SPSO Individual Decisions

C complained about the care and treatment that they received over a series of interactions with the practice. C believed that their symptoms had not been properly investigated. C subsequently suffered a stroke and felt that the outcome for them could have been better if they had been listened to when they contacted the practice. C also felt that the practice’s complaint handling had been unreasonable, failing to provide C with information that they were entitled to and incorrectly directing them to the local NHS Board as part of the complaints process. We took independent advice from a GP adviser. We found that some of the assessments of C did fall below a reasonable standard, although it was not possible to conclude that the stroke could have been predicted or prevented. Therefore, we upheld and did not uphold aspects of these complaints around the assessment of C's symptoms over different periods. We also found that the handling of C’s complaint fell below a reasonable standard. We upheld this aspect of the complaint.

C asked a doctor at the practice to complete a DVLA medical examination. The doctor advised C that they did not have capacity to assist C and directed them to a private firm who could help. C made a complaint to the practice about the decision and availability of doctors at the practice. In their response, the practice asked C to apologise for insulting staff or they would be removed from the practice. C was subsequently removed from the practice list. C made a further complaint to the practice regarding the decision to remove them from the practice list. The practice responded to the complaint, explaining the rationale for removing C. C was dissatisfied with the responses provided by the practice to their complaints. We found that, whilst C's complaint was likely to have been difficult for staff to learn about, the practice's response was poor. Demanding C apologise was not an appropriate manner in which to try and establish an understanding or re-build trust between a complainant and members of staff. Therefore, we upheld this part of C's complaint. We also found that it was not reasonable for the practice to have treated C's complaint as having caused an irretrievable breakdown of the relationship between C and the practice. The practice did not follow the appropriate process should they have wished to warn C about the appropriateness of the complaint. Therefore, we found it was unreasonable for the practice to remove C from the practice list and upheld this part of C's complaint. The practice apologised to C.  While we acknowledge that an apology was given, that apology did not, in our view, meet the SPSO guidelines on apology, as was required by our recommendation.  In this respect it only partially met the recommendation. Our office tried to engage constructively with the practice over a considerable period of time about giving a further apology, recognising that the original circumstances giving rise to the complaint, were rooted in an already difficult relat

C made a complaint to the practice regarding the care and treatment provided to their late spouse (A). A attended the practice with pain and a family history of cancer. C said that the practice caused unnecessary suffering and stress to A and their family through misdiagnosis of A's condition. They also said that there was an unreasonable delay in progressing the ultrasound and that this led to poor management of A's pain. A was later diagnosed with lung cancer. We took independent advice from a general practitioner adviser. We found that overall the practice did provide reasonable care to A. We found that the practice took reasonable steps to investigate A's symptoms and their actions were reasonable based on the information known at the time. As such we did not uphold the complaint. Related reading View Decision Report 202111931 as a PDF (24.17 KB) Updated: June 21, 2023

C complained about the care and treatment provided to their late parent (A) by the practice in the months prior to A’s death in hospital. C complained that the practice failed to look at A’s leg and foot pain and that A was only prescribed water tablets. C also said that no home visits were arranged for A, that they were informed that A had a hiatus hernia (when part of the stomach moves up into your chest), and that A’s family did not receive a telephone call back when promised. We took independent advice from a GP. We found that there was no failure on the part of the practice to look at A’s leg and foot pain or that A was prescribed water tablets. We also considered that there was no need for home visits in the time specified and that A had been diagnosed with a hiatus hernia in hospital. Finally, we considered that the practice had provided a reasonable explanation in relation to not phoning the family back given that A’s family had called an ambulance for A by the time in question, so a telephone consultation was no longer required. Therefore, we did not uphold C's complaint. We did provide feedback to the practice that they may wish to remind staff of the importance of keeping clear documentation for every home visit. Related reading View Decision Report 202107115 as a PDF (24.4 KB) Updated: March 22, 2023

