SPSO Individual Decisions

C complained on behalf of their child (A) who is in their late teens. C complained that Child and Adolescent Mental Health Services (CAMHS) failed to carry out appropriate Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) assessments and failed to provide A with appropriate support for a number of years. The board said that A had undergone a number of assessments and reviews within CAMHS prior to turning 18 and no conclusive diagnosis had been reached. During our investigation they acknowledged that the family may have been unintentionally given the impression that an ASD diagnosis was likely or expected. We took independent advice from a clinical psychologist with experience in CAMHS. We found that while there were multiple professionals involved, given the complexity of this case there should have been further demonstration of shared, integrated clinical reasoning by the multidisciplinary team (MDT) in formulating a diagnostic conclusion. We further found that there was a lack of documentation regarding clinical reasoning for the type of psychological therapy offered; and that there was a lack of clarity about the expected/communicated timescales for ASD assessment. Therefore, we upheld C’s complaint. We noted the board’s explanation that service changes have been implemented and are ongoing since the events considered in this investigation, and that this work is being informed by the Scottish Government and the National Autism Implementation Team. It may be that some of the issues identified in this investigation have been addressed by improvements already made. If that is the case, evidence of those improvements can be provided in support of the recommendations being fulfilled.

C complained about the board’s decision not to provide thyroid chondroplasty (a surgery to reduce the size of the Adam’s apple) as part of their gender affirming treatment. The board explained that though they used to have surgeons who could carry out this surgery, they no longer do. They said that the Scottish Government does not fund thyroid chondroplasty and therefore they cannot recruit surgeons for the purpose of performing the surgery and are prevented from using public finances to fund it. We found that there is no obligation for the board to provide thyroid chondroplasty on the basis of Scottish Government protocols. However, protocols state that health boards should ensure they have clear documentation on what is available to their patients and have local policies in place regarding access to them. We gave feedback to the board on this point, but ultimately did not uphold C’s complaint. C also complained that when they were in the process of having hair removal prior to gender reassignment surgery, the board stopped providing this service. Because hair removal at the site of surgery is a requirement, C had to pay for the hair removal to be completed privately. During the course of our investigation, the board accepted that they had not been clear to them at the point of C’s complaint that it is the responsibility of the health board where the patient lives to arrange hair removal prior to gender reassignment surgery. The board apologised for the failure and financial inconvenience caused and offered to reimburse C for the laser hair removal. We upheld the complaint and made no further recommendations. Related reading View Decision Report 202311694 as a PDF (24.62 KB) Updated: May 21, 2025

C, a support and advocacy worker, complained on behalf of their client (A) regarding the partnership's decision not to backdate kinship care allowance. The partnership confirmed that they had reviewed matters in light of new Scottish Government guidance and would be willing to apologise to A and calculate the allowance due. C confirmed that this would resolve the complaint and we closed our investigation. Related reading View Decision Report 202307268 as a PDF (23.94 KB) Updated: July 24, 2024

C complained about the way that the council handled the planning process and the building warrant process for a self-build project within an existing development of houses. Planning permission had been granted, and three years later only limited progress had been made and an application was made by the developer to place a static caravan on site, where they would live whilst completing the project. There were several applications relating to the caravan, and some years later an enforcement notice was served by the council. This was appealed by the developer. Two years later, the council served a completion notice on the site, and the case was appealed to the Planning & Environmental Appeals Division (DPEA) by the developer. C complained to the council. The Scottish Government reporter concluded planning permission had lapsed, because development had not lawfully commenced. The council took legal advice, which suggested that they reluctantly accept the reporter’s findings. The advice noted that should further evidence be submitted, then the council could take this into account if it supported a contrary position on the implementation of the initial planning permission. C continued to correspond with the council, and brought a number of complaints to the SPSO. We took independent planning advice and we found that the council had the discretion to decide what enforcement action to pursue, if any. The council had followed the legal advice that they had received, serving a notice requiring submission of a new planning application. The developer had chosen to pursue an alternative course of action, by applying for a Certificate of Lawful Proposed Use or Development (CLPUD). This was not the same as being granted planning permission, but was an acceptable course of action by the developer. The decision of the Scottish Government reporter was only directly applicable to the completion notice, which could not be served. The council were entitled to determine whe

