SPSO Individual Decisions

C had concerns about the care and treatment that their late parent (A) received from the practice. At the time the care and treatment took place, the practice was being managed as a GP partnership arrangement. By the time C had submitted their complaint to the practice, the previous partnership arrangement had ended and a medical group took over the running of the practice. The named GP Partner who C had raised concerns about had also left the practice. C was concerned that the practice, under its new management, refused to respond to their complaint and did not follow the complaint handling procedure. GPs are independent contractors who deliver general medical services to patients on behalf of the health board. If a complaint is received about care given by a practice and the practice still has an active contract, then the practice will deal with the complaint accordingly. However, if the complaint relates to a closed practice or a partnership arrangement that no longer exists, as is the case here, this means that the contract with the health board would no longer be active. The practice’s position is that they had no involvement in the care and treatment provided to A because this took place under the dissolved partnership arrangement. We found that the practice should have advised C to contact the NHS board at the earliest opportunity, in line with the complaints handling procedure. The board could have facilitated, where possible, communications between the former partner(s) and C. If the former partners were not able to provide a response, the Primary Care Service department within the board could then have considered either providing a response, or commissioning an external review and/or signposting to another appropriate body if applicable. We upheld this aspect of C’s complaint. Additionally, C considered whether the practice should have carried out a Significant Event Analysis (SEA) or similar review in line with the Healthcare Improvement Scotland national

C complained about the care and treatment provided to their late parent (A). A had a terminal illness and was discharged from hospital to be cared for at home. A few days later, the family requested a visit from a doctor. They spoke to a doctor on the phone but it was an Advanced Nurse Practitioner that visited them at home. C was also unhappy that A was not provided with emergency medication. We took independent advice on the complaint from a GP. We found that A should have had a named and experienced clinical lead coordinating and planning their care. We found that it would have been preferable that a GP had visited A following their discharge from hospital. However, it was not unreasonable that A was visited by an ANP. We found that A should have been provided with emergency medicine. We upheld C's complaint. We noted that the practice had recognised potential failings and had demonstrated that they had taken reasonable learning and improvement action. Therefore, we made no further recommendations. Related reading View Decision Report 202309340 as a PDF (24.29 KB) Updated: June 18, 2025

C complained about the care and treatment that their adult child (A) received from the practice following their discharge from hospital. C complained that A had struggled to get an appointment with a GP and that the practice failed to provide a reasonable standard of care in relation to pain management, A’s mental health needs, and follow-up with the health board. The practice said that they were short-staffed and had been working on an emergency-only basis at the time of the complaint. When A had enquired about seeing a GP, there had been no indication that an emergency appointment was required. A was advised to phone again the next day or to attend A&E. In respectof A’s pain, the practice said that the discharge medication had been managed in accordance with their policy and in recognition of the nation-wide shortage of the drugs prescribed. A was given an appointment to discuss pain when they reported that the medication was not working and a prescription for nerve pain was given. In reference to A’s mental health, the practice said that this was discussed during a phone appointment. However, A had breached the practice’s zero tolerance policy during the conversation. A was issued with a warning letter after the incident but was not removed from the practice (as would be policy) in recognition of the mental health difficulties that they were experiencing. This incident was reviewed as a part of a Significant Event Analysis Review (SEAR) and the practice identified learning to manage this type of occurrence in the future. In respect of A’s follow-up with the health board, the practice confirmed no post-discharge requests had been made and that it was the responsibility of the hospital to issue clinic appointments. We took independent advice from a GP. We found that the practice had reasonably managed the discharge prescription for pain medication. While A had been appropriately directed to other services when no appointments were available, we found that the messa