C complained about the treatment which their partner (A) received when they attended their GP practice with confusion and could not walk unaided. A could not provide a urine sample and was given a prescription for antibiotics. A collapsed in the car park following the consultation and was taken to hospital. C believed that the GP should have arranged a hospital admission for A. The practice felt that appropriate clinical treatment had been offered. We took independent clinical advice from a professional adviser. We found that the GP had carried out an appropriate assessment of A and had diagnosed A as having an infection and therefore prescribed alternative antibiotics with advice to seek further medical advice should their condition deteriorate. It could not have reasonably been foreseen that A would collapse shortly after leaving the GP practice. We did not uphold the complaint. Related reading View Decision Report 202102039 as a PDF (24.17 KB) Updated: January 19, 2022

C complained about the treatment provided to their late parent (A) by their GP practice. A had prostate cancer for a number of years which later spread to their liver. C complained that the practice failed to reasonably monitor A's blood sugar levels (HbA1c) after prescribing medication. We took independent advice from a GP. We found that the decision to commence medication for A's raised HbA1c was reasonable and appeared to be made with the input of a specialist medical consultant. However, there was no record to indicate that the practice discussed the risks of hypoglycaemia (low blood sugar) with A or took steps to allow A to monitor their blood sugar levels. We considered that the responsibility of monitoring any risks from the medication fell to the practice. Therefore, we upheld this aspect of C's complaint. C complained that the practice failed to reasonably respond to A's reduced haemoglobin (Hb) levels. We found that, while the actions taken after the blood test results reported two weeks prior to A's death were reasonable, there was an opportunity prior to that to act on A's falling Hb levels. We noted that given the trend of A's falling Hb levels and their overall clinical picture, there was a fair to good chance that A's condition would deteriorate prior to a scheduled admission for a blood transfusion. We considered that the decision not to admit A prior to the scheduled admission, was a doctor-led decision rather than one made in conjunction with A and their family's wishes. As such, we upheld this aspect of C's complaint. Finally, C complained that the practice failed to reasonably manage A's pain and comfort. We found that the pain management was reasonable and that the practice provided a high standard of palliative care. The medications administered, the timing of them and the increases in dosage were in keeping with the recommended standards of care, and in keeping with A's needs. Therefore, we did not uphold this aspect of C's compla

C's adult child (A) had anxiety and a functional neurological illness (a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts). One morning A was found to be anxious and unwell. A's other parent (B) thought that it appeared different to A's previous episodes and called the GP who visited A at home. The GP believed that A should be admitted to hospital and called 999. An ambulance crew attended the scene. There was some discussion between the GP and the hospital about which department A should be admitted to; the Mental Health Unit or the Clinical Assessment Unit. The ambulance crew transported A to hospital where A was quickly assessed and taken to the Intensive Care Unit. A died later that day. C complained that the GP had not properly assessed A, they had not taken blood pressure readings or their temperature. C said that the GP assessed A through the prism of mental health and had not properly considered whether there could be another cause to their presentation, which was different from previous ones. We took independent advice from a GP. We found that it was appropriate for the GP to consider A's prior medical history when assessing their condition. We found that the GP correctly identified that assessment at hospital was needed, recognising the seriousness of A's condition. On the basis of information available to the GP at the time, their assessment and conclusions were reasonable. Therefore, we did not uphold the complaint. Related reading View Decision Report 201907500 as a PDF (24.53 KB) Updated: March 24, 2021

