SPSO Individual Decisions

Mrs C had a new heating system installed by a contractor working on behalf of the Scottish Government. Mrs C complained that the contractor required her to lift additional flooring in her home, which was not agreed at the pre-installation survey. We found that while the need to lift additional flooring was not agreed at the survey, Mrs C signed a document on the day of the survey which stated that it was her responsibility to lift any specialist flooring. The document also stated that while every care would be taken to keep upheaval to a minimum, it might not be possible to carry out the installation without removing some of the flooring. In addition, the document stated that the contractor would not accept responsibility or be held liable for any damage to the flooring arising from the installation. When the installation team visited, they found that Mrs C needed to lift more flooring than she originally thought. Although Mrs C was not expecting this, the paperwork she signed meant Mrs C was responsible for lifting the flooring should she want the installation to go ahead. We also noted that the contractor offered to replace the flooring in one of Mrs C's rooms as a gesture of goodwill. We did not uphold Mrs C's complaint. Related reading View Decision Report 201602586 as a PDF (11.14 KB) Updated: March 13, 2018

Mr C complained that the council unreasonably rejected his planning application on the basis of reasons which were outwith their jurisdiction. He said that as a result he had to appeal to the local review body, who granted consent, and that this process resulted in additional costs for him. We found that the council rejected the application on grounds which did not appear to fall within the remit of the planning authority. The rejection focused on an element of the application which related to the marine environment and which was subject to licensing through Marine Scotland, rather than the planning authority. We noted that, where there was doubt about jurisdiction, this should be reflected in the planning officer's report and that this did not happen in this case. We also noted that no reference to the relevant Scottish Government planning circular was made in the officer's report and that the officer failed to fully explain their assessment of the proposals against the planning policy which was used to refuse the application. For these reasons, we upheld the complaint.

Mrs C made an application for a High Hedge Notice under the High Hedges (Scotland) Act 2013 Act. The council notified Mrs C and her neighbours of consideration of the high hedge application. Approximately a month later, a site inspection was carried out. Based on the inspection, the council reached the view that the trees in question did not qualify as a high hedge, and the council refused the application on this basis. Mrs C complained that the council unreasonably failed to process the concerns she had about planting in her neighbour's garden. She raised particular concerns about the stage in the process at which the council considered the question of whether the trees amounted to a high hedge. We obtained independent planning advice in relation to Mrs C's complaint. We found that the council had reached a particular decision about the process for a high hedge application, based on their legal advice. However, we considered that having reached that decision, the council should have been clear about the process they were following to the complainant (who expected the council to follow the guidance), and moreover, appropriately escalated their concerns about the guidance to the Scottish Government. Therefore, we upheld the complaint.

Mr C complained on behalf of his constituent (Mrs B). Mrs B was concerned about the care her mother (Mrs A) received from her medical practice. Mrs A was receiving palliative care in the home from Mrs B and the district nursing service. Mrs B was concerned that the GPs at the practice did not undertake home visits to provide medical and emotional palliative care support for her and her mother. In particular, Mrs B felt that a GP should have visited in the days prior to her mother's death. We took independent advice from a GP adviser. The adviser was satisfied that the GPs visited Mrs A on a reasonable number of occasions. Similarly, they did not find evidence that the GPs unreasonably failed to visit in the days before Mrs A's death and noted that the medical records did not indicate that an urgent home visit was clinically required at this time. Furthermore, the adviser did not consider that the practice had unreasonably failed to provide a reasonable level of support and guidance to Mrs B. We therefore did not uphold this aspect of Mr C's complaint. Mrs B also expressed concern that the practice had not responded to her complaint in a compassionate manner. We found that the practice had not followed their own complaints procedure in this instance in that they had not adopted as conciliatory and sympathetic a tone as possible when responding to the complaint. We further considered that the practice had failed to respond to the complaint in a person-centred way as required by the Scottish Government's 'Can I help you?' guidance for handling healthcare complaints. For these reasons, we upheld this aspect of Mr C's complaint.