C complained about the care and treatment provided to their late parent (A). A was experiencing shooting back pain, tingling sensations, abdominal swelling, weight loss, poor balance and constipation. A contacted the practice on four occasions with deteriorating symptoms. By the last contact, A was incontinent and unable to mobilise. After some delay, the practice organised (seated) ambulance transport to hospital. A was diagnosed with malignant spinal cord compression (MSCC) caused by metastatic renal cancer. A was paralysed and incontinent until they died a few months later. C complained that the practice failed to spot red flag symptoms for MSCC and cancer, missed opportunities to send A to hospital earlier and failed to appropriately manage A’s transfer to hospital. C said that when A was discharged from hospital their pain, nutrition, appetite loss and low oxygen levels were not effectively managed. They also complained that a GP inappropriately discussed A’s terminal prognosis and do not attempt cardiopulmonary resuscitation (DNCPR) decision at a home visit. The practice said that, in previous appointments, they had examined A, conducted blood tests, inquired about symptoms of cord compression, and provided advice on what to do if the condition worsened. They recommended going to the hospital only after symptoms deteriorated. They advised that on discharge, the GP had considered it important to discuss prognosis and DNCPR at the earliest opportunity and had made every effort to do so sensitively. They said that they had adjusted A’s pain medication and referred to palliative care nurses. The practice also said that they had referred to a dietician and it would not be standard practice to check oxygen levels as it would not change the overall palliative care. We found that it had been unreasonable not to arrange a stretcher transfer to hospital at an earlier date. We also considered that it was unreasonable that changes to pain medication had not been timeously

C complained about the delay in the practice diagnosing their parent (A)'s cancer. C said that A was seen by a GP with recurring chest infections but was sent away with antibiotics and their initial requests for a chest x-ray were denied. When the x-ray was arranged and the results received by the practice, the GP did not contact A directly to discuss the results. Instead, A received a copy of the report from the reception staff, which was not easy to understand. C said the communication issues regarding the x-ray also led to a delay in an urgent prescription for antibiotics being passed to a pharmacy. C said that the delays in diagnosis limited the treatment options available to A. C complained that the practice failed to reasonably investigate A’s respiratory symptoms. We took independent advice from a GP. We found that while the majority of the care provided to A was reasonable, there was a missed opportunity to refer A for an x-ray, given their symptoms and the lack of success with previous treatments. Therefore, we upheld this part of C's complaint. C also complained that the practice failed to inform A of the results of the x-ray in a reasonable manner. We found that the x-ray report should not have been provided to A by reception staff and the findings should have been shared in person or over the phone with the GP, including all relevant information. Therefore, we upheld this part of C's complaint.

C complained about the care and treatment provided to their parent (A) by the practice. Over a period of several months, A and/or family members had multiple contacts with the practice. A started to physically decline more rapidly and was experiencing severe pain which was presumed to be from a prolapse (a displacement of a part or organ of the body from its normal position). Shortly afterwards, there was a more acute clinical deterioration and an Out-of-Hours medical assessment concluded that A was terminally ill and in need of end-of-life care. There were subsequent assessments by the practice and discussion on best management. A's care was continued at home with general practitioner (GP) and district nurse involvement until A's death. We took independent advice from a GP adviser. We found that there were occasions where a face-to-face review or examination of A would have been appropriate, or where a more comprehensive assessment of the history and more detailed management discussion would have been reasonable. Whilst a number of the reviews and adjustments of medication made by the practice were reasonable, we found that there was a lack of medication review on two occasions. We found that the documentation of the consultations was often lacking in detail and that there was little history or clinical findings to support clinical decisions taken. On some occasions, consultations were not documented at all. Overall, we upheld the complaint that the practice failed to provide reasonable care and treatment to A.

C is a former patient of the medical practice. C complained to the practice that they failed to address their enquiries about their healthcare, which they submitted to the practice in writing and by email. The practice decided that they could not meet C’s expectations and concluded that there was a breakdown in the doctor/patient relationship. The pracitice subsequently removed C from their patient list. C complained to the practice but were dissatisfied with the response that they received. C complained that the practice failed to respond to C's complaint and earlier correspondence, and that the practice did not follow reasonable process when removing C from their patient list. In respect of how they responded to C’s correspondence, we agreed that the situation became complex. While C did not always get a response to their correspondence, we concluded that the practice acted reasonably overall. We recognised that the practice were trying to meet the individual needs of their patient, but the situation had become untenable. We did not uphold this aspect of C’s complaint, however we provided feedback to the practice on their handling of the complaint. With regard to the decision to remove C from the patient list, we concluded that the practice failed to follow General Medical Council (GMC) guidelines as they did not warn C that they were considering removing C from the patient list. We upheld this aspect of the complaint and recommended that the practice apologise to C and take steps to ensure they have an appropriate policy in place.

