Portsmouth Hospitals NHS Trust

4. Mr W complains about aspects of care and treatment his father received during his admission, between 27 August and 23 September. Specifically, he says the Trust: · did not take into consideration his father’s previous medical history and co-morbidities including type 2 diabetes, peripheral neuropathy, and high risk of developing pressure ulcers. These were not considered with his treatment and a care plan was not put in place to manage his father’s condition or ongoing treatment.

· did not take the necessary precautions to prevent his father getting pressure ulcers. There was also a lack of input from tissue viability nurses, and he was not repositioned regularly in contrast to what is in his medical records.

· did not meet his father’s nutrition and hydration needs.

· did not have enough equipment for intravenous (IV) cannulation.

· used inappropriate moving and handling techniques.

· did not give oral care on an hourly basis, as opposed to what is written in his father’s medical records.

· did not investigate the cause of necrotic tissue damage to his father’s left leg and foot.

· did not carry out a speech and language therapy (SALT) assessment when his father was transferred to another hospital.

· communicated poorly between staff and the family, and the multidisciplinary team (MDT) showed a lack of compassion, dignity, and transparency.

· put his father on a palliative care pathway, and he was nil by mouth (NBM). A few days later, the family were told that his father should not be NBM.

· did not monitor his father’s seizures or apnoea, nor did it monitor his blood sugar or ketone levels regularly, as opposed to what is written in his father’s medical records.

5. Mr W says the lack of care and treatment his father received contributed to his father’s death. He says his father showed some improvement in his recovery, but the treatment he received meant his medical prognosis and outlook was poor.

6. He says his father developed multiple pressure sores on his back, buttocks, arms, and legs. He says his father developed mouth secretions that blocked his airway and he needed suctioning on several occasions. He also needed nebulizers to help him breathe because of his poor oral care. He said the poor moving and handling caused his father several injuries.

7. Mr W says the family continually raised concerns about his father’s care, but these were ignored. He says the poor communication the family experienced added to the frustration they felt, at what was an already difficult time.

8. He says the family were always at his father’s bedside and they can corroborate that some entries in his medical records are inaccurate. He says the family experienced significant distress in witnessing his father’s daily suffering.

9. Mr W seeks a financial remedy as an outcome to the complaint.

10. Mr W’s father was admitted to the Trust on 27 August. A bilateral subdural haematoma (an accumulation of blood between the skull and the surface of the brain) was diagnosed following a CT scan.

11. Surgery was performed to remove the haematoma on 28 August.

12. A further CT scan identified cerebritis, a brain infection. Surgery was carried out to clear the infection and he was transferred to the intensive care unit (ICU).

13. Mr W’s father was transferred to another hospital on 23 September.

14. Mr W’s father was admitted to a hospice on 22 October. He sadly died on 25 October.

16. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances.

17. We have discussed this with Mr W to understand his circumstances and the outcomes he is seeking. We do not consider whether legal action would succeed, but whether it would be a reasonable option to look into.

18. We have considered that Mr W’s complaint relates to clinical issues about the care and treatment his father received. He says the lack of care and treatment his father received from the Trust contributed to his death.

19. Mr W is seeking a financial remedy. He has also confirmed that he is pursuing legal action against the Trust.

20. We consider Mr W does have the option of pursuing a clinical negligence claim against the Trust. As the complaint relates to clinical issues and the treatment provided, combined with Mr W’s ongoing legal action against the Trust, and request of a large financial award, we think it is reasonable to expect him to continue to seek legal action.

21. We have not identified any reasons that would prevent Mr W from pursuing legal action, given that Mr W is currently pursuing this route. We therefore will take no further action on this complaint at this time.

1. We have carefully considered Mr W’s complaint about Portsmouth Hospital NHS Trust (the Trust).

2. We recognise how important the complaint is for Mr W and how strongly he feels about the care and treatment his father received from the Trust. We are sorry to hear about the impact this has had on Mr W, his family, and his father.

3. We consider it is appropriate for Mr W to continue with legal action on the concerns he has brought to us. We go onto explain the reasons for our decision.