The Royal Wolverhampton NHS Trust

4. Mrs O complains about the care and treatment the Trust gave to her mother in November 2022.

5. Mrs O complains the Trust:

• discharged her mother when she was not well enough • discharged her mother with a pressure sore and an ulcer without giving her any pain relief • discharged her mother without telling the family or next of kin • failed to tell the family when her mother’s condition deteriorated • told her the incorrect time of her mother’s death.

6. Mrs O also complains the Trust’s medical records are unclear and food and fluid sheets do not match nursing notes. She also says it recorded conversations with people that she does not know in the notes.

7. Mrs O explains because the Trust did not discharge her mother safely, this led to her premature death. She says her mother was crying in pain when the Trust discharged her.

8. Mrs O says because the Trust discharged her mother without telling the family, her mother was left on her own in the back of the ambulance while staff tried to get into the house. There was only a neighbour there to help.

9. Mrs O says because the Trust did not tell the family about her mother’s deterioration or death, her mother died on her own. She explains she and the family had always been there for her mother and cared for her. She said they are devastated that her mother died on her own and feel they let her down when she needed them the most.

10. Mrs O says the medical records being unclear mean she has not been able to understand what happened or what care her mother had.

11. Mrs O wants the Trust to accept that it got things wrong and to make service improvements.

12. Mrs O would also like a financial payment.

13. On 18 October 2022, Mrs E went to the Trust’s emergency department and she was later admitted.

14. On 1 November, the Trust told Mrs O it was going to discharge her mother, which she objected to. The Trust discharged Mrs E the next day.

15. On 3 November, the district nurses saw Mrs E at home, thought she was too unwell to be at home and arranged for her to be readmitted to hospital. On 4 November, the Trust readmitted Mrs E.

16. Shortly after this Mrs E sadly died in hospital.

19. 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. We have discussed this with Mrs O to understand her circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

20. Based on the claimed failings Mrs O told us about, she could potentially make a claim in court for medical negligence. This is because Mrs O feels the failings directly contributed to her mother’s pain, deterioration and death.

21. Mrs O also says the Trust discharged her mother without telling the family, failed to tell the family her mother’s condition had deteriorated or about her death and the records are unclear. These issues cannot be dealt with by a clinical negligence claim because they do not seem to have caused harm or directly led to Mrs E’s suffering or death.

22. While these issues may not fall under a clinical negligence claim, they relate to Mrs O’s main concerns and are part of the same events. They are linked to the main issues. Because of this, it would not be right for us to split the complaint and deal with these issues separately without being able to investigate the main issues.

23. We think it is reasonable for Mrs O to get legal advice on her whole complaint to see if she can make a claim. Mrs O can bring any unresolved concerns back us once she has explored her legal options fully.

24. Mrs O wants an acknowledgement of failings, service improvements and a financial payment.

25. We have discussed the amount of payment Mrs O wants. She told us she thinks the Trust should pay compensation, due to how it treated her mother. She thinks this should go to her mother’s oldest grandchildren. She said it was difficult to know the amount of compensation she wanted. We discussed our severity of injustice scale (a tool we use to decide on the right amount of payment to recommend) and she said based on this she would like between £3,000 and £10,000.

26. Having carefully thought about how Mrs O told us she, her mother and the family were affected by what happened, the claimed injustice is serious. We think legal action may provide a better outcome for the family.

27. We do not look at financial payments in the same way a court can. We do not want her to miss out on the best possible outcome to resolve her complaint.

28. We realise Mrs O also wants the Trust to accept what it got wrong and to make service improvements. A successful clinical negligence claim would involve a court deciding if the Trust did get things wrong. If clinical negligence is found this would likely lead to the Trust making improvements.

29. Mrs O has not made us aware of anything that would stop her from making a clinical negligence claim. This is the most appropriate route to achieve the outcomes she wants. For this reason, we have decided not to consider the complaint further at this time.

30. If after Mrs O has spoken to several solicitors and a negligence claim is not possible, she has the option to return to us. Mrs O should return to us as soon as possible, due to our time limit on when we can look at a complaint.

1. We have carefully considered Mrs O’s complaint about The Royal Wolverhampton NHS Trust (the Trust).

2. We are sorry to hear about Mrs O’s complaint and we appreciate this would have been a very upsetting and distressing time for her, her mother Mrs E, and the family.

3. We think Mrs O could take legal action on the matter she has brought to us and we explain more about the reason for this decision below.