Mr C complained about the way the board dealt with his review application for NHS continuing healthcare for his late mother (Mrs A), who was resident in a care home. He also complained about how the board handled his subsequent complaint. Mr C's application was rejected by the board on the basis that Mrs A did not meet the criteria as set out in the Scottish Government Guidance Circular CEL 6 (2008), the relevant guidance at the time. By the time the board had referred the application to two clinicians for assessment, Mrs A had died. Their assessments were paper based. We took independent advice from a consultant in medicine for the elderly. They said it could reasonably be interpreted from the wording of the CEL 6 (2008) guidance that a paper based assessment constituted a clinical opinion. The adviser agreed with the findings of the clinicians that Mrs A had not satisfied the criteria for NHS continuing healthcare. The adviser also said that Mrs A's deteriorating health, her admissions to hospital, and the fact that her care home was unable to meet her care needs did not mean that she met the criteria. We accepted that advice. However, we found that that there were unacceptable and lengthy delays by the board in reaching a decision on Mr C's application, that their review process was slow and disorganised, and that they had not appeared to have taken Mr C's review application and concerns seriously. We also found that there was a failure to communicate effectively with Mr C during the review process. For this reason, we upheld the complaint. The board had accepted there had been unacceptable delay in responding to Mr C's complaint, for which they had apologised. However, we considered the board's actions were then aggravated by their failure to obtain a suitable person to carry out an independent review of their decision, having said to Mr C that they would do so, which resulted in yet further unreasonable delay.

Mrs C complained that over a 12-month period, two doctors at her medical practice failed to provide her with appropriate clinical treatment for her back. Mrs C said that when an MRI scan was eventually arranged, this showed that she had a tumour on her spinal cord which she had surgery to remove. Mrs C said the two doctors at the practice failed to listen to her when she explained her ongoing symptoms and asked for help, failed to undertake appropriate assessments and investigations, and failed to arrange appropriate specialist referrals. We took independent medical advice and found that the two doctors communicated reasonably with Mrs C, undertook appropriate assessments, investigations and referrals and provided her with appropriate treatments based on her clinical symptoms at the time. We found that the doctors followed the Scottish Government back pain guidelines and the Healthcare Improvement Scotland referral guidelines for suspected cancer and said that the care Mrs C received was of a reasonable standard. The adviser also explained that GPs could not arrange referrals for MRI scans and that such scans could only be requested by a physiotherapist or a hospital specialist. We therefore concluded that the doctors did not fail to provide Mrs C with appropriate clinical treatment in view of her reported symptoms and we did not uphold her complaint. Related reading View Decision Report 201508517 as a PDF (11.23 KB) Updated: March 13, 2018

Mr C complained to us on behalf of his constituent (Mrs A) about planning applications at a site neighbouring her property. In particular, Mrs A was concerned that the council had failed to take enforcement action when planning conditions were not met in relation to engineering works and that the council had failed to issue a stop notice requiring activity on the planning site to stop when work began before planning permission had been granted. Mrs A also complained that the council had failed to take reasonable account of her concerns about the development. We took independent planning advice and found no evidence that when the alleged breach of planning control was brought to the council's attention, they failed to investigate the matter in line with the Scottish Government's planning enforcement charter or the council's planning enforcement charter. We also found no evidence of fault by the council when arriving at the decision not to issue a stop notice. We were satisfied that the council, in considering the application for the erection of houses on the neighbouring site, properly took into account the relevant guidance and planning policies. We found no evidence of procedural omissions by the council in the handling of the planning application. We therefore did not uphold Mr C's complaint. Related reading View Decision Report 201508338 as a PDF (11.18 KB) Updated: March 13, 2018

Miss C complained that staff at the Assisted Conception Service at Glasgow Royal Infirmary failed to provide her with appropriate in vitro fertilisation treatment (IVF) and failed to communicate appropriately with her. IVF is where an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory. The fertilised egg is then returned to the woman's womb to grow and develop. Miss C's concerns included that during four referrals she was not once told that she was ineligible for treatment because she was a smoker. Miss C said she also attended various appointments at the service with an egg donor, only to be told at the last appointment that the donor was unsuitable because she was also a smoker. We obtained independent medical advice from a consultant in reproductive medicine and surgery. The adviser said the IVF treatment provided to Miss C by the board was reasonable. However, the new Scottish Government Access Criteria for NHS-funded treatment for all NHS boards had already been introduced and this set out that smokers were no longer eligible for treatment. Miss C and her partner attended three appointments at the service over a nine-month period before they were finally advised that they were ineligible for treatment because they were both smokers. We were critical of the board in this regard. The evidence also suggested that Miss C and her partner attended an appointment at the service in which a proposed donor was put forward but the eligibility of the donor under the new access criteria was not discussed.