C complained that their late sibling (A) should have been given a telephone or face-to-face consultation with a GP following increasing contact with the practice and an escalation of symptoms relating to chest pain that resulted in A's death from acute myocardial infarction (heart attack). C also complained that the practice's handling of the resulting Significant Adverse Event Review (SAER) was unreasonable. The practice considered the care and treatment of A to be reasonable. The GP was shielding at home during the COVID-19 pandemic and could not see patients face-to-face. The practice stated it was subject to restrictions imposed by the Scottish Government at the time. The practice also said that A was appropriately triaged and their care managed by a range of healthcare professionals. We took independent clinical advice from a GP. We found that A should have been offered a telephone consultation with the GP and a face-to-face appointment with the locum GP. We found that A's care was delegated to nursing staff when GP input was required and there was a lack of review between the GP and nursing team when A's symptoms failed to resolve. We also found that the SAER failed to identify learning points, failings and reflection and did not include the health care professionals involved in A's care. Therefore, we upheld C's complaints.

C complained about the council’s decision-making in relation to the allocation of Scottish Government Town Centre funding. In terms of the relevant governance arrangements, local Area Committees were expected to identify and rank eligible projects for the funding. C complained that their local Area Committee had failed to publicise the scheme, failed to invite applications and failed to discuss the funding in meetings. C complained that there was a lack of transparency in the council’s decision-making process. With regard to the complaint about lack of community engagement, the council said that they were not operating a challenge fund. The council’s position was that the grant was allocated to projects in accordance with the governance arrangements agreed by the Environment, Development and Infrastructure Committee. We found that the council failed to follow appropriate processes when making decisions regarding the allocation of Scottish Government Town Centre Funding. Specifically, we found that the council failed to evidence how they followed the agreed process that Area Committees become involved in identifying and recommending projects. There was no public record as to how the decision to recommend a particular project was reached and there was no evidence as to how this project was assessed as meeting the eligibility criteria. Taking all of the above into consideration, we upheld the complaint.

C complained about the treatment they received from the board following a knee injury. C’s injury had occurred when level 3 of the Scottish Government’s COVID-19 lockdown measures were in place, which limited travel between local authorities to essential travel only. C’s accident had occurred outwith their own local authority area. C complained that the A&E staff repeatedly asked them about their local accommodation and travel arrangements. C reported that they were only admitted to hospital for one night, and they were obliged to make their own travel arrangements for their discharge the next day despite experiencing severe pain. The board said that C had been timeously assessed and treated at the A&E, with orthopaedics (specialists in the musculoskeletal system) taking over their care due to the diagnosis of a displaced fracture with foot drop. C’s injury had been immobilised with a knee brace and they were assessed using crutches by physiotherapy prior to discharge the next day, with the plan being for C to travel back to their own health board area to arrange further care and treatment of their injury. C was given an immediate discharge letter to pass to the receiving clinical team and a prescription for pain killers. We took independent advice from an orthopaedic consultant. We fond that the board’s treatment of C was reasonable, both in terms of the type of injury they had sustained, and in keeping with the guidance in place at the time for management of orthopaedic injuries during the pandemic. We considered it was appropriate for A&E staff to enquire about C’s travel and accommodation arrangements to help inform their plan of care. They also commented that without lockdown measures in place, C’s injury would have required transfer to a specialist centre for surgical reconstruction. However the guidance at the time had been appropriately followed by the board for non-operative management of the injury with later reconstruction. Therefore, we did not uphold C’