C complained about the care and treatment a close family member (A) had received from the practice. A was admitted to hospital having suffered a heart attack and stroke. On further investigation masses were found on both of A’s ovaries, later confirmed to be ovarian cancer. A died a short time later. C complained to the practice that they had not given proper consideration to A’s presenting symptoms and had missed opportunities to identify A’s cancer and start treatment sooner. C also complained that the practice had not given appropriate consideration to the family’s history of breast cancer or undertaken CA125 testing (blood test to check for raised levels of a protein called CA125, which is linked to ovarian cancer). The practice apologised for being unable to detect A’s cancer at an earlier stage, noting ovarian cancer often only presents at a very advanced stage which had been the case for A. They explained a CA125 test had not been checked as the clinical information available at that time had not suggested malignancy. They also noted that a family history of breast cancer would not directly predispose to a risk of ovarian cancer in the absence of evidence of BRCA gene (specific mutations to this gene increase lifetime risk of cancer) positivity. They did not identify any substantive failings in A’s care and treatment, but agreed to use A’s case for reflective learning. To investigate the handling of this complaint, we sought independent advice from a GP. We found that CA125 testing is not an effective screening tool for ovarian cancer. While A’s initial presentation at the practice had met the National Institute for Health and Care Excellence (NICE) criteria for considering checking CA125 levels, A had undergone further gynaecological review a few months later, which had suggested no evidence of an abdominal pelvic mass. Overall, we considered that the practice had not acted unreasonably in not identifying A’s malignant diagnosis prior to their pres

C complained that the practice failed to provide their late spouse (A) with appropriate care and treatment. C said that GPs at the practice failed to see their partner at face to face consultations where they could observe their reported symptoms of facial weakness. Phone calls were made on a Friday and Monday but A was still not seen despite contacting the Out Of Hours Service (OOHS) at the weekend. A died a few days later of a stroke. C felt that the practice should have seen A face to face rather than via telephone consultations. The practice believed that the GPs involved had provided A with appropriate care and treatment based on their reported symptoms at the time. We took independent advice from an appropriately qualified adviser. We found that the practice had provided a reasonable level of care based on A’s reported symptoms. Therefore, we did not uphold the complaint but provided the practice with feedback concerning the standard of record keeping. Related reading View Decision Report 202103864 as a PDF (24.19 KB) Updated: November 23, 2022

C complained to the practice about a failure of their GP to offer them a face to face consultation when they reported being concerned about a breast lump. C was given a telephone consultation only. C was not seen for a further three months and when they attended the breast clinic, C was diagnosed with breast cancer. We took independent advice from a GP. We found that the GP had acted reasonably in that the plan was to review C two weeks following the telephone consultation should the symptoms not have resolved. C did not contact the practice for a number of months and when they did, appropriate referrals were made to specialists for further consideration. We did not uphold the complaint. Related reading View Decision Report 202100230 as a PDF (24.05 KB) Updated: June 22, 2022

C complained that they had been unreasonably removed from the practice list without prior warning due to alleged verbal abuse. We reviewed the guidance provided by the General Medical Council (GMC), British Medical Association (BMA) and the National Health Service (General Medical Services Contracts) (Scotland) Regulations 2018. We took independent advice from a GP. While we appreciated that C disagreed that their behaviour was inappropriate, this is how the staff at the practice perceived the behaviour. This was also supported by extracts from the contemporaneous records detailing that the practice found C's behaviour to be abusive and upsetting. The Regulations and the guidance from the GMC and the BMA indicate that a warning should be given to the patient, giving the reasons for the possibility of removal from the practice list. The only exceptions to the requirement to give a warning appear to be on the grounds of violence where the police and/or the procurator fiscal are involved, or where the practice believes that issuing the warning would put the safety of members of the practice or those on the premises at risk or it is, in the GP's opinion, not otherwise reasonable or practical for a warning to be given. The practice decided that a warning letter did not apply due to how upset a staff member was. We found that the practice appeared to have taken the view that issuing a warning to C would not be appropriate due to the impact of this incident on the member of staff. We found that the practice acted reasonably (by requesting C's immediate removal from the practice list) and within established rules for removing a patient from the list. We did not uphold C's complaint. Related reading View Decision Report 202005987 as a PDF (24.62 KB) Updated: April 20, 2022