Mrs C was referred for a colonoscopy for bowel cancer screening and was asked to contact the hospital to book this in. Mrs C contacted the board to raise concerns that there were no arrangements for her to see a consultant beforehand. She was also concerned to discover the procedure was booked with a nurse rather than a consultant. After further correspondence, the board arranged an appointment for Mrs C with a consultant to discuss the procedure. While Mrs C was dissatisfied that this delayed the procedure for three weeks, she attended the appointment and chose to go ahead with the procedure with the consultant. After the procedure Mrs C complained to the board about the attitude of the male nurse who prepared her for the procedure, the procedure itself, and the board's communication about this. The board issued two written responses to Mrs C's complaint and met with her and her MSP to discuss the outstanding issues. The board apologised for some aspects of the procedure, including that the male nurse had touched Mrs C when demonstrating the procedure and that another member of staff had entered the room during the procedure to access a storeroom. After taking independent medical and nursing advice we did not uphold Mrs C's complaints. The advice we received was that the board's care, treatment and communication were reasonable and they had apologised where appropriate. We were concerned that the steps taken by the board may not be sufficient to address the privacy issues raised and we made a further recommendation about this. While we considered some aspects of the board's complaints handling could have been improved, we found their response was reasonable and in line with Scottish Government guidance.

Miss C complained about her son (Mr A)'s admission to the Langhill Clinic at Inverclyde Royal Hospital. Mr A was admitted with suicidal thoughts and diagnosed with personality disorder, but requested a second opinion. This was provided by a different psychiatrist about a week later, and supported the clinical team's view that Mr A did not suffer from a major psychiatric illness, with his presentation relating to personality traits and recent trauma and bereavement. The following day, Mr A was found to have taken illicit drugs while absent from the hospital on a day pass. In view of this and increasing incidents of aggression towards staff, the doctor decided to discharge Mr A the following morning. Mr A then became aggressive and staff called the police to escort him from the hospital. Miss C was concerned that Mr A was not appropriately assessed and felt he should not have been discharged so early. She also raised concerns about the board's handling of her complaint. After taking independent psychiatric advice, we did not uphold Miss C's complaints. We found that Mr A received reasonable assessments which appropriately took into account his risk of self-harm. He was also given a second opinion when he requested this. We also found the discharge was reasonable and in line with the board's policy on the management of violence and aggression. In particular, we noted that Mr A's admission was intended to be short and there were numerous documented instances of aggressive behaviour not caused by a major psychotic illness. However, we found the board failed to handle Miss C's complaint in line with Scottish Government guidance as they did not accept her complaint at first because it was not in writing, there were significant delays in the investigation and there was no evidence that staff contacted Miss C to explain the delay.

Mrs C and her husband decided to defer their child, who has a February birthday, starting Primary One. They wanted their child to spend a further year at nursery. Mrs C said that in terms of the Scottish Government statutory guidance, The Children and Young People (Scotland) Act 2014, children born in January or February have the right to have the deferred year funded by a local authority. Mrs C and her husband secured a place for their child at a partnership nursery school within the council area and applied for funding. The council initially refused the application because in terms of their early years admissions policy deferred funding was only provided for the nursery the child had attended in their pre-school year. In the case of this child, the nursery was in another local authority where the family resided. The council then wrote to Mrs C stating they would fund her child's place but shortly thereafter withdrew their funding offer. The council said the letter offering to fund the child's place had been sent as a result of human error and because their database had not been updated. Mrs C complained to us about the council's handling of her application. In terms of the statutory guidance, we were satisfied that the council were entitled to set their own local admissions policy and at the time Mrs C made her application, her child did not meet the criteria for funding. Nevertheless, we accepted that the failings in the handling of Mrs C's application had left her in a difficult situation and had caused her concern and distress. For this reason, we upheld the complaint. We also made a recommendation to the council in relation to their computer system in respect of funding applications. The council subsequently reviewed their admissions policy and agreed to fund the child's deferred year place.

