicine of the elderly). We found that the treatment C received during their stay in hospital was reasonable and consistent with the symptoms they experienced and that the communications recorded were reasonable. Therefore, we did not uphold these complaints.