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East Sussex Healthcare NHS Trust

P-002394 · Statement · Decision date: 22 January 2024 · View East Sussex Healthcare NHS Trust scorecard
Administration Administration Administration Administration Inadequate Pre-Operative Risk Assessment Patient dignity and privacy
Complaint (AI summary)
Mrs N complained East Sussex Healthcare NHS Trust prematurely cancelled her knee surgery after she returned early from holiday, due to poor communication about blood pressure.
Outcome (AI summary)
The ombudsman closed the case, noting the Trust had agreed to take further steps to rectify the situation and put things right for Mrs N.

Full decision details

The Complaint

4. Mrs N complains about the Trust’s service when it arranged her knee surgery in September 2022.

5. While Mrs N was on holiday with her husband, the Trust called her to say she could have surgery on 27 September 2022 because there had been a cancellation. Mrs N and her husband returned from holiday early for this surgery. They were then told she was not suitable for surgery due to a high blood pressure reading at the pre-operative assessment on 13 September 2022.

6. Mrs N complains that the Trust: • did not tell her that a high blood pressure reading meant she would not be fit for surgery • did not give her the opportunity to have her blood pressure checked again between 23 and 27 September despite telling her it would • told her that four days of Octenisan (an antimicrobial hair and body wash) washing rather than five would be enough for her to have the surgery • did not advise her to have a check with her GP after her high blood pressure reading on 13 September 2022, despite the Trust saying it had done this.

7. Mrs N says she has experienced financial loss because she returned from holiday early to have the surgery.

8. Mrs N wants a financial payment of £1,602. Mrs N says £602 of this is the cost of returning from holiday early and £1,000 for the loss of enjoyment of her holiday.

Background

9. On 13 September 2022, Mrs N had a pre-surgery appointment. At this appointment her blood pressure was recorded as being high.

10. In the complaint response the Trust explains that at this appointment Mrs N was advised she should have another blood pressure check with her GP before she would be seen as fit for surgery. Mrs N told us she was not told this.

11. On 21 September 2022, while on holiday, Mrs N got a call from the Trust advising her that an appointment was available on 27 September. Mrs N accepted this appointment.

12. On 23 September, the Trust called Mrs N for her pre-surgery consultation. In this call it advised her that four days of Octenisan washing rather than five would be fine. The Trust also said she would have the opportunity to have her blood pressure measured again before her surgery.

13. On 25 September, Mrs N and her husband returned to the UK early after getting new flights to be home in time for the surgery.

14. On 26 September, Mrs N got a call from the Trust saying she would not be able to have the planned surgery due to her high blood pressure reading on 13 September.

Findings

Communication of high blood pressure reading and what it meant

16. To decide if we should do a detailed investigation of a complaint, we consider whether there are any signs that something went wrong that the organisation has not yet put right. We look at whether we can resolve a complaint quickly by achieving the outcomes wanted, at an earlier stage in our process.

17. The Trust admitted it should have told Mrs N that she would not be fit for surgery due to her high blood pressure result on 13 September. The Trust explained it had made an error where an incorrect ‘outcome code’ was entered on its system that meant it showed Mrs N was fit for surgery when she was not. The Trust apologised for this error in its complaint response.

18. Mrs N did not feel the Trust had done enough to put this right because it had not offered a financial payment.

19. Mrs N and her husband paid over £600 for flights to get home in time for the surgery. On 26 September, the day after they had returned to the UK, the Trust contacted Mrs N to tell her she could not have the surgery.

20. Our ‘Principles for Remedy’ say, ‘Where maladministration [fault] or poor service has led to injustice or hardship, public bodies should try to offer a remedy that returns the complainant to the position they would have been in otherwise. If that is not possible, the remedy should compensate them appropriately.’

21. We reviewed our severity of injustice scale and thought Mrs N’s injustice was at level two. This includes emotional impact like distress, worry and annoyance that did not affect the person’s day-to-day functioning or their ability to live a normal life. Level two impact usually lasts for up to around six months and we expect any impact to diminish completely in time. We recommend £100 to £450 for level two cases.

22. We approached the Trust and asked if it would consider making a payment to Mrs N in line with our scale. The Trust agreed to pay Mrs N £850. £600 is to cover the cost of her flights and an extra £250 for any stress and anxiety caused to Mrs N.

23. Based on this, we are satisfied that the Trust has taken steps in line with our Principles and our severity of injustice scale.

The Trust did not give Mrs N the opportunity to have her blood pressure checked again between 23 and 27 September

24. Mrs N said the Trust told her in the phone call on 23 September that she would have the opportunity to have her blood pressure read again before her surgery. Mrs N said she was never given this opportunity.

25. In the complaint responses the Trust admits the pre-operative communication was not clear enough and the processes were not followed fully. The Trust apologised for this.

26. The Trust explained that due to the high blood pressure reading on 13 September, Mrs N would not have been fit for surgery even if she had another blood pressure reading that was in the ‘normal’ range. The Trust recognised its communication will have caused Mrs N stress and anxiety.

27. We think the payment offered by the Trust, together with the apology it has already given, is enough to put things right in line with our Principles.

Octenisan washing

28. The Trust acknowledged it should not have told Mrs N that four days of Octenisan washing rather than five would be suitable for her to be fit for surgery.

29. The Trust has apologised for this mistake and has communicated with staff that the rules around Octensian washing need to be strictly followed. The Trust recognises this contributed to Mrs N thinking she was fit for surgery and making the decision to return from her holiday early.

30. We think the financial payment offered by the Trust, together with the apology and service improvements it has already given, is enough to put things right in line with our Principles.

Further blood pressure check with the GP

31. In the complaint responses the Trust said staff at the blood pressure check did advise Mrs N to get an urgent appointment with her GP after her high blood pressure reading. Mrs N says that this did not happen.

32. It is difficult for us to say whether or not Mrs N was advised to contact her GP. In the complaint responses the Trust apologises that it cannot offer Mrs N closure on this matter.

33. We think the payment the Trust has agreed to make, puts right this part of the complaint.

34. We recognise that Mrs N had a poor experience, and we understand how upset she was when her surgery could not go ahead after she had ended her holiday early at financial cost to herself.

35. We are pleased the Trust has offered to make the payment to Mrs N. This puts right her financial loss and the emotional impact of the Trust’s actions.

36. We have spoken to Mrs N about the Trust’s offer and she is happy with it.

37. There is no need for us to take any further action. We thank Mrs N for bringing her complaint to us and appreciate the difficult circumstances she experienced.

Our Decision

1. We have carefully considered Mrs N’s complaint about East Sussex Healthcare NHS Trust (the Trust).

2. We are sorry to hear about Mrs N’s experience and we recognise the stressful impact this had on her.

3. We have considered the information and spoken to the Trust. It has agreed to take further steps to put things right for Mrs N.

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