Mrs C complained about the care and treatment provided to her late sister (Miss A). Miss A attended the practice and was prescribed medication for suspected vertigo (a sensation of whirling and loss of balance). The following day she collapsed at home and was admitted to hospital. It was found that she had hypercalcaemia (excessive calcium levels), acute pancreatitis (inflammation of the pancreas) and severe dehydration. Miss A's condition continued to deteriorate and she died. Mrs C raised concerns about the level of medication Miss A was prescribed and queried whether they played a role in her death. Mrs C complained that the practice failed to monitor Miss A's medication regime appropriately, to ensure that she received appropriate follow-up for specialist care and that they failed to carry out an appropriate assessment of her condition the day before she collapsed. We took independent advice from a GP. We found that the practice correctly followed the prescribing instruction received by Miss A's specialist and that the list of medications prescribed were reasonable given her symptoms. We concluded it was not the practice's responsibility to chase up the hospital with regards to follow-up appointments. We also found that an appropriate and thorough examination was carried out and there was no evidence to suggest that Miss A was suffering from pancreatitis the day before she collapsed. We did not uphold Mrs C's complaints. Related reading View Decision Report 201901036 as a PDF (24.43 KB) Updated: July 22, 2020

Mrs C complained on behalf of her late son (Mr A) about the care and treatment he received from his GP practice. Mr A phoned the practice as he was coughing and felt unwell. Mr A was considered to have symptoms of a cold and he was prescribed a cough suppressant. Around a week later, Mr A died from pneumonia (an infection of the lungs). Mrs C complained that the practice unreasonably diagnosed Mr A over the phone, even though he had asthma and learning difficulties. We took independent advice from a GP. We found that as Mr A was noted to have symptoms of a cold, it was reasonable that he was diagnosed over the phone, even though he was a vulnerable adult. We did not uphold this aspect of the complaint. Mrs C also complained that when she was admitted to hospital shortly afterwards, the practice did not contact her son to check on his condition. We found that the practice had not been informed of Mrs C's hospital admission or advised of any concerns about Mr A. Therefore, we found that the practice had no cause to check on Mr A's condition. We did not uphold this aspect of the complaint. Lastly, Mrs C complained about the practice's handling of her complaint. We found that there were failings in their complaints handling, which the practice had already acknowledged and apologised for. We noted that Mrs C's complaint was not acknowledged within the relevant timescale and her request for a phone call was not followed up. Therefore, we upheld this aspect of the complaint.

Ms C complained that her prescribed medications had been mismanaged by the practice. She said that her medications were rarely available to collect from her local pharmacy after she had ordered them through the practice. Ms C said that she had been without key medication due to these access problems. We took independent advice from a GP. We found that the practice prescribed Ms C's blood pressure medication regularly, however, we could not say whether this was provided within a reasonable time of Ms C's requests because there was insufficient evidence available. We also found that the practice was not unreasonable in failing to prescribe an updated contraception medication because they were not notified of the change prior to the medication being issued. Therefore, we did not uphold this aspect of Ms C's complaint. Ms C also complained that the practice refused to take complaints by phone and did not respond to complaints made in writing. Ms C submitted two complaints. We found that the tone used by the practice in their response was confrontational, did not recognise the inconvenience Ms C had experienced, and did not reflect on whether there was learning to be taken from the complaint. We also found that Ms C was given no information about the complaints process and was not told whether she could escalate her complaint, either to stage two of the complaints process or to our office. In responding to the second complaint, there was no acknowledgement that Ms C had not received the previous response, despite it being clearly mentioned to them. We considered that the practice's responses to Ms C's complaints were unreasonable. Therefore, we upheld this aspect of Ms C's complaint.

