11. Before we decide if we should investigate a complaint, we look at whether there are signs the event(s) complained about had a negative effect which the organisation has not put right. We have done this, and we have found the Trust has already done enough to put right the impact of these events.
12. The Trust’s response to the complaint, dated July 2021, explains that while in the Emergency Department with ongoing chest pains, in May 2021, Mr O was reviewed by a consultant cardiologist and a speciality registrar (senior doctor in training). Mr O felt the team dismissed his concerns about his health.
13. The response explains Mr O was provided medication with a view to be followed up in the cardiology outpatient’s clinic. The letter goes on to say Mr O was escorted to the main entrance and took a bus home when he became uncomfortable and was sick.
14. In June 2021, Mr O was followed up in the Rapid Access Chest Pain Clinic by a specialist nurse. He was then referred for an echocardiogram (ultrasound of the heart) with an appointment made for July 2021.
15. The Trust’s letter, dated July 2021, directly responds to the complaint about the attitude of the consultant cardiologist. The Trust has provided an apology from the consultant cardiologist and advised the episode has been investigated fully. The Trust has also explained the consultant cardiologist’s words were a miscommunication and not spoken or intended in the way Mr O heard it. The Trust again has directly apologised for the consultant cardiologist’s words.
16. The Trust has also directly acknowledged the suggestion the consultant cardiologist undergo further training. It advised the medical team receive regular training and development. This includes supervision and appraisals, as well as a review of all feedback by patients and colleagues. It has also assured Mrs R her concerns have been discussed as part of this process, including the consultant cardiologist having a conversation with their medical supervisor.
17. The Trust has acknowledged the consultant cardiologist will no longer be overseeing Mr O’s care and he will be overseen by another consultant.
18. Finally, the Trust offered Mrs R to meet a member of the team to discuss any outstanding issues she or Mr O may have. Mrs R called the Trust in August with further concerns. In response, the Trust again apologised for any distress the incident concerning the consultant cardiologist may have caused Mr O.
19. We can see the Trust has provided a detailed response to Mrs R, including a number of apologies from both the Trust and the consultant cardiologist. The Trust has also advised the consultant involved has been given feedback with learning points.
20. In reviewing the outcomes Mrs R is seeking, we consider the majority have already been met. Acknowledgements and apologies have been provided, and action has been taken to learn from Mr O’s experience with the consultant cardiologist. We are satisfied that action is in line with our principles for remedy which say:
The remedy should be appropriate and proportionate to the injustice sustained.
Appropriate remedies can include:
· Apologies, explanations or acknowledging responsibility - an apology should always be by personal communication from a suitably senior person within the organisation in jurisdiction to the aggrieved or his or her representatives. The apology should be specific in what it is addressing rather than general and should be for the injustice. Expressions of regret and apology made through this Office rather than direct to the aggrieved are not an appropriate form of remedy.
· Remedial action such as reviewing or changing a decision.
· Revising published material or revising procedures to prevent a recurrence.
· Financial compensation.
21. The outstanding outcome of financial remedy, which Mrs R believes to be a level five on our severity of injustice scale, is not appropriate for this case. We have carefully considered the impact on Mr O and are satisfied this falls into level one. A level one on our severity of injustice scale is detailed as follows:
A case will generally be level one if we consider the person affected has experienced a low impact injustice such as annoyance, frustration, worry or inconvenience. This would typically arise from a single (one-off) incidence of maladministration or service failure, where the effect on the person complaining is of short duration, and where there are no other adverse effects or ongoing wider impact.
We will usually consider an apology to be an appropriate remedy for these cases.
22. A level five taken from the severity of injustice scale is as follows:
Typically, level five cases will be when the person affected has experienced a marked and damaging effect on their ability to live a relatively normal life.
In these cases, recovery is likely to take a significant amount of time.
23. While we recognise Mrs R and Mr O do not agree with this, our injustice scale is based on previous cases we have investigated and awards we have made on similar injustices. As noted above, we consider this case falls into level one of our scale. In these cases, we do not consider financial remedy is appropriate.
24. Mrs R and Mr O requested this doctor be struck off, something we are not able to consider.
25. In conclusion, we will not take any further action on this complaint as we are satisfied, where failings have been identified, the Trust has already taken action to address them.