C, a support and advocacy worker, complained on behalf of their client (A). A presented to the practice with symptoms of stomach pain and upper and lower backpain. Following several consultations, a GP referred A for an abdominal and renal ultrasound on a routine basis. A was contacted by the hospital with an appointment and was advised that their GP could expedite this if they considered it appropriate. A was referred on an urgent basis by the practice to gastroenterology (specialism of the treatment of conditions affecting the liver, intestine and pancreas) which later confirmed A's diagnosis of cancer. A complained to the practice that they had failed to expedite the referral despite their worsening symptoms. A believes that if they had been referred to secondary hospital services punctually and had obtained a timely diagnosis, their medical treatment would not have been as invasive and that the risk of cancer spreading to other organs would have been reduced. In response to the complaint the practice said that an urgent referral was sent to gastroenterology when it was clear that A's symptoms had progressed. A was dissatisfied with the practice's response and C brought the complaint to our office on A's behalf. During our investigation we requested independent advice on the practice's consultations with A and the arrangements for referring A for further investigations. We found that the decision to refer A initially on a routine basis for an ultrasound was reasonable, given A's symptoms. We found that the medical records indicated consultations with A were reasonable and on the basis of the progression of A's symptoms, there was no unreasonable delay in the urgent referral to gastroenterology being made. We found that the referrals were reasonable and there was no unreasonable delay in making them, as such we did not uphold the complaint. We provided some feedback to the practice on the management of A's pain. Related reading View Decision Report 202103

C complained that the practice failed to provide their parent (A) with appropriate medical treatment. A had health problems affecting their heart and lungs and was under the care of hospital specialists. A reported symptoms of back pain and weight loss and had a number of telephone consultations at the practice and was given painkillers. A deteriorated and was referred immediately to hospital where they were diagnosed with cancer. C felt that A should have been referred to hospital earlier in view of their rapid weight loss and pain symptoms. We took independent advice from an appropriately qualified adviser. We found that A was under the care of hospital specialists for their longstanding health problems and although A had reported some symptoms to GPs at the practice, there were no red flag signs to indicate that A was suffering from cancer. We considered that the treatment provided by the practice was of a reasonable standard. Therefore, we did not uphold the complaint. Related reading View Decision Report 202006020 as a PDF (24.19 KB) Updated: August 18, 2021

C was diagnosed with a meningioma (a tumour that forms on membranes that cover the brain and spinal cord just inside the skull), which required surgical removal. C complained about the failure of the practice to appropriately assess their symptoms in the years preceding diagnosis. C said their records showed that they presented at the practice with red flag symptoms on a number of occasions dating back years. C also said that the practice failed to make appropriate referrals for investigation. We took independent advice from a GP. We considered that C had been assessed appropriately by the practice. We found that C’s care was reasonable and in line with General Medical Council Good Medical Practice. We did not consider that there had been any missed opportunities to refer to secondary care in respect of C’s meningioma, taking into account their presenting symptoms. We did not uphold either aspect of C's complaints. Related reading View Decision Report 201911530 as a PDF (24.2 KB) Updated: November 18, 2020

C complained about the treatment they received from the practice. C had a pre-existing diagnosis of Chronic Fatigue Syndrome (CFS). C attended the practice about back pain they were experiencing. They were referred to neurology (specialists concerned with the diagnosis and treatment of disorders of the nervous system), urology (specialists in the male and female urinary tract, and the male reproductive organs), rheumatology (specialists that deals with rheumatism, arthritis, and other disorders of the joints, muscles, and ligaments) and orthopaedics (specialists in the treatment of diseases and injuries of the musculoskeletal system) on a routine basis. The neurological service performed two MRI scans which identified a lesion (a region in an organ or tissue which has suffered damage through injury or disease, such as a wound, ulcer, abscess, or tumour). C was advised by specialists to come back in six months for a review. At around this time, C was advised that, despite referrals to orthopaedics, they would not be offered an appointment as they had passed the referral to the pain clinic. The practice followed this up with the service, requesting further MRI scans. On several occasions, C consulted with the practice regarding severe pain and worsening symptoms. C was later seen by neurosurgeons, who confirmed that the lesion was the cause of the pain and C underwent surgery. The lesion was cancerous, and C underwent therapy to treat it. C said that the practice showed a lack of understanding of the pain and symptoms that they presented with and failed to prioritise investigations which would have resulted in a timelier diagnosis. C considered that there was an assumption that the pain had an underlying psychological element. We took independent advice from an appropriately qualified adviser. We found that GPs were responsive to C's requests for further investigations and appropriate referrals were made. There was no significant delay in any referrals bei

C complained that when the Driver & Vehicle Licensing Agency (DVLA) contacted the practice about C's fitness to drive, the practice incorrectly advised the DVLA that they had attended detoxification for alcohol in the past 12 months. We took independent advice from a GP. We found that the treatment C had received from the practice was not to treat alcohol withdrawal and would not be classed as a detoxification programme. We found that there was no evidence that C had attended a detoxification programme in the past 12 months. Therefore, we upheld the complaint.