Mr C complained to us about the decision making of his GP practice. Mr C had received annual checks for prostate cancer for several years. However, the practice decided to change this to every two years. When Mr C's PSA levels were next checked, they had risen considerably and Mr C was found to have developed prostate cancer. Mr C complained that the practice unreasonably changed the frequency of his prostate checks. In addition to this, he complained about a number of administrative and communication issues relating to his prescriptions and treatment following his diagnosis. We took independent advice from a GP. We found that there is currently no national guidance relating to prostate screening but noted that it was important to discuss the pros and cons with the patient so they could make an informed decision. The practice told us that a discussion had taken place but Mr C recalled that it was more a case of the practice stating a firm position and taking the decision. We were unable to confirm that a discussion had taken place. However, the records did state that Mr C should be monitored based on symptoms rather than testing and that he should be seen as required. In addition to this, an International Prostatic Symptoms Score (IPSS, a tool used to screen for, rapidly diagnose and track the symptoms of prostate enlargement) taken after the consultation showed a lower score. In light of the known information at the time of the consultation, and the fact that there is no national policy regarding screening for prostate cancer, we considered that the practice's decision was reasonable. Therefore, we did not uphold this aspect of Mr C's complaint. In respect of the administration and communication issues, there appeared to have been some minor failings which were partly acknowledged in the practice's response to Mr C's complaint. However, we considered that the administration of prescriptions and paperwork had been largely adequate. Therefore, we did no

Ms C, who works for an advocacy and support agency, complained on behalf of her client (Mrs A) about the care provided by the practice following a phone consultation. The day following her discharge from hospital for heart bypass surgery, Mrs A called the practice for advice. A GP called her back a short time later and discussed medication with her. At this time, Mrs A reported a clicking sensation in her chest. The GP reassured her about this sensation and advised her to contact the practice again if she became more unwell. Mrs A's condition deteriorated later that day and she was admitted to hospital, where she was treated for an infection. Ms C raised concern that the GP did not identify that Mrs A had an infection and felt that a home visit should have been carried out. We took independent advice from a GP adviser. Whilst they noted that the GP's clinical record of the consultation was brief, on balance, the adviser considered that the assessment and care provided was reasonable. We accepted this advice and we did not uphold this complaint. Related reading View Decision Report 201701293 as a PDF (11.14 KB) Updated: March 13, 2018

Mr C complained that the practice failed to appropriately manage pulmonary fibrosis (a lung condition) in his late mother (Mrs A). The condition was first identified in a scan carried out five years prior to Mrs A's death and she regularly attended the practice over the intervening years with symptoms that included breathlessness. We obtained independent medical advice and we identified that there were missed opportunities to appropriately refer Mrs A to respiratory medicine. In particular, we considered that a referral should have been made following the initial scan. We also considered that a referral should have been made a year before Mrs A's death, when an x-ray reported progression of the pulmonary fibrosis. We found that all tests in between these times were not reported back to the practice in terms that would have prompted referrals. However, we noted that one GP expressed awareness of the condition during this period and made a referral to a geriatric clinic. While we considered it appropriate that further investigation was arranged, we noted that a respiratory referral would have been more appropriate. We were assured that the limited available treatment options for pulmonary fibrosis meant an earlier referral was unlikely to have altered Mrs A's prognosis. However, we recognised that earlier specialist intervention would have afforded Mrs A and her family the opportunity to better understand the nature of her condition and be assured that her symptoms were being appropriately managed. We upheld the complaint.

Mr C complained that the practice had failed to act appropriately on his reported symptoms of imbalance. Mr C has diabetes and related diabetic neuropathy (nerve damage). He said that over a long period he had complained to the practice of imbalance and falls but that this had always been attributed to his diabetic neuropathy. Mr C was diagnosed with multiple sclerosis (MS - a disease that effects the nervous system) and told us that he felt GPs at the practice should have picked up on this diagnosis earlier. In investigating this complaint, we took independent GP advice. We found that Mr C had complained to the practice of imbalance on two occasions. On the first occasion, this was attributed to the existing diagnosis of diabetic neuropathy, and we found this to be reasonable. On the second occasion, six years later, Mr C was thoroughly examined and no features of concern were found. Mr C was told to return if his symptoms changed, but this was the last time he was assessed by the practice. We found that the symptoms which later led to his diagnosis of MS seven years after his initial examination were not present during the previous two appointments and that the practice had acted appropriately. Therefore, we did not uphold Mr C's complaint. Related reading View Decision Report 201604349 as a PDF (11.21 KB) Updated: March 13, 2018

