Carer's Experience Medical Neglect

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The following is a short summary of the NHS complete complaint process. Text links are provided to the sub-pages giving the details as shown in the letters between myself and the hospital's Complaints Office; the Independent Review Convener and the Health Service Ombudsman's Office along with the Ombudsman's Report. The Report has linked sections that show my views of the medical evidence in new windows from the Report's sub-page (Comments), and similarly within the full Comments page back to Report. The Final page is my last letter in response to the request for my views on the Report.

Due to my dissatisfactions with the NHS neglect of an elderly person both at Primary Care and Hospital level, I felt that it was necessary to pursue the matter at the time of her death; certain that there were anomalies. I knew within myself that the treatment we both received at the hands of the NHS was questionable and that there were failings associated with the last days of her life. To any carer, I would advise "pushing of the issue", but be prepared to be stonewalled, fed waffle by the NHS and for substantial delays. It is all part of the attempt to wear you down and with the hope that you will throw in the towel.

My attempts to have questions answered with regard to the circumstances around the last days of my Mother's life took 7 months of Stage One Local Resolution followed by further Stage Two delays and the Convener's refusal of an Independent Review.

My complaint to the Ombudsman was put on my behalf by Glasgow Health Council. The Ombudsman, on this first approach, decided not to take up my complaint, but did comment that his office would not condone the delays which occurred. He also noted that the Convener had broken the Scottish Executive Health Department's guidance on complaints handling in having taken clinical advice from a doctor previously involved. The trust was reminded of the need for complaints to be handled correctly.

Upon my querying certain points in his response I was advised to write since the matter could always be looked at again. The result of my letter was that an investigation was conducted. It did indicate numerous failings on the part of the Staff to communicate with me, as I had accused them of earlier, but which had been glossed over locally. The Staff evidence is full of contradictions, inconsistencies, concocted/imagined recollections and that which I can only consider as downright fabrication. The Staff were also shown to have not been communicating between themselves nor had they been documenting various matters as required. They were also considered to have failed to have demonstrated adequate communication and support of myself particularly during the last 24 hours of my Mother's life.

The Report stated that there was little chance of her survival upon her admission, and that the outcome was in no way related to any shortcoming in her management since she had many of the risk factors known to predict death in patients with pneumonia, but I attribute the exacerbation of these factors, and her mental frame of mind to the previously referred to neglect.

The Trust claimed that I had been informed of a decision that in the event of Cardiac Arrest there was to be no CPR, but this was false, and they had not completed the required documentation.

They were found to have incorrectly conducted procedures with regard to such decisions, and were advised that all staff had to be familiar with resuscitation policy and that the matter had to be discussed fully with relatives and recorded in clinical records. The Report also showed that they had based their nursing care plan upon assumptions which was described by the Health Service Ombudsman as a highly undesirable and potentially dangerous practice and strongly criticised.

Upon being asked by the Health Ombudsman's office as to what I thought about the way my complaint had been dealt with, I stated that I was satisfied with the above recognised failings, but that I was dissatisfied with the Report's apparent acceptance of Staff claims that they had difficulty in giving bad news and had had past difficulty in getting me to understand my Mother's problems, which is waffle. I also indicated that I did not accept, as the Report does, that the final decision on clinical management rests with medical staff. I also felt it necessary to point out that I believe that the Health Ombudsman should take a much more critical stance on issues and make it clear to medical staff that they should expect intensive scrutiny.

Select a dated order Ombudsman sub-page.
Local 1a Local 1b Local 1c Local 1d
Review First Report Comments

Iain R. Stewart, Ex-Carer

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