Mr C complained about the time he had to wait for a gastroscopy procedure (a procedure where a thin, flexible telescope called an endoscope is used to look inside the gullet and stomach) at Raigmore Hospital. Mr C was referred for the procedure by his GP after he complained of symptoms of indigestion. Mr C was offered an appointment 16 weeks after referral, but when he attended the appointment the procedure could not go ahead as the endoscopy department did not have the required equipment available. Mr C complained to the board about the delay and expressed concern that the anticoagulation medication he was taking (treatment with drugs that reduce the body's ability to form clots in the blood) could have posed a risk to his health in the period while he waited for the procedure. The board apologised to Mr C and noted that the equipment was not available at the previous appointment because of a delay in the return of endoscopes following decontamination. We took independent medical advice from a consultant physician who was critical that the time between referral and the procedure exceeded the target waiting time set by the Scottish Government. The adviser also noted that the appointment booking process should not have required two interventions from Mr C's GP. The adviser concluded that because of the delay in the procedure, Mr C suffered from his symptoms longer than was necessary, which was unreasonable. In view of this, we upheld this complaint and made two recommendations. Mr C also complained that the board did not fully address the concerns he raised in his complaint and had exceeded their complaint response time target. The board acknowledged that a letter explaining the delay was not sent in this instance, and stated that staff have since been reminded about the requirement to send holding letters when appropriate. We were critical that, once they had received Mr C's complaint, the board failed to quickly offer Mr C an appointment, and therefore an

Mr C saw a dentist at the practice. Arrangements were made for future treatment and Mr C attended a further appointment a few weeks later. In the interim, ownership of the practice had changed and Mr C was seen by a new dentist. He complained that the practice had not advised him of this change. The practice responded to Mr C's complaint and explained that they had been assured by the previous owner that all patients would be advised of the changes prior to the transfer. They also advised that no other patients had reported problems with this and that they were reassured that it had been an isolated incident. After investigating Mr C's complaint, we accepted his position that he was not made aware of the upcoming changes at the practice. However, as the practice expected all patients to have been informed of this by the previous owner, we considered it was reasonable that they did not take steps to separately advise Mr C of the changes. Consequently, we did not uphold this complaint. We made a recommendation to the practice that they review their complaints handling procedure as, during our investigation, it was noted that some parts were not in line with Scottish Government guidance on NHS complaints.

Mr and Mrs C complained about the standard of work undertaken at their property by a company installing insulated cladding. The company had a contract with the council, who were coordinating this work under Scottish Government grant funding. The company were responsible for offering the insulation works to owner occupiers, and Mr and Mrs C signed a contract for them to deliver this work. The council's role was to monitor the works as they were being undertaken, to ensure that they were of an appropriate standard, and to ensure that appropriate materials were used. This was to ensure that the final product fulfilled the criteria for a full warranty on the works. They also took on a role as intermediary in any dispute between the company and Mr and Mrs C. Our investigation found that the council inspected the works as they progressed, and were satisfied with the work on site. Mr and Mrs C started to express dissatisfaction when the work was nearly completed. The council discussed these concerns with them and with the company. Over the period of a year they worked with both sides to try and find a satisfactory resolution to the issues raised, but Mr and Mrs C remained dissatisfied. We found that the council had fulfilled their responsibilities in relation to the work being undertaken and we did not uphold Mr and Mrs C's complaint. We did however note that Mr and Mrs C's contract was with the company, so they could pursue the issue further with the company if they wished to do so. Related reading View Decision Report 201502012 as a PDF (11.27 KB) Updated: March 13, 2018

