Blackpool Teaching Hospitals NHS Foundation Trust

3. Mrs D’s husband sadly died in hospital on 15 August 2021. She says his death certificate lists double pneumonia as the cause of his death. Mrs D complains the Trust left her husband cold as he was insufficiently clothed in just a hospital gown throughout his admission. She believes he would not have died, if he had been kept warm by appropriate clothing.

4. To resolve her complaint, Mrs D would like the Trust to learn from this failing in care and to act differently in future, for other patients.

5. Mr D was 88 years of age at the time of these events. He received inpatient care at the Trust in 2021 for pleural effusion (a build-up of excess fluid on his lungs) and for pneumonia (a type of lung infection).

6. After a period of inpatient admission, the Trust determined Mr D was medically fit for discharge, and on 23 July he was discharged to a care home. On 1 August Mr D was returned to the Trust from his care home.

7. In its response to Mrs D’s complaint, the Trust explained Mr D was initially being treated for community acquired pneumonia (sometimes abbreviated as CAP). It said unfortunately, despite treatment, this infection progressed into hospital acquired pneumonia (sometimes abbreviated as HAP).

8. Mr D sadly died in hospital on 15 August 2021. The death certificate lists the cause of Mr D’s death as directly due to HAP, with frailty and CAP listed as other conditions that may have contributed, though were not part of the direct cause.

9. Remaining unhappy with the response she received to her complaint, Mrs D asked us to consider her outstanding concern.

13. We were very sorry to hear of Mrs D’s concerns, about her husband not being dressed in the clothes she took in for him to wear during his admission. It must have been very upsetting for her to have seen her husband in hospital and to have heard him say he felt cold.

14. From speaking with Mrs D, we know how strongly she believes that her husband would not have died from his pneumonia if he had been kept warm during this admission. We carefully considered whether we could link this impact to her complaint. We hope we can offer her comfort, in explaining that we cannot make this link.

15. There are well-established national guidelines that advise clinicians about the treatment of a person with pneumonia. Our Lead Clinician explains that none of these published guidelines mention temperature as an aspect of care that needs particular attention.

16. Our Lead Clinician explains that the people who publish these national guidelines look at all the evidence. This means that if there was any indication that adding or removing clothing from a patient to manage their temperature would help them recover from a pneumonia, then this would appear in that guidance.

17. NICE guidance on the diagnosis and management of pneumonia is one example of a well-known national piece of guidance. This only mentions temperature in terms of it being raised, recommending a patient should remain in hospital if their body temperature is significantly high. It does not make any reference to a patient being or feeling cold.

18. When we spoke with Mrs D, she expressed an understanding of keeping a person warm, particularly if they are at home and unwell with a pneumonia infection. We understand her perspective. It is often reported upon in the news, as well as being outlined in guidance such as that published by the UK Health Security Agency, that cold weather can cause complications and illness particularly to those who are vulnerable and elderly.

19. Our Lead Clinician explains that this tells us cold weather or cold temperatures can increase the likelihood of a person developing a chest infection. In Mr D’s case, he already had a pneumonia infection at the point he arrived at the Trust. This was sadly not a case of preventing him from developing an infection, as he was already unwell with a developed chest infection from the start of this admission.

20. Our Lead Clinician explains there is no clinical evidence-base that says altering the thermal conditions of a patient is helpful in them recovering from a pneumonia infection.

21. We understand why Mrs D has remained very upset and concerned about this aspect of her husband’s experience in hospital. We hope our explanation here can allay those concerns. We thank Mrs D for bringing her complaint to us and hope we can provide her assurance that for the reasons explained, we see no need to take this complaint further.

1. We have carefully considered Mrs D’s complaint, and we cannot make a link between what she says went wrong and what she says happened as a result. We do not find any link between Mr D feeling cold and the very sad outcome of his death.

2. We know how strongly Mrs D feels about what happened, and we recognise her ongoing grief in remembrance of her beloved husband. We hope our explanation can offer her the comfort and reassurance of knowing that we do not see anything to suggest this had any bearing on his very sad death.