4. Mr O complains Nottingham University Hospitals NHS Trust, unreasonably delayed a sleep study for four weeks between 2 February and 2 March 2023 for his son, A.
5. Mr O says as a result they missed an opportunity to diagnose and appropriately treat sleep apnoea which led to A experiencing damage to his brain and ongoing learning and developmental disabilities.
6. Mr O is looking for a financial remedy at level three on our SOI.
7. A has been under paediatric care since birth for a number of complex health conditions related to oxygen intake.
8. In January 2023, Mr O approached the Trust to advise he suspected A of having obstructive sleep apnoea (OSA), due to excessive snoring.
9. On or around 2 February 2023, A was examined by the Trust’s community paediatric consultant, who observed symptoms that warranted a sleep study and a referral was made.
10. Mr and Mrs O chased the progress of the referral over the next two weeks. This alerted the Trust that the referral had failed to progress and was expedited.
11. A sleep study was conducted on 2 March 2023 following which OSA was diagnosed for A.
Timeliness of sleep study
15. Mr O complains Nottingham University Hospitals NHS Trust (the Trust), unreasonably delayed a sleep study for four weeks between 2 February and 2 March 2023 leading to a missed opportunity to diagnose and appropriately treat sleep apnoea. The Trust say a referral was made. They dispute the referral was delayed or an opportunity to diagnose sleep apnoea was missed.
16. In reviewing the evidence, we can see the Trust suspected possible obstructive sleep apnoea on or soon after 2 February 2023 leading to a referral for a sleep study, which occurred on 2 March 2023. The Trust say a system error resulted in the referral not going through on the first attempt, which they were alerted to by Mr O chasing the referral.
17. We have very much in mind, A’s difficulties in breathing while sleeping was understandably of utmost concern to Mr and Mrs O and their frustration that A’s sleep study should have been a matter of urgency, is not lost on us.
18. In reviewing the hospital records and exploring the availability of guidelines in terms of the timeliness of the sleep study, we have found no national standard or clinical guidance, that points to a recognised timeframe for a sleep study. Our clinical adviser has also confirmed that no guidelines exist in this respect. We have asked the Trust about local guidelines or policies to support their position that the four-week waiting time in A’s case was standard. They have advised us their use of the word ‘standard’ was not intended to relate to any recognised or established policy in arranging a sleep study.
19. In the absence of focused guidelines here, we have looked at the Good Medical Practice guidelines published by the General Medical Council which advise prompt investigations. It is the role of the doctor ordering the investigation to act upon the results of any investigations. However, we do recognise no national or local NHS policy providing a mechanism for tracking and alerting on investigations that have been ordered, appears to exist. Our adviser has confirmed the lack of such a mechanism.
20. When asked whether the promptness of the sleep study was appropriate, our adviser has explained the time taken to arrange a sleep study for A, was not unreasonable.
21. We appreciate that due to the system error mentioned above, A had to be re-referred. We also appreciate it was the parents query which led to this understanding. However, we can see the Trust has apologised for this error and took immediate action to remedy it which resulted in the sleep study on 2 March 2023. Whilst we acknowledge an error here, we are not persuaded this goes so far as to indicate a failing on the part of the Trust particularly in light of their action to put this right once alerted.
22. As explained, we fully appreciate A’s breathing difficulties while sleeping was a very worrying and upsetting time for Mr and Mrs O and we are very sorry that A continues to experience problems in this respect. Overall, while we fully accept this would have been a very frustrating experience, with the lack of local or national guidelines for the timeliness in undertaking a sleep study, we have not seen a basis to suggest there is a failing in the time taken to arrange the study.
1. We have carefully considered Mr O’s complaint about Nottingham University Hospitals NHS Trust (the Trust). We were very sorry to learn of the very frustrating and worrying time Mr and Mrs O have experienced in trying to arrange a sleep study for their infant son, A.
2. Having now considered the evidence available to us in Mr O’s complaint, we have come to a view that the Trust has not done anything that could be considered a failing which would be appropriate for us to investigate further.
3. We acknowledge there was a period of four weeks from referral to a sleep study being conducted. However, we have not seen that fell below an appropriate standard.