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

Mrs C complained that her husband (Mr C) did not receive a reasonable standard of care from the practice. Mr C suffered from a number of health conditions, including asthma, and passed away from sudden cardiac arrest whilst he was a patient at the practice. Mrs C felt that the practice did not investigate Mr C's condition urgently enough, and said that there had been a sequence of failed attempts to diagnose and treat Mr C. We took independent advice from a GP adviser. The adviser noted that the practice had investigated Mr C's condition within a reasonable timeframe and with the appropriate level of urgency. The adviser said that appropriate investigative tests had been arranged and concluded that the care Mr C received was reasonable. We accepted the adviser's comments and we did not uphold Mrs C's complaint. Related reading View Decision Report 201508751 as a PDF (10.98 KB) Updated: March 13, 2018

Mr C, who works for an advice and support agency, complained about the care and treatment of his clients' late daughter (Miss A). Miss A attended the practice on a number of occasions from May 2014 with symptoms including a persistent cough, sore joints, fatigue and weight loss. A number of possible diagnoses were considered and investigated but Miss A's symptoms persisted. In October 2014 following an out-of-hours attendance, Miss A was admitted to hospital and diagnosed with endocarditis (a rare and potentially fatal infection of the inner lining of the heart). Miss A passed away in hospital a few weeks later. Her parents raised concern that a window of opportunity had been missed to diagnose Miss A. They felt that there was a delay in the practice arranging appropriate investigations and referrals. The practice met with Miss A's parents and carried out a significant event analysis. The practice considered the care provided was reasonable, although they identified some learning points for improvement including improving continuity of care and having a lower threshold for investigatory blood tests in young people with persistent symptoms. After taking independent medical advice we did not uphold Mr C's complaint. We found the practice had arranged appropriate investigations in view of Miss A's symptoms, including seeking advice from Miss A's former specialist to check for any connection between her symptoms and another ongoing condition and making referrals to hospital specialists. The adviser explained that Miss A's symptoms varied over this time and appeared more in keeping with a respiratory problem (which the GPs appropriately investigated). The adviser considered symptoms indicating a possible problem with the heart were first documented at the out-of-hours admission in October 2014, so it was not a failing that the practice did not investigate this possibility earlier. Related reading View Decision Report 201508194 as a PDF (11.57 KB) Updated: March

Mr C, an advice worker, complained about the treatment which his client (Mr A) received when he attended a consultation. Mr A had a previous medical history of facial and arm weakness and was thought to have long-standing hydrocephalus (build-up of fluid on the brain). He saw a GP as he wanted to have further investigations in order to reach a diagnosis. Mr A felt the GP had dismissed his symptoms. Mr A was admitted to hospital two days later with worsening neck and back pain, increasing confusion, poor mobility, right upper limb weakness and urinary incontinence. Over the next six months Mr A was found to have stable chronic hydrocephalus along with possible abscesses (painful swellings caused by a build-up of puss) of his neck and the area between the spine and spinal cord. It was subsequently discovered he had chronic discitis (infection of the vertebral disc space). Mr A believed that the GP had dismissed his symptoms and that his condition had deteriorated because of the delays which he had encountered. We took independent medical advice from a GP and concluded that the GP had provided a reasonable level of care. When Mr A had attended the consultation the GP was aware of Mr A's medical history, including that he had attended hospital the previous day. He carried out an appropriate examination given the symptoms which were presented. There was no indication at that time for a hospital admission. It was clear from the records that Mr A's condition deteriorated two days after the GP consultation and it was only then that a hospital admission was appropriate. We did not uphold the complaint. Related reading View Decision Report 201508752 as a PDF (11.44 KB) Updated: March 13, 2018