Mrs C complained about the care and treatment provided by the practice. Mrs C raised concerns that the practice did not provide a reasonable standard of care when she presented with symptoms of bowel discomfort and diarrhoea over a period of several months. In particular, she was concerned the practice failed to diagnose her colonic cancer at an early stage. Mrs C also raised concerns about timeliness of blood tests, the antibiotics prescribed, and her concerns that the practice was dismissive of her symptoms. She also complained the practice unreasonably failed to provide a letter of referral she asked for in order to arrange a private scan. The practice said that Mrs C's treatment had been reasonable. In particular, they noted that Mrs C had attended a colonoscopy (an examination of the bowel with a camera on a flexible tube) two months prior to the period in question, which had shown no signs of cancer, but provided an alternative explanation, which was consistent with her symptoms. The practice said that the GP in question understood Mrs C had requested a scan, and had arranged appropriate investigations. After receiving independent advice from a GP, we did not uphold Mrs C's complaint. We found that the practice had acted reasonably in the circumstances, based on the result of the colonoscopy, the alternative diagnosis, and the nature of the symptoms Mrs C experienced. We also considered that the practice provided appropriate care and treatment in relation to blood tests, prescription of antibiotics, and was responsive to her symptoms. We also considered the actions of the practice in relation to the scan were reasonable in the circumstances. During the course of our investigation, we noted aspects of the practice's complaints procedure did not comply with the Scottish Government's 'Can I help you?' guidance, so although we did not uphold the complaint, we made a recommendation about this.

As Mrs C lived within a two-mile radius of her child's secondary school, her child was not entitled to free transport to school. Although she accepted this, she considered that the route her child had to walk was not safe because of the lack of lighting, the low priority the path had for gritting in the winter, and the volume of traffic on a fast road. She said that the council had not paid appropriate heed to guidance from the Scottish Government. When she complained to the council about the assessment of the walking route, she did not consider their response adequately addressed her complaints and the issues she raised. We found that the council had applied an assessment methodology which was developed around English legislation, which did not consider street lighting to be significant. We also reviewed the Scottish Government guidance on this issue, and found that it allowed for significant flexibility in how councils consider various aspects of road safety. We therefore considered that it was reasonable for the council to use the assessment methodology as they did, and this was in line with the exercising of their professional judgement, and so we did not uphold this complaint. We also noted that neither set of guidance mentioned the need to take account of gritting of pavements in winter weather. However, we noted the lack of any internal policy at the time of the assessment in question. The council assured us they had since adopted a policy, but did not provide a copy. In relation to complaints handling, we found that the council had not provided clear responses to the concerns which Mrs C raised. We therefore upheld this complaint. We also noted that the officer who investigated the complaint was the same one involved in earlier correspondence on this issue, which raised concerns about the independence of their investigation.

Mr and Mrs C complained that the council had not done enough to prevent their home from flooding. However, the council considered that they had done everything that was reasonable, given competing claims for funds and the budgetary constraints under which they operated. We found that in 2010 the council had commissioned consultants to look into the cause of the flooding and find options to deal with it. However, the works were not done as there were insufficient funds. Since then, the council had undertaken flood prevention works that were proportionate, and in accordance with their policy and responsibilities under current legislation. They had installed a kerbed drainage unit; regularly inspected and cleared culverts, water courses and gullies; cut back trees and shrubbery; met with a landowner about water flowing from his fields; and met with Mr and Mrs C and others to discuss and advise on options to increase their property's resilience to flooding. Mr and Mrs C continued to have problems but Scottish Government guidance confirmed that the primary responsibility for protecting their property fell to them, not the council. On the basis of these findings, we did not uphold the complaint. Taking all these factors into account, we found that the council had taken reasonable action. They had acted in terms of legislation and in accordance with their own policy. Related reading View Decision Report 201405047 as a PDF (11.29 KB) Updated: March 13, 2018

Mr C was informed that his daughter (Miss A) would be allocated to a composite class (where two or more year groups are taught together) the following academic year. She was the only female member of her current class who was to be placed in the composite class. Mr C was concerned about the impact of this decision on Miss A and her learning. Mr C complained to us that the council had failed to take into account the Scottish Government 'Getting it right for every child' (GIRFEC) provisions. Mr C was also unhappy about the way the council handled his complaint. We contacted the Scottish Government who explained that, at present, the GIRFEC provisions were best practice. The council explained that best practice was followed when allocating children to composite classes. They said the relevant council policy makes allowances for headteachers to make decisions on the basis of individual needs. If a headteacher judges that a child's needs will not be met, they can exercise their discretion and move the child to a more appropriate class. We was satisfied that, in Mr C's case, the headteacher gave consideration to the relevant criteria for allocating children to composite classes and made their decision on that basis. Mr C also complained about the way his complaint had been handled. He said that his complaint was not properly understood or represented and that Miss A's previous teachers were not interviewed. He said that it was not demonstrated how his proposed alternative solution would have compromised the council's policy. Additionally, he said that the GIRFEC provisions were not identified as a consideration in the response to his complaint. Following detailed consideration of all the relevant documents and correspondence, we concluded that the handling of Mr C's complaint was reasonable and did not uphold his complaint to us. Related reading View Decision Report 201502748 as a PDF (11.46 KB) Updated: March 13, 2018

