As part of the revised complaints procedure, if a complainant is unhappy with an NHS Organisation's formal response to their complaint they have the right to request a review by the Scottish Public Services Ombudsman. The Ombudsman's final report into the findings of any review is laid before Parliament and published on the Ombudsman's website.
The link to these reports published on the Ombudsman's website is:
www.spso.org.uk/reports/index.php
Should you require a hard copy of any of these reports please contact Richard Mutch on 0131 536 9441 or at richard.mutch@nhslothian.scot.nhs.uk
January
Case Ref 200800801 – NHS Lothian Board
The Board did not act reasonably in failing to re-test for Huntington's disease following the introduction of more accurate tests (upheld). Recommended to remind clinicians of the importance of open discussions of available new genetic tests and recording such discussions including information provided to patients.
Case Ref 200801828 – NHS Lothian Board
Complain in relation to the Practice’s failure to detect problems with pregnancy and failure to carry out appropriate tests, to take concerns and questions into account, for the failure to provide correct advice and a time lapse of more than thirty minutes from the decision to perform an emergency lower uterine caesarean section to the start of this procedure (upheld). Board to issue a formal written apology to the partners for the inadequate standard of care and treatment provided at the Centre. Inform them of the measures undertaken to address the inadequate level of staff interface and communication between the partners at the Centre, measures undertaken to ensure that the practice is adhered to, with reference to NICE Antenatal Guidelines 2008 and measures undertaken to ensure that the delay does not recur in a similar situation.
Case Ref 200802225 – NHS Lothian Board
Complain that the Board did not provide reasonable care and treatment following the operation for carpal tunnel syndrome (upheld). Recommended to reinforce with staff the importance of referring patients back for a consultant review as soon as possible if there are complications or adverse symptoms which need attention and to issue a letter of apology.
Case Ref 200801582 / 200801583 – NHS Lothian Board and Borders NHS Board
Patient was not investigated properly and that the diagnosis could have been made sooner by the NHS (upheld). Recommended that both Boards review their procedures for monitoring and auditing the referral process, remind clinicians the need to carefully consider information provided as part of the referral process. Also recommended that NHS Lothian Board reassure to the patient that there has been improvement in the time taken to review CT scans and discuss them with patients. Borders NHS Board to undertake an 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 also reimburse the patient for the costs of the private treatment required to identify the condition.
December
Case Ref 200801134 – NHS Lothian Board
Family complains that the consent process was improper (partially upheld). Surgical decision making process was inappropriate and that the surgical complications were not dealt with appropriately (upheld). Also concerns about the premature discharge from the hospital (not upheld). Recommended to review areas including consent procedure and consultant involvement in surgical and apologise to the family for the failings identified.
Case Ref 200800557 / 200800997 – NHS Lothian Board and a Medical Practice
Complaining in relation to the care and treatment received and Practice’s response to enquiries (partially upheld). Also, the actions taken by the Board in response to the complaint was not reasonable (upheld). Recommended that the Board apologise to the family for the failure to uncover misreporting of the X-ray during investigation of the complaint and to remind medical staff to dictate letters to GPs immediately after consultations with patients. Also recommended that the Practice apologise for the aspects of care and treatment that were not reasonable and conduct several reviews including adherence to national guidelines, clinical record-keeping using the Royal College of General Practitioners (Scotland) template on section 3D (2) of the Revalidation Toolkit and their complaints handling procedure.
November
Case Ref 200800148 - NHS Lothian Board
Patient believed that plaster cast applied was not an appropriate treatment, the care and treatment received was inadequate and also that they contracted a MRSA infection whilst in hospital (not upheld). Patient concerned of the inadequate standards of record keeping (upheld). Recommended to remind staff the significance of fully completing significant documentation and provide copies of the next Scottish Patient Safety Programme audit documentation in relation to all patient records within the orthopaedics department of the hospital to the Ombudsman. Apologise to the patient for failing to review plaster cast.