The Hospital Trust
12. Mrs A complains that staff in the emergency department left her husband in pain and discomfort when he attended on 19 February 2024. When we spoke to Mrs A she said she understood the issues in her complaint would not have affected the progression of her husband’s aggressive cancer. She said her husband was unable to sit because he found it too painful, so he had to walk around the department for several hours. She believes staff should have taken action to make her husband more comfortable, by giving him stronger pain relief or providing him with a bed.
13. The Trust has explained how the Hospital was extremely busy on the night in question. This meant patients waited longer than usual for a doctor to see them and also that no beds were available. The Trust offered sincere apologies to Mrs A in person at a complaint meeting and also in writing.
14. The Trust also accepted its clinicians should have offered further pain relief to Mr A. It was sorry this meant there was a delay in his treatment and that he left the department because he could not wait any longer. The Trust confirmed that it had offered Mr A and option to return later that morning, which he declined. It said new protocols were in place to ensure patients are given the right amount of pain relief when they are waiting for a clinician to see them.
15. During our primary investigation we look at whether there are any indications of failings. We then look at whether those failings could have had an impact and whether the organisation has taken appropriate steps to put things right.
16. In this case we can see how the lack of pain relief and a bed could have been a failing. We can see how Mr A may have experienced pain and discomfort that could have been avoided. So, there are indications of failings that could have had an impact.
17. We consider the Trust has already taken appropriate action to address Mrs A’s complaint. It has acknowledged failings and apologised to Mrs A. It has also taken action to show there has been learning from the complaint. It seems the Trust has already provided Mrs A with the outcomes to her complaint that she seeks. There is nothing further we would be able to add by starting a detailed investigation.
18. We appreciate how upsetting it must have been for Mrs A to witness her husband’s distress while he waited in the emergency department. We hope she can see why we have decided not to start a detailed investigation of her complaint about the Trust.
The Ambulance Trust and the Practice
19. Mrs A told us she believes paramedics and the out of hours GP should have arranged for her husband to attend the Hospital on 20 February 2024. She suggests that failings by these clinicians meant her husband was left in pain for more than a week until he attended a scheduled appointment with his specialist.
20. We understand the paramedics attended Mr A’s home within one hour of Mrs A calling the Ambulance Trust. They reviewed Mr A and did not consider it would be beneficial for him to return to the Hospital, particularly in light of his experience during his last attendance there. They instead arranged for an out of hours GP from the Practice to attend.
21. The GP who attended also decided Mr A did not require hospital treatment. They considered Mr A’s problems were related to his liver cancer and understood he was waiting for surgery. The GP noted Mr A felt nauseous and gave him medication for that. They did not consider he was in significant pain at that point. They advised him to speak with his usual GP the following day to see if they could arrange a more urgent specialist appointment.
22. Mrs A told us she contacted her husband’s the GP the following day. They advised her to wait for the appointment that was already scheduled. At that appointment the specialist decided Mr A was too unwell to have the planned surgery.
23. We can see how distressing it must have been for Mrs A and her family during the time when her husband was unwell. The evidence we have seen suggests the paramedics and the Out of Hours GP could not have been responsible for Mr A’s ongoing symptoms following the call to his usual GP on 21 February 2024. Even if we were to investigate and find failings in the care they provided, we would not be able to conclude this led to avoidable pain for Mr A over the following days. At most Mr A would have experienced pain and discomfort for a few hours that could be linked to any inaction on their part.
24. We have decided to focus on the more serious complaints that people bring to us, where they may have faced a big impact. For example, these may be about a potentially avoidable death or where someone has suffered prolonged pain. These types of complaints are where we can often make the biggest difference. This will allow us to provide the right level of service to those people, as quickly as possible. This means we are not looking into complaints where we can see there has been a smaller impact. Based on the impact Mrs A told us about, this applies in her complaint about the Ambulance Trust and the Practice.
25. We have decided not to start a detailed investigation of Mrs A’s complaints about the Ambulance Trust and the Practice. This is because we cannot see that if there were any failings in care and treatment they could have led to a serious impact on Mr A and his family. Any pain and discomfort would have only been for a short period of time.
Conclusion
26. We recognise it will be disappointing for Mrs A and her family to find that we have decided not to start a detailed investigation of this complaint. We hope they can appreciate the reasons for our decision.