4. Mr G complains about the following aspects of his care and treatment at the Trust, on 9 October 2020. He says:
· he was left unattended for long periods of time · the Trust failed to send details of his prescription to his GP · he was not happy he had a cannula left in his hand on discharge.
5. Mr G says it made him feel upset and angry. He says he worries about what will happen if he goes into hospital again.
6. Mr G says he wants a financial remedy.
Mr G was left unattended for long periods
9. Mr G says that after being admitted to the ward, he was not given adequate attention from medical staff. He says he was transferred to another ward, and no examinations were taken during his stay.
10. The Royal College of Physicians National early Warning Score (NEWS) 2 guidance sets out a scoring system to standardise the assessment and response to acute illness. It sets out the required frequency of observations in response to different NEWS scores. Scores of zero require minimum 12-hourly monitoring. Scores between one and four require four- to six-hourly monitoring.
11. The records show the Trust took observations of Mr G. His NEWS score in the afternoon of 9 October 2020 was zero, an hour later was recorded as zero, then late that evening was recorded as three. On 10 October 2020, in the early morning, his score was recorded as one. These are low level NEWS scores. A score of zero indicates 12-hourly observations. A score between one and four would indicate a frequency of four- to six-hourly observations. The Trust’s observations of Mr G were within those timescales.
12. Mr G’s notes also show evidence of hourly individualised care rounding. There are entries within the nursing notes demonstrating interactions with Mr G. For example, the Trust noted: ‘breakfast declined’, ‘call bell within reach and managing fluids’, and ‘introduced to staff’. We cannot see any evidence the Trust left him unattended for long periods.
13. While Mr G felt he was not attended to sufficiently, there is nothing in his medical notes to suggest he was not assessed and monitored in line with the RCP guidance. As this is the case, we can see no indication of failings.
Failed to send prescription to GP
14. Mr G says the Trust told him he had a prescription for antibiotics, and this had been sent to his GP.
15. The Trust says it is unaware of a prescription and believes it was a misunderstanding. It says he was told to contact his GP to be prescribed the antibiotics.
16. Mr G’s discharge letter makes no reference to further medication. However, it does say the treatment plan, on admission, was to include tazocin (a penicillin antibiotic).
17. Section 44 of the GMC guidance says doctor must: ‘contribute to the safe transfer of patients between healthcare providers and between health and social care providers. This means you must: share all relevant information with colleagues involved in your patients’ care within and outside the team, including when you hand over care as you go off duty, and when you delegate care or refer patients to other health or social care providers’.
18. We have considered the discharge documents, the comment from Mr G, and the complaint response from the Trust. There is no record to say the Trust intended to offer a further prescription for antibiotics. As this is the case, there is no indication the Trust did not share all relevant information with the GP, even if there was some misunderstanding about what would happen next. There are no indications it did not act in line with the GMC guidance.
Cannula left in hand
19. Mr G says he was not happy at being discharged with the cannula still in his hand.
20. The Trust says Mr G discharged himself and would not allow anyone to remove the cannula. Mr G agrees with this statement and says the cannula was removed successfully when he got home.
21. Although Mr G and the Trust agree he was discharged without the cannula being removed, we considered if the Trust should have done anything differently to ensure it was removed before he left.
22. The issue with removing the cannula would be down to consent. The Trust would need to consider if Mr G lacked capacity to make the decision to refuse to have the cannula removed.
23. There is no evidence that the Trust should have questioned Mr G’s capacity. The Trust is not able to force a patient to receive treatment if they refuse. This is in line with section 4 of the Nursing and Midwifery Council Code – ‘Act in the best interests of people’
24. Section 4.1 says nurses should balance the need to always act in the best interests of people, with the requirement to respect a person’s right to accept or refuse treatment. Given the Trust cannot force Mr G to have the cannula removed, and that he discharged himself knowing it was still in his hand, we can see no indications of failings in this instance.
1. We have carefully considered Mr G’s complaint about County Durham and Darlington NHS Foundation Trust (the Trust). We were sorry to hear about his concerns, and the distress this has caused him.
2. We have seen no indications the Trust did not follow relevant guidelines during his admission. We saw no indications the Trust left him unattended for long periods of time, failed to send his GP a prescription, or failed to remove a cannula from his hand.
3. We will not be taking any further action on Mr G’s complaint.