The Trust did not arrange for personal apologies from Ms H and Dr O
15. The Trust’s own complaint’s policy sets out that, ‘If you have a concern about the treatment or care that you receive, it is best to address it straight away. If you are staying in hospital, or are visiting someone who is staying in hospital, please ask to speak with the ward manager, sister or matron who will listen to your concerns, agree with you the actions that will be taken to resolve the matter, and update you on progress as required.’
16. At no point in the Trust’s complaint policy is it explicit that personal apologies from clinical team members are part of the remedy.
17. We can see this was a very distressing time for Miss A, as her clinically vulnerable son was in hospital during the pandemic, and she was extremely concerned for his welfare. We recognise her concerns were heightened when she was informed her son may be moved into a ward where he would be more at risk from infection and specifically to COVID-19.
18. Miss A says she and her son were left distressed when they thought he would be moved. We are pleased to hear this did not happen and acknowledge this would have been a very upsetting experience for them both.
19. Miss A tells us she will not accept apologies from the Trust and for her complaint to be resolved she requires a signed personal apology from Ms H and Dr O, who she spoke with on 6 January 2021.
20. From the evidence we can see the Matron attempted to resolve the complaint and offered apologies (on behalf of the Trust) to Miss A when they met on 11 January for the misunderstanding which occurred on 6 January. Miss A sent an email to the Trust on 17 January saying she had met with the Matron who had apologised, but considered this was not sufficient for her, and she wanted personal written apologies from both Ms H and Dr O.
21. The Trust sent a letter to Miss A on 18 January from the Patient Advice and Liaison Service (PALS) Manager who apologised that Miss A had reason to complain and referred to the personal apologies made by the Matron on behalf of the Trust when they met on 11 January. We can see Miss A was not happy with this and sent an email saying the matter was not resolved until she had a signed personal apology from the staff involved. The Trust sent a letter to Miss A on 20 January from the Head of Complaints saying the Matron had apologised on behalf of her colleagues.
22. Miss A remained unhappy and sent another email on 21 January saying she wanted personal written and signed apologies from the staff involved. The Trust responded in a letter dated 1 February saying Miss A had received a personal apology from the Matron on behalf of her colleagues and the Trust on 11 January.
23. In this instance we can see the Matron apologised on behalf of the Trust and an attempt to offer an explanation and apology from Dr O was made, but Miss A did not agree with what was being said.
24. Regarding the exact details of what was said, as an independent organisation we would struggle to find impartial evidence to help us reach a view, we could take witness statements from Dr O or the Matron, but time lapsed and their employment within the Trust does not offer any certainty of the statement being impartial third-party accounts. For those reasons, with this complaint part, moving from a preliminary stage investigation to a full investigation would not provide any further independent impartial evidence on which we can confidently reach an independent view.
25. The NHS Complaint Policy sets out that in good complaint handling, complainants are entitled to an explanation and, where appropriate, an apology.
26. As we can see the Matron did apologise, it is our view there are no indications of maladministration here. Though Miss A sought a personal apology, the Trust and NHS complaint process does not state personal apologies are part of the complaint process.
27. We understand the Matron acknowledged Miss A’s concerns and explained to her how the misunderstanding had arisen, the Matron also personally apologised to Miss A for the poor service she had received on behalf of the Trust.
28. Our Principles of Good Complaint Handling says public bodies should be open and accountable and take responsibility for the actions of their staff and those acting on behalf of the public body. Against these principles, our view is this apology from the Trust is appropriate to remedy the upset caused to Miss A and do not consider a failing in not receiving a personal written signed apology from specific staff members.
29. After careful consideration of all the above information, we have found no indications of failings here and have decided not to investigate this part of the complaint.
The Trust wanted to move Miss A’s son out of a cubicle and did not listen to her concerns about the care being provided to him as he is vulnerable and was shielding.
30. Before we decide if we should investigate a complaint, we look at whether there are signs the event complained about had a negative effect which the Trust has not put right. We have done this, and against our own Principles for Remedy, we have found the Trust has already done enough to put right the impact of these events.