Ms C attended her GP with swelling and hardening tissues between her vagina and rectum. The GP prescribed antibiotics to be taken for seven days. She was told to return in one week, or sooner if her symptoms became worse. Three days later, she returned to the practice and saw a different GP as the pain was worse. The medical notes also state that she was experiencing diarrhoea and vomiting. She was examined and the medical records indicate that her vaginal symptoms were no worse, and that the GP considered the diarrhoea and vomiting to be side effects of the antibiotics. On Ms C's request the GP prescribed anti-sickness medication. The GP told her to take the antibiotics for only five days, recorded that there was no sign of infection and gave her a one-week sick note. Six days later, Ms C attended the first GP again, who diagnosed a perianal (situated in or affecting the area around the anus) abscess. Ms C was admitted to hospital. Ms C complained that, at her second appointment, the GP had failed to provide adequate medical advice, care and treatment. We obtained independent advice from one of our GP advisers. We concluded that, while the care and treatment provided to Ms C was reasonable, it was unreasonable that Ms C was not given any specific instructions by the GP at the second appointment about what to do if her vaginal symptoms did not improve or got worse. As this particular failure was significant, we upheld Ms C's complaint. During our investigation, the practice apologised to Ms C and the GP reflected on her practice. The GP explained that, in future, she would try to give more specific instructions for patients so they are sure they can come back if they need to. Therefore, we did not consider that we needed to make any specific recommendations. Related reading View Decision Report 201502335 as a PDF (11.48 KB) Updated: March 13, 2018

Mr C complained about the care and treatment provided to his wife (Mrs C) by her GP practice in relation to her stomach problems. The practice investigated her stomach problems by carrying out blood tests and arranging for further investigations in hospital. When she was admitted to hospital, it was subsequently established that she had a mass on her liver, and it was confirmed that she had secondary cancer of the liver. Mr C complained of a lack of treatment and investigations into Mrs C's symptoms by the practice, and said that if they had taken her abdominal problems more seriously, then the cancer would have been diagnosed sooner. We took independent advice from one of our medical advisers, who specialises in general practice. We found that the practice properly investigated Mrs C's symptoms, including making referrals to secondary care within a reasonable time, and that, overall, the treatment provided was reasonable. Related reading View Decision Report 201501912 as a PDF (11.05 KB) Updated: March 13, 2018

Miss C said that she first went to her medical practice about continuing dizziness in April 2011 and was diagnosed with labrynthitis (an inner ear infection affecting hearing and balance). Worsening headaches led her to attend the emergency department in her local hospital and she then had a scan, which was normal. Miss C said her symptoms got worse and she was no longer able to work. The practice made an urgent referral for her to attend a hospital clinic, but after examination and tests everything was found to be normal and the clinic reassured her that her condition would improve over time. She continued to feel ill, however, left the practice, and complained that despite many visits there, they did little to help her. She said that they should have made more timely referrals for her to receive a specialist opinion. We obtained independent advice from one of our medical advisers, who considered all Miss C's medical records. We also took into account all the complaints correspondence. Our investigation showed that over the period concerned, Miss C attended the practice regularly and doctors made a referral for her to be seen urgently at the hospital ear, nose and throat department. She had had a normal scan and further examination and tests confirmed labrynthitis. She was referred to physiotherapy for therapy to retrain her brain to deal with the problems associated with dizziness. We decided that the GPs provided her with good care and support and tried alternative medication for her. Related reading View Decision Report 201304811 as a PDF (11.38 KB) Updated: March 13, 2018

Mrs C complained on behalf of her son (Mr A) that his medical practice failed to provide him with appropriate care before and during appointments when he attended the practice with concerns about his physical and mental health. She also complained that the practice had, following the appointments, unreasonably removed her and her son from their list of patients. We reviewed the clinical records and obtained independent advice from our medical adviser. Having considered the medical records, he said that the care given to Mr A was reasonable, so we did not uphold this element of the complaint. We noted that, after the second appointment, the police had to be called because of Mr A's violent and threatening behaviour and Mrs C's abusive behaviour, and that it was following this that both were removed from the practice list. Having reviewed the case we established that the practice had followed the correct procedure in terms of removing Mr A from their list because of his violent behaviour, and we did not uphold this aspect of the complaint. However, Mrs C had not been violent and they did not give her a written warning, allowing her the opportunity to modify her behaviour. Before removing a patient whose behaviour is non-violent, but unacceptable, the practice are required to warn them about this, and so we upheld this aspect.