When C became a patient of the practice their 'as required' medication was reduced and stopped. Within a couple of years C moved to another GP practice. They complained to the practice that the decision to reduce and stop their medication had been unreasonable, that they had not been reasonably monitored following the ending of these prescriptions and that the practice had failed to provide their notes to the new practice within a reasonable timescale. The practice responded that they felt the decision to stop medication had been reasonable and that C had received good and safe clinical care. They also stated that, while one specific summary part of C's notes had not been provided to the new practice initially, this had been corrected as soon as they had been made aware of it, and they had apologised for it. We took independent advice from a GP adviser. We found that the decision to stop the medication was reasonable in principle given C's circumstances and the possible long-term effects of their use; that the withdrawal was carried out in line with applicable guidance; that a reasonable level of follow-up was provided; and that the practice's explanation that the failure to provide part of C's medical record to the new practice had been reasonable. We did not uphold C's complaints. Related reading View Decision Report 201810977 as a PDF (24.32 KB) Updated: July 22, 2020

Ms C, an advocacy worker, complained to us on behalf her client (Mr A) about the care and treatment Mr A received at a consultation when he disclosed details of his mental ill health. Ms C said that the GP did not make eye contact with Mr A and rushed through the consultation. Ms C also complained that Mr A was subsequently removed from the practice list after they submitted a complaint. We took independent advice from a GP. We were unable to comment on the amount of eye contact made during the consultation as there was no evidence in relation to this. We noted, however, that the GP had stated that they would try to learn from this. The practice had also stated that the consultation took longer than the ten minutes allocated. We found that the practice had a lot of history available for Mr A and the decision to decline referral to psychiatric services was based on their knowledge of Mr A and his medical history. We considered that the care and treatment provided to Mr A at the consultation was reasonable and we did not uphold this aspect of the complaint. In relation to the complaint that the practice unreasonably removed Mr A from their list, we found that the practice should have issued a warning letter to Mr A before removing him from their list. We upheld this aspect of Ms C's complaint.

Mrs C complained about the care and treatment provided to her late sister (Ms A) by practice. Ms A had attended the practice on a number of occasions over many months. She had symptoms of low energy and mood, fatigue, and lack of motivation. The practice diagnosed a depressive illness and prescribed antidepressant medication. Ms A continued to deteriorate and was admitted to hospital where it was found that she had had a tumour at the base of her skull and she later died. Mrs C said that the practice should have considered alternative diagnoses rather than depression. We took independent advice from a GP. We found that it was reasonable for the practice to continue along the route of a depressive illness in view of Ms A's reported symptoms, and it was only when red flag symptoms were reported that it was appropriate to refer Ms A to hospital. Therefore, we did not uphold the complaint. Related reading View Decision Report 201909985 as a PDF (24.18 KB) Updated: July 22, 2020

Mr C complained about the care and treatment provided by the practice in respect of his ongoing knee pain. He attended two consultations with knee pain and had requested to be referred to the orthopaedic (conditions involving the musculoskeletal system) clinic and for a multi-resonance imaging scan (MRI) to be carried out. However, at the first consultation, the practice prescribed anti-inflammatory medication and provided advice regarding exercise and knee care. At the second consultation, the practice arranged for x-rays to be carried out and advised Mr C to make a self-referral to physiotherapy. Based on Mr C's presentation, the practice concluded that the source of the pain was likely to be osteoarthritis (the most common form of arthritis, usually occurring in older people, with chronic breakdown of cartilage in the joints leading to pain, stiffness, and swelling or the most common form of arthritis that affects the joints). The x-ray results confirmed this but the results were not relayed to Mr C. Years later, Mr C attended a further consultation and the practice made a referral to the orthopaedic clinic. At the time of making his complaint to the SPSO, Mr C was still on the waiting list to be seen at the orthopaedic clinic. This was partly due to the fact that the practice did not consider it appropriate to make an urgent referral. In Mr C's view, the practice unreasonably delayed in referring him to the orthopaedic clinic and for an MRI scan. We took independent advice from a GP. We found that Mr C received appropriate care and treatment for his knee pain. This care and treatment was in line with the Scottish National Knee Pain and Management Pathway, produced by the Scottish Government. We recognised that Mr C was concerned that the practice did not contact him following his x-ray or physiotherapy appointment. However, we did not consider this to be unreasonable or out of line with the procedures of other practices. We did not uphold Mr C's com

