13. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation 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 that something went wrong.
Statin prescribing
14. Ms H complains the Practice stopped prescribing atorvastatin to Mr C without completing any tests in June 2023. Ms H says the Practice told her partner he had a low risk of developing heart problems.
15. The Practice said since Mr C made significant lifestyle changes and reduced his cholesterol level, and a shared decision was made for him to stop his statin and to review the decision again.
16. GMC, Good medical practice, point 49, tells clinicians ‘You must work in partnership with patients, sharing with them information they will need to make decisions about their care, including: • their condition, its likely progression, and the options for treatment, including associated risks and uncertainties • the progress of their care, and your role and responsibilities in the team • who is responsible for each aspect of patient care, and how information is shared within teams and among those who will be providing their care.’
17. NICE, NG238, 1.11.11 tells us ‘During the annual medication review: • discuss and encourage medicines adherence if the shared decision is to continue with lipid lowering treatment • discuss and encourage dietary and lifestyle changes if appropriate • address CVD risk factors.’
18. The Practice records show Mr C was prescribed atorvastatin for high cholesterol until a face to face appointment took place in mid-June 2023.
19. Between January and April 2023, the Practice monitored Mr C’s blood pressure and completed blood tests. The Practice noted Mr C’s blood pressure and blood results were normal. These reviews were in line with NICE 1.11.11 guidelines.
20. The records show Mr C was taking a statin in early September 2022 for raised cholesterol levels and was also noted he had a 10% risk of experiencing a heart event in ten years.
21. Mr C spoke with a Practice GP in June 2023 about stopping his statin medication. The GP agreed but wanted him to have his cholesterol checked in four to six months’ time.
22. Mr C and the Practice GP talked about his lifestyle changes, weight loss and reduction of his cholesterol and Mr C’s intention to carry on with the changes he had made. The GP talked to Mr C about his risk factors for having a cardiac event which had reduced to a 6% risk of happening in a ten year period. This was in line with GMC Guidance.
23. Our adviser told us and as we can see in the records, the Practice monitored Mr C’s cholesterol levels appropriately while taking the statin medication. The adviser told us no investigations are needed before trialling stopping medication.
24. Based on the evidence we have seen, the Practice acted in line with GMC and NICE guidelines by having a discussion with Mr C before making a shared decision with him to stop taking statins.
25. We understand Ms H said further investigations should have been completed before stopping the medication and her partner may not have died if this happened.
26. We have seen the Practice explained the appropriate risks and how these could happen anytime within ten years. This unfortunately happened to Mr C within three weeks.
27. We acknowledge the profound grief and distress this experience has caused Ms H and her family. We thank her for bringing her complaint to us and hope our explanation reassures her we saw nothing to suggest stopping Mr C’s statins was incorrect.