31. What should have happened in this situation can be found in COVID-19: Guidance for maintaining services within health and care settings: Infection prevention and control recommendations, August 2020.
32. Section 10 of these guidelines covers patient placement in a hospital setting and says if a patient has symptoms or a history of contact/exposure with a case, they should be prioritised for single room isolation or cohorted (if an isolation room is unavailable) until their test results are known. If single rooms are in short supply, priority should be given to patients with excessive cough and sputum production, diarrhoea or vomiting and to those at high risk/extremely high risk of severe illness. Local risk assessments and clinical decisions must be made regarding placement of patients/individuals with availability of single rooms taken into consideration.
33. Miss A tells us on 6 January 2021 she took her son to A&E at the Trust. He was admitted to hospital and moved to a cubicle in a paediatric ward for ongoing care. Miss A says she was informed by staff on the ward her son would have to be moved if another patient was admitted who needed the bed he was occupying.
34. Miss A says she and her son were left distressed when they thought he would be moved out of the cubicle and concerned the hospital staff were not aware of her son’s condition and shielding status.
35. From the evidence we can see Miss A complained directly to the Matron on 11 January about the events on 6 January. The Matron acknowledged Miss A’s concerns and apologised on behalf of her colleagues and the Trust and explained the staff involved were not aware of her son’s shielding status and this how the misunderstanding had arisen. She assured Miss A her son would remain in the cubicle due to his shielding status.
36. We recognise this would have been a very upsetting experience for Miss A and her son especially as she thought the Trust were dismissing her concerns.
37. We have considered this complaint in accordance with our Principles of Remedy, which says we can ask an organisation to take action to put things right. This could mean acknowledging its mistakes, improving services, apologising, or making a payment if the person complaining has been left out of pocket because of what happened.
38. Our view is we will not investigate this part of the complaint. This is because Miss A’s son was not moved, against our own Severity of Injustice (annex) we consider the apology is appropriate to remedy the distress caused to Miss A and her son when they were informed he might be moved from the cubicle as this was short lived emotional and a one-off instance.
The Trust did not answer the questions in Miss A’s complaint about shielding guidelines, and the Trusts policies on testing parents and guardians.
39. Before we decide if we should investigate a complaint, we look at whether there are signs the Trust has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and, we have not found any indications that something has gone wrong.
40. What should have happened here can be found in the NHS Complaints Policy which says a response to a complaint will include an explanation of how the complaint has been considered, an apology if appropriate, and an explanation based on facts.
41. Miss A tells us she asked in her complaint what policies the Trust had in place for both paediatric and adult patients who were shielding and being admitted to hospital and asked about legal rights to advocate on behalf of her son.
42. From the evidence available we can see Miss A sent an email to the Trust on 11 January asking these, as well as some other questions. We can also see that at the meeting on 11 January 2021 with the Matron, Miss A’s questions were verbally discussed with the Matron.
43. The Matron advised the admissions pathway of patients with clinical need was changing week to week due to the ongoing pandemic. The Matron explained that whilst the Consultant’s at the Trust were aware of Miss A’s son’s disabilities and the need for shielding, the doctor who had spoken to her on 6 January 2021 was not aware of this.
44. They also discussed advocacy and Miss A informed the Matron that she was in the process of applying to the court for legal rights to act on her son’s behalf.
45. The Trusts letter to Miss A dated 1 February, answered her questions about Trust policy for shielding children, and policy for testing parents and carers. It said it did not have a Trust policy for shielding children and no policy for testing parents and carers as there were no government guidelines for this at the time.
46. Our Principles of Good Complaint Handling says organisations should act fairly and proportionately, acknowledge mistakes, and apologise where appropriate.
47. We understand Miss A was frustrated with the complaint handling and did not accept the responses from the Trust as resolution to her complaint. We can see the Trust did respond to her questions, verbally at the meeting with the Matron on 11 January and in writing in its letter dated 1 February. Our view is we cannot identify any indications of maladministration here so have decided we will not progress this part of the complaint.