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Oxleas NHS Foundation Trust

P-003123 · Statement · Decision date: 19 November 2024 · View Oxleas NHS Foundation Trust scorecard
Complaint (AI summary)
Mr A complained the Trust transferred him back to prison without properly considering his mental health, alleging misdiagnosis, lack of assessment, and inappropriate medication changes.
Outcome (AI summary)
The complaint was closed. Some issues were outside the ombudsman's remit, and for others, no investigation would reach a satisfactory outcome.

Full decision details

The Complaint

4. Mr A complains about the Trust’s decision to transfer him back to prison without properly considering his mental health. In particular, Mr A complains that:

• a doctor misdiagnosed him and incorrectly attributed his mental health issues to substance abuse. This information was written in a psychiatrist report and impacted on a Judge’s sentencing decision • the Trust did not carry out a full psychiatric assessment before his transfer back to prison • the Trust took him off mirtazapine (an antidepressant) which caused him undue stress during his stay at the Trust’s inpatient mental health unit.

5. Mr A says as a result of being taken off mirtazapine, he was distressed and had multiple altercations with staff members at the inpatient mental health unit.

6. He says negative and unbalanced information about his behaviour in hospital were included in a psychiatrist report which was reviewed by a Judge. He says this resulted in his mental health not being considered as a mitigating factor by the Judge and led to a harsher sentencing decision.

7. Mr A would like to be properly diagnosed and given the right medication. He would also like financial compensation.

Background

8. Mr A has a background of mental illness, which at times has required him to be detained in hospital under the Mental Health Act 1983. Mr A has also spent time in prison.

9. In February 2023, Mr A was transferred from prison to the Trust’s inpatient mental health unit. In June 2023, a Judge decided Mr A would return to prison.

10. Mr A was transferred back to prison on 23 June 2023.

Findings

13. Before we decide if we should consider a complaint further, we first consider if we can consider the matters and whether an investigation is likely to achieve an outcome that would be satisfactory for the complainant. If we do not think we would be able to achieve a satisfactory outcome, we may decide not to consider the complaint further.

Mr A complains that a doctor misdiagnosed him and incorrectly attributed his mental health issues to substance abuse. This impacted on the Judge’s sentencing decision

14. Mr A said while he was at the Trust’s inpatient mental health unit, he was misdiagnosed during a psychological assessment. He said the doctor incorrectly stated that his mental health issues were due to his substance abuse. This information was included in a report which was later reviewed and relied upon by a Judge during his sentencing in court.

15. Mr A said the impact of the misdiagnosis is the Judge relied upon incorrect information about his mental health and therefore did not consider his mental health issues as a mitigating factor during sentencing.

16. The law says we can investigate actions carried out by people or organisations who were carrying out an NHS service at the time. The NHS consultant contract says work requested by the courts on the medical condition of an offender or defendant is not part of the NHS contractual services. This means by law we cannot consider what the doctor wrote in the report, as this had been requested by the Judge in relation to Mr A’s sentencing.

17. Although we cannot investigate what is written in the report, we considered whether we should investigate the diagnostic process more generally. We think it is unlikely that any investigation into the diagnostic process is likely to lead to a suitable outcome for Mr A.

18. On this occasion, Mr A’s psychological assessment report was reviewed by a Judge and considered to be sufficient at the time of the sentencing decision.

19. We cannot legally challenge the content of the report and we cannot overturn decisions made by a Judge.

20. We understand that Mr A had concerns about the reliability of the psychiatrist report however the Judge viewed the report as valid enough to base its decision on it. This is not a matter that we can interfere with. It is likely that Mr A would have had the opportunity to challenge the doctor’s report during the court proceedings. This would have been the most effective time to do so.

21. We would never be able to comment on the claimed link between the complaint about misdiagnosis and the Judge’s sentencing decision. This is the key part of Mr A’s complaint. Therefore, any investigation we did would not reach a satisfactory outcome for Mr A. Therefore, we have decided to take no further action.

Mr A complains that the Trust did not carry out a full psychiatric assessment before his transfer back to prison and challenges the quality of the psychiatric assessment

22. While Mr A was at the Trust’s inpatient mental health unit he underwent a mental health assessment. Mr A says the assessment was incomplete as the Trust did not seek a second opinion before he was transferred back to prison. Mr A complains that the results of the assessment were written in a report and materially impacted on the Judge’s sentencing decision.

23. We would never be able to comment on the claimed link between the complaint about the psychiatric assessment and the Judge’s sentencing decision. This is the key part of Mr A’s complaint. Any investigation we did would not reach a satisfactory outcome for Mr A. Therefore, we have decided not to take any further action.

Mr A complains the Trust took him off mirtazapine which caused him undue stress during his stay at the mental health inpatient unit

24. Mr A states that on 9 February 2023, the day after he was admitted to the inpatient mental health unit, the Trust took him off mirtazapine. He told us this caused him distress. He says the decision to stop mirtazapine worsened his health symptoms and contributed to the altercations he had with staff while at the inpatient unit.

25. Mr A’s complaint about being taken off mirtazapine is directly linked to the fact that the impact on his behaviour was outlined in the psychiatrist’s report for the Judge and influenced the sentencing decision.

26. Any investigation into these issues would not have a material impact on Mr A’s current circumstances as the sentencing decision has already been made and we cannot interfere with it.

27. We would never be able to comment on the claimed link between the decision to stop mirtazapine and the Judge’s sentencing decision. This is a key part of Mr A’s complaint. Any investigation we did would not reach a satisfactory outcome for Mr A. Therefore, we have decided not to take any further action.

Conclusion

28. We have decided not to investigate on the basis that the outcome of any investigation we carry out would not reach a satisfactory conclusion for Mr A. We recognise this decision will be disappointing.

29. We would like to take this opportunity to thank Mr A for bringing his complaint to us. We know it is not easy to complain. We hope we have explained the thorough consideration we have given to our decision and clearly outlined the reasons for it.

Our Decision

1. We are sorry to learn of Mr A’s experiences with Oxleas NHS Foundation Trust (the Trust) and the issues he has complained about surrounding his return to prison.

2. We have carefully considered Mr A’s complaint about the Trust and have decided not to investigate it. Some of the complaint relates to issues we cannot legally consider. For the issues we can legally consider, we do not think any investigation would be limited and would not reach a satisfactory outcome for Mr A.

3. We thank Mr A for the effort he has gone to in bringing us his complaint. We know this was and continues to be an upsetting time for Mr A and his family. We recognise our decision not to take further action may be disappointing. We have explained the reasons for our decision below.

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