Ms C complained to the practice about treatment that her son (Mr A) had received. She was unhappy with the response that she received and information that was provided about the principal dentist at the practice. After investigating, we upheld Ms C's complaint. We considered that although the response to her complaint about treatment addressed her concerns adequately, there were a number of other complaints handling failings. We found that the response letter did not refer Ms C to us if she remained dissatisfied with her complaint and that the practice's complaints handling procedure was not in line with the relevant Scottish Government guidance. We also found that there had been a failure to advise Ms C of changes to the staff structure at the practice in a timely fashion.

Mr C said that the board failed to follow Scottish Government procedures on NHS continuing healthcare which resulted in his father (Mr A) not being assessed for continuing healthcare when he should have been. Mr C said that if an assessment had been carried out, Mr A would have had care provided by the NHS and would not have had to pay around £45,000 for residential care in a private nursing home. We took independent advice from one of our medical advisers, who specialises in care of the elderly. We found that Mr A did not meet the criteria for continuing care. Having said that, the process was not as clear as it should have been to Mr C. The board accepted that the decision about whether or not to provide NHS continuing care should be fully explained to the family at the time of an assessment. The board took this issue forward with healthcare staff. Given that the guidance has been superseded and the process changed since June 2015, and that the communication issue had been taken forward by the board, we made no recommendations. Related reading View Decision Report 201405012 as a PDF (11.08 KB) Updated: March 13, 2018

Ms C complained that a GP and a nurse had acted unreasonably by failing to provide treatment to remove ear wax. Ms C had attended the practice on three occasions with compacted wax. Initially, her ears were not syringed as it was suspected she may have had an infection. On the third occasion, she was referred to a community-based NHS treatment area for ear irrigation, however, there were no appointments available in the following month. We sought independent advice from one of our nursing advisers. Our adviser found that the evidence indicated that the care and treatment was reasonable and in keeping with best practice. We did not uphold the complaint. Ms C also complained about the way the practice had handled her complaint. Specifically, she was unhappy that there had been a delay in responding to her complaint, and that the response she received to a 16-page letter was inadequate. Ms C sent two letters - the first was responded to within 20 working days. The second (which raised some new issues) took three months to respond to. We recommended that the practice apologise to Ms C for the delay in responding to her second letter. Following careful review of the practice's response to Ms C's 16-page letter, we concluded that the response was appropriate and adequate. We considered that the overall handling of the complaint was reasonable and, therefore, we did not uphold the complaint. However, as the practice's complaints handling procedure was not in line with Scottish Government guidance, we made a recommendation to address this. Ms C also complained that a member of reception staff failed to tell the truth about what had happened when Ms C returned to the practice after visiting the NHS treatment area. She was also unhappy that the receptionist discussed confidential information in the waiting room in front of other patients. There was no objective evidence to support Ms C's version of events and, therefore, we could not uphold the complaint. We w

Miss C complained regarding the care and treatment she received for a benign breast lump in 2011. In 2014, Miss C was diagnosed with breast cancer. The board said that the lump had been benign in 2011 and it was very unlikely that a benign lump becomes cancerous. Miss C said that she had not been provided with adequate follow-up or advice, and that the lump had become malignant. Miss C said the board should accept this was possible and that the lump should have been removed in 2011. Miss C also complained of an excessive delay in providing her with radiotherapy. We took independent advice from one of our advisers, who is a consultant oncologist. Our adviser said there was no evidence to show benign lumps could become malignant. It was possible that despite the appropriate tests being carried out and the results from these showing no sign of cancer that it had in fact been malignant in 2011. Our adviser said that this did not constitute an unreasonable standard of care. However, the delay in the provision of radiotherapy was unreasonable, since it had breached Scottish Government targets and the board had been unable to provide evidence that they were taking steps to prevent a reoccurrence. We found that the board had acted reasonably in 2011, both in terms of the tests carried out and the decision not to remove the lump from Miss C's breast at this time. When further tests in 2014 showed it to be malignant, the lump was appropriately removed, but the board unreasonably failed to provide radiotherapy within Scottish Government targets, so we made a recommendation about the delay.

