5. Mr X complains about the care and treatment provided in 2024. Mr X complains the Trust:
• failed to give Mr X a bed in a psychiatric hospital as planned • staff were rude and refused to speak to him.
6. Mr X says this caused:
• Mr X's illness to progress as he could not begin his medication.
• caused stress to Ms X and worsened her mental health.
7. By bringing this complaint to us, Mr X would like a financial remedy
8. In May 2024, Mr and Ms X moved into the Trust’s area to access better treatment for Mr X for treatment resistant schizophrenia.
9. In August 2024, Mr and Ms X attended the first assessment appointment for Mr X. This assessment was terminated due to Mr X becoming frustrated during the appointment.
10. In September 2024, the Trust offered a further assessment due to frequent contact with the crisis team.
11. In October 2024, after Mr X stated he wanted to start clozapine, the Trust stated Mr X would go into hospital for this medication to be started.
12. In November 2024 Ms X informed the Trust they wanted to transfer Mr X’s care to a different catchment area as they were unhappy with the service he had received.
16. When we look at a complaint we look at what happened and compare that to what should have happened. We consider any gaps between the two and whether that amounted to maladministration or service failure.
Mr X’s hospital bed
17. Mr X complains he was not given a hospital bed as planned. This meant Mr X could not start his medication of choice, clozapine, as to begin this medication it needed a time of monitoring in hospital for it to be administered safely.
18. NICE Guidelines on patient experience states the medical professionals should ‘accept that the patient has the right to decide not to have a treatment, even if you do not agree with their decision, as long as they have the capacity to make an informed decision.’
19. In September 2024, Mr X wanted to start clozapine. The consultant psychiatrist explained Mr X would have to go into hospital as clozapine requires a registering process to monitor his bloods and physical health needs. We can see that a bed management referral form was created on 9 October 2024 as per Mr and Ms X’s wishes.
20. Records from a home visit in October 2024 show Mr X expressed he no longer wanted to be admitted to hospital therefore his hospital bed referral was cancelled.
21. In early November 2024, Mr X expressed he would like some time to think about going into hospital. Ms X later called and stated they would like to go ahead with Mr X’s admission into hospital so he could start clozapine. On 11 November 2024, a further bed management referral form was created for Mr X.
22. On 15 November 2024, Mr X contacted the Trust stating that he no longer wanted to be admitted to hospital. Ms X also expressed they would like to transfer care to a different Trust as she was unhappy with the care being provided. She was informed this would require changing GP surgery and this was completed on 20 November 2024.
23. When care is transferred from one Trust to another, the Trust cancelled the second hospital bed booking so that Mr and Ms X could seek care elsewhere.
24. We consider the Trust acted on the wishes of Mr and Ms X. First, they sent the hospital referral form when Mr X wanted to go into hospital and later cancelled it when he changed his mind.
25. They re-referred Mr X when he again decided he wished to go into hospital and then cancelled it when Mr and Ms X decided they wished to leave the Trust’s care. The Trust followed NICE guidelines in listening to the patient’s wishes and accepting the patient has the right to decide not to have treatment.
26. We do not see a gap between what should have happened and what happened in relation to this complaint as the Trust have followed the wishes of Mr and Ms X.
27. For these reasons, we will not consider this issue further.
Communication with staff
28. Ms X states that staff at the Trust refused to speak with Mr X as they did not feel comfortable treating him.
29. The records show between September and November 2024, there were 67 calls to the Crisis and Community Mental Health Teams. Some of these calls were from Mr X and some of these calls were from Ms X.
30. There were many calls between September and November 2024, to adult mental health services. On many occasions there were multiple calls a day. We can also see Mr and Ms X terminated some of these calls.
31. Mr X was seen in person by staff in August 2024, September 2024 and October 2024 and they engaged in conversation with Mr X.
32. In August, the meeting was terminated as Mr X became frustrated.
33. In September we can see meaningful conversation was engaged in and Mr X decided he would like to go back onto the medication clozapine.
34. In October staff made a home visit to Mr X and were accompanied by two PCs due to potential risks to staff, based on recorded alerts and statements made by Mr X. We can see, despite police presence, meaningful conversation was achieved and, on this date, as Mr X decided he no longer wished to go into hospital.
35. The NHS unacceptable behaviour policy states that staff should ‘uphold their duty of care for patients and others whilst maintaining staff safety and security, including physical, emotional and psychological wellbeing.’ We have seen evidence this standard of care was maintained, whilst staff safety was also a priority.
36. We have seen no evidence the Trust refused to speak to Mr X. The Trust maintained regular contact with Mr X and Ms X both in person and over the phone.
37. We cannot see a gap between what should have happen and what did happen from communication with staff and therefore do not see any indication of failings.
38. Overall, we see no evidence to suggest that the Trust failed to provide Mr X with the necessary care and treatment needed. The Trust followed both the GMC and NICE guidelines.
39. Taking all this into account we have not seen any indications of failings in the care and treatment provided to Mr X, so we have decided not to consider this complaint further.
40. We thank Mr and Ms X for taking the time to bring his complaint to our attention. We hope our explanations bring some reassurance about the care and treatment provided to Mr X. We wish Mr and Ms X the best for the future.
1. We have carefully considered Mr X’s complaint about the care and treatment he received from the Trust.
2. Mr X says in May 2024, he and his wife moved into the Trust’s area to get better treatment for his treatment resistant schizophrenia. Mr X states the Trust failed to provide the appropriate care which led to his illness worsening.
3. We sincerely appreciate this was a very distressing time for both Mr X and his wife and appreciate the effect this had on Mr X’s health. We hope this statement gives Mr and Ms X reassurance we have thoroughly considered their concerns. We are very grateful for the time and effort they made in bringing the complaint to our attention.
4. We would like to assure Mr X that we have not seen indications the Trust got things wrong. We have not seen indications the Trust’s actions were responsible for Mr X’s condition worsening.