Mrs C's mother (Mrs A) died from complications following surgery for an abdominal aortic aneurysm (bulging of part of the aorta, the body's largest artery). Mrs C complained that there was a delay in diagnosing the aneurysm (a weak point in the blood vessels, which causes them to bulge or balloon out). She said that her mother had been visiting the practice for two years and had been diagnosed with sciatica (back and leg pain, caused by irritation of or pressure on the sciatic nerve). However, she felt that her mother should have been referred to hospital earlier for further tests. She also complained about the follow-up care after her mother had surgery, in particular a delay in identifying post-operative complications. To investigate the complaint, we considered all the relevant documentation, including the complaints correspondence and Mrs A's medical records. We also obtained independent advice from one of our medical advisers. Our investigation found that the practice had acted reasonably, and that there was no evidence of an unreasonable delay in referring Mrs A to hospital for tests. Our adviser said that there was no evidence of specific symptoms that would have alerted the practice to an aortic aneurysm, and that it was in fact picked up by chance during an x-ray to investigate back pain. She also said that as there are usually no symptoms, such aneurysms are often not discovered until they leak or burst. Once the aneurysm was identified, appropriate action was taken to investigate it further and to resolve it. We also found no evidence that the practice had failed to assess Mrs A after her operation or that there was a delay in diagnosing the post-operative complications. The operation was clearly a risky one, as Mrs A had other health conditions. The medical records show that the procedure was complicated, and we noted that doctors had discussed the risks with Mr and Mrs A (Mrs C's parents) before the operation was carried out. Related reading

Mrs C complained about a specific consultation with a GP in her local practice. She attended with a flare-up of her longstanding physical health problems, which included fibromyalgia and osteoarthritis (conditions that cause the muscles and joints to become painful and stiff). She complained that the GP was dismissive of her problems and suggested that there was nothing wrong with her. In responding to the complaint, the practice said that the GP had felt that there was no physical reason why Mrs C could not get out and go about her normal business. Mrs C strongly objected to this and reported how she struggled on a daily basis and, on some days, was unable to even get out of bed. We obtained independent advice from one of our medical advisers, and this indicated that the advice offered to Mrs C was appropriate for her conditions. We were informed that the management of fibromyalgia would include trying to keep the muscles strong by keeping as active as possible. The adviser noted that Mrs C’s conditions were painful and debilitating and he accepted that she would be limited in her activities. However, he felt it was appropriate for the GP to have tried to encourage her to remain active. Mrs C clearly disagreed with the advice she received, and she was unhappy with the GP's handling of the consultation, and the attitude he displayed. However, in the absence of evidence that the GP acted unreasonably, or offered inappropriate advice, we did not uphold the complaint. Related reading View Decision Report 201302758 as a PDF (11.37 KB) Updated: March 13, 2018

Mr C complained that his medical practice refused to update him on changes in his son (Master A)’s medical file, about which his estranged wife had not told him. Mr C also complained that the practice had prevented him from transferring his son to an alternative practice in the area. We looked at the information provided by Mr C and obtained information from the practice. We also took independent advice from our GP adviser. Our investigation found that the practice were not required to keep Mr C informed, and that it was a matter for him and his estranged wife to resolve. We also found that the practice had acted correctly dealing with Mr C's request to transfer Master A, as it was not reasonable for one parent to try to re-register a child without the other parent's knowledge. Related reading View Decision Report 201204853 as a PDF (10.99 KB) Updated: March 13, 2018