Mr C complained to us on behalf of his client (Miss A) who had been refused an application made to the council for a crisis grant. The reasons for the refusal were that she had already received a grant in the preceding 28 days and her circumstances had not changed. Miss A requested a review of this decision, which was unsuccessful. In the response letter no reasons were given for the decision. Miss A then requested a second stage review, which was also unsuccessful, and again no reasons were provided in the response. Mr C then complained to us about the lack of reasoning provided. He also felt that the decision to not award a second grant within 28 days was not in line with Scottish Government guidance. After our enquiries to the council, they accepted that there had been errors in providing reasoning and, as a result, agreed to overturn their decision and pay Miss A the grant. They also agreed to implement new processes to ensure that future decision letters contained detailed reasoning. However, they maintained that their decision-making with regards to her repeat application had been correct. On consulting the Scottish Government guidance, we agreed that there had been failings with regards to the reasons provided but also that they had been correct in their assertion that a second grant should not be paid within 28 days. We believed that the actions they had already agreed to perform were reasonable and, as such, made no further recommendations. Related reading View Decision Report 201501567 as a PDF (11.29 KB) Updated: March 13, 2018

Ms C complained that the board had not managed her Individual Patient Treatment Request (IPTR) panel appropriately. She had been obliged to make an IPTR in order to obtain a drug which helped control the symptoms of her multiple sclerosis (MS) as the drug was not licensed for prescription in Scotland. Ms C had been prescribed a free trial of the drug and said her neurologist supported the prescription of it once the trial had finished. She said there had been undue delay in arranging her hearings and that the board had not provided her with information about the panel's decisions appropriately. Ms C also complained that the panel had failed to consider the evidence she had presented appropriately. Ms C said this had caused her considerable distress and worsened her MS. We took independent advice from one of our medical advisers who said he believed the panel had been conducted appropriately. He noted there were delays in the submission of the original IPTR request, and further delays caused by the departure from the board of Ms C's original neurologist. The board had acted to mitigate these delays, but were not responsible for them. Our investigation found the board had arranged the IPTR process appropriately. Although Ms C had been successful on appeal, this was due to a change in Scottish Government guidance, rather than a reassessment or reinterpretation of the evidence by the IPTR Panel. The substantial delays in the IPTR process were due to the actions of Ms C's neurologists and the delays in submitting documents. We did not find the board failed to provide Ms C with information about the panel's decisions. Related reading View Decision Report 201401952 as a PDF (11.38 KB) Updated: March 13, 2018

Mrs C complained about the delay in diagnosing her late husband (Mr C)'s cancer. Mr C suffered intermittent pain over about two years, following a fall. Mrs C said Mr C attended A&E at Glasgow Royal Infirmary on numerous occasions, as well as being seen by colorectal (bowel) and gastroenterology (digestive system) specialists. Mr C's cancer was first diagnosed over two years after his fall, following a scan which showed possible cancer in his liver. Mrs C raised concerns that Mr C should have been given this scan earlier. The board considered that Mr C received appropriate treatment and investigations. They said they only had records of Mr C attending A&E on two occasions, although Mrs C said he attended numerous times. After taking independent medical advice from A&E, colorectal and gastroenterology specialists, we upheld Mrs C's complaint. We did not find any evidence that Mr C attended A&E on more than two occasions, and we found that the care and treatment at A&E was mostly reasonable. However, on one occasion the A&E doctor did not specifically record checking whether Mr C was losing weight (which would have been a 'red flag' symptom), and we were critical of this. We found the investigations carried out by the colorectal service were reasonable and timely, and there would have been no reason for them to arrange a scan, based on Mr C's symptoms and the results of other tests and examinations at that time. We also found the gastroenterology clinic arranged appropriate investigations. However, we found there was a delay of several weeks in performing the initial investigations (including the scan) and reviewing the results, which meant that Mr C's care did not meet the Scottish Government's standards for cancer waiting times (HEAT targets).