15. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications the Trust did anything wrong.
16. Mrs B is concerned the Trust failed to carry out the tests it had initially planned to. She feels the Trust were unable to treat her mother properly as staff did not know exactly what was wrong.
17. The Trust explained Mrs L was treated for pneumonia and heart failure, and further tests would not have changed her management, given her condition at the time. Pneumonia is a specific type of chest infection that affects the small air sacs in the lungs.
18. On 19 April, the notes show a consultant spoke with Mrs B and Mrs L. They explained it was important to treat Mrs L’s symptoms, rather than look for more possible diagnoses as this would not help. Mrs L indicated she did not want to be in hospital and the consultant wanted to facilitate her wishes. The consultant explained Mrs L had deteriorated since the beginning of the year and was now frail.
19. GMC guidance says at section 14b: ‘You use specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which options for investigating, treating or managing the patient’s condition (including the option to take no action) are clinically appropriate.’
20. The notes indicate the Trust spoke with Mrs L about her preferences and wishes. The Trust made a decision about further tests while respecting Mrs L’s wishes.
21. Our adviser explained an Echo or CT scan would not have altered Mrs L’s management. She was being treated for pneumonia and heart failure, with oxygen, antibiotics and diuretics. All these treatments would have helped her with her symptoms of shortness of breath.
22. Our adviser also noted that exposing Mrs L to the radiation of a CT scan would be potentially harmful, if there was no deemed benefit of carrying out the scan.
23. We have carefully considered all the evidence showing what happened. This indicates the Trust acted in line with section 8.7 of the BTS guidance on pneumonia in providing Mrs L with the appropriate antibiotics, given her allergies.
24. It also acted in line with the BTS guidance on home oxygen, in particular section i20, which says Palliative oxygen therapy can be used to reduced breathlessness and improve quality of life.
25. Overall, we consider the Trust acted in line with Mrs L’s wishes and relevant guidance in not performing further tests. Mrs L was on the correct treatment for her symptoms of breathlessness. Based on this, we have seen no indications of failings and have decided not to consider the complaint further.
26. We are sorry to hear of how quickly Mrs L deteriorated when she was discharged and recognise the distress this caused her family. We hope Mrs B can be reassured the Trust has acted in line with guidance when treating her mother.