Ms C complained that the care and treatment she received from the practice was unreasonable. Ms C attended the practice on a number of occasions complaining of a sore lump. She was referred to the treatment room (the treatment room is staffed by nurses who are trained and specialise in wound care) for assessment and management of a post-operative wound she had. Ms C also attended the hospital and was informed she had cellulitis (an infection of the deeper layers of skin). We took independent advice from a GP. We found that the practice had assessed Ms C's wound, arranged an appropriate referral to the treatment room and arranged appropriate treatment. We did not uphold the complaint. Related reading View Decision Report 201805018 as a PDF (24.05 KB) Updated: March 18, 2020

Ms C complained about the care and treatment her late mother (Ms A) had received from the practice before Ms A completed suicide. She complained that the practice failed to identify that her mother had a personality disorder. We took independent advice from a GP adviser. We found that it had been reasonable for the practice not to diagnose that Ms A had a personality disorder. We did not uphold this aspect of the complaint. Ms C also complained that the practice failed to manage Ms A's anti-depressants and that they had failed to take appropriate action when she stockpiled medication. We found that the practice had acted reasonably in relation to these matters and did not uphold these aspects of the complaint. Ms C then complained that the practice had failed to call her back, after she had contacted them to raise concerns about her mother's behaviour. We found that there was no evidence that Ms C requested or was promised a follow-up call by the practice. In view of this, we found that it was reasonable that the practice did not call her back. We did not uphold this aspect of the complaint. Ms C complained that the practice had failed to take action when Ms A reported abuse of her children. We did not find any evidence in the practice's records that Ms A had reported physical abuse of her children. However, we considered that there was evidence of emotional abuse by Ms A to her children and that social work input should have been arranged in relation to this. We upheld this aspect of Ms C's complaint. Finally, Ms C complained that the practice had unreasonably failed to deal with her complaint appropriately. We found that the practice had made a reasonable attempt to respond to the issues raised. It was also reasonable that one of the GPs named in the complaint carried out the investigation, given the size of the practice. That said, we found that the practice had unreasonably failed to provide updates on the investigation or information about when the

Mrs C complained about the care and treatment provided to her late daughter (Ms A) by the practice. Ms A attended the practice complaining of severe leg pain and was diagnosed some time later with cancer. Mrs C complained that the practice failed to carry out the appropriate investigations in response to Ms A's symptoms and previous history of breast cancer. We took independent advice from a GP. We found that Ms A's symptoms, which she discussed with the GP on the first two appointments, were not indicative that cancer was a likely diagnosis and the appropriate treatment was provided. When Ms A began to complain of back pain, and it was noted that she had weight loss, we found that the practice acted appropriately by making an urgent referral for imaging and arranging for blood tests to be carried out. We concluded that the treatment provided was in line with national guidelines and we did not uphold the complaint. Related reading View Decision Report 201807724 as a PDF (23.8 KB) Updated: September 18, 2019

Mr C complained that the practice wrongly focused their assessment and treatment on the wrong condition, which caused a delay in him being diagnosed with pancreatic cancer. We took independent GP advice and found that the care provided, and investigations carried out, were in line with the Scottish Cancer Referral Guidelines. When Mr C's symptoms changed, the appropriate referrals were made. We did not uphold the complaint. Related reading View Decision Report 201807078 as a PDF (23.55 KB) Updated: July 24, 2019

Mr C complained about the care and treatment provided by the practice for his skin issues, sinus issues and headaches. We took independent advice from a GP. We found that there was no evidence of any delay in Mr C being referred to the Plastic Surgery Unit at the board for his skin issues and that the care and prescriptions Mr C received for his sinus symptoms were reasonable. Mr C's symptoms were consistent with a working diagnosis of allergic rhinitis. There is no evidence of any delay in the treatment Mr C received or the management of his sinus symptoms. We found the assessment and management of Mr C's headache symptoms was reasonable. We did not uphold the complaint. Related reading View Decision Report 201806303 as a PDF (23.64 KB) Updated: May 22, 2019