C was a grower of seed potatoes. They complained about the actions of the Scottish Agricultural Science Agency (SASA), a division of the Scottish Government. C complained that SASA failed to follow their own published procedures when handling the assessment and certification of C's seed potato crops. C complained that SASA unreasonably delayed inspecting their crops by requiring payment for the inspections in advance, contrary to the normal procedure of paying after the inspection. C also complained that the initial crop inspection identified an unrealistically high level of plant virus. Whilst a check inspection found C's crops to be well within the tolerance levels for virus, C was advised that the crops would not be certified until further lab tests were carried out. C complained that they were subjected to unreasonable additional testing and that they were not treated the same as other farmers. C said that the testing process caused unnecessary delays to their crops being certified and listed on the Potato Register. As such, C was unable to market the seed potatoes for sale until the purchasing season had ended. C explained that, as a result of the issues they encountered, they lost sales worth hundreds of thousands of pounds. We found that SASA required C to pay for the inspection in advance as their account was in arrears. We were satisfied that this was standard practice in the circumstances and, whilst there was a delay to the payment being confirmed by SASA, this did not have a significant impact on the time taken to arrange C's initial crop inspection. We were satisfied that SASA were able to demonstrate that they took a reasoned approach to inspecting and testing C's crops that focussed on the health of the crops and their suitability for sale. We did not find any evidence to suggest that C was treated unfairly or that SASA instructed additional testing without giving proper consideration to all of the circumstances. We did not uphold these asp

C complained on behalf of their late grandparent (A). A was admitted to hospital. The next month they were moved to an NHS continuing care bed in a care home. Shortly after, A's child and Power of Attorney (POA) received a call from a social worker to inform them that A would be transferred to a different care home the next day. C spoke to the social worker the same day and this was confirmed. The move was stated to have been due to the need to free up beds in light of the developing pandemic. C asserted that both they and A's POA were told that A would be moved to another NHS bed. Subsequently, A's family received a fee note from the new care home. C complained that A's move had been unreasonable and that A's family had not been informed of any potential costs. The council said that A's move was reasonable in light of a clear directive from the Scottish Government to free hospital beds. They said that the social worker had informed A's family that the move would be to a private nursing home. C complained to us. We took initial independent advice from an appropriately qualified adviser. We found that the council's response regarding the move appeared reasonable, but that its response regarding fees was unreasonable. The adviser highlighted the information they would expect a family to be given prior to such a move. We opened an investigation into the case and notified the council of this decision. In response, the council changed their position. While it noted the circumstances of the developing pandemic, the council accepted that its communication with A's family had been inadequate. They proposed resolving the complaint by acknowledging their failure and by paying the care home fees. C accepted this resolution. As it was considered that there was no systemic learning to be found (due to specific nature of the failure) the complaint was closed on this basis. Related reading View Decision Report 202001347 as a PDF (24.69 KB) Updated: January 19, 2022

Concerns were raised during C's time on community work placement. Investigations were carried out and having considered the information available, the risk management team (RMT) at Prison A took the decision to return C to closed conditions (Prison B). C considered that Prison A failed to seek relevant evidence as part of their investigation, and dismissed relevant evidence, prior to taking the decision to return C to closed conditions. We found that the RMT at Prison A appropriately considered the circumstances of C's case, taking relevant information into account, prior to reaching the decision to return C to closed conditions. Therefore, we did not uphold this aspect of C's complaint. C also complained about the way the Scottish Prison Service (SPS) handled their complaint. They said that no Internal Complaints Committee (ICC) hearing was convened and the recommendation put forward by them was unachievable. We found that C escalated their complaint to the ICC around the time the Scottish Government requested everyone to stop non-essential contact and travel due to the COVID-19 pandemic. C's complaint was passed from Prison B to Prison A to respond at ICC stage because the matter related to actions taken by the RMT at Prison A. Whilst an ICC hearing was not convened because of restrictions in place, Prison A did appoint a representative to consider C's complaint. However, we found that Prison A failed to share their findings and recommendation in relation to C's complaint with Prison B to ensure the matter could be given further consideration. We considered that the ICC failed to handle C's complaint reasonably and upheld this aspect of C's complaint. In relation to the recommendation put forward by the ICC, we found this to be reasonable. We did not uphold this aspect of C's complaint.

C is the owner of nurseries which provide childcare. During normal operation, C receives funding to provide an amount of childcare hours to parents without charge as these are funded by the Scottish Government. During the COVID-19 pandemic, the advice was for childcare providers to close their businesses unless they were providing critical childcare for keyworkers. C closed their businesses during this time. When arranging to reopen their business, C sought advice from the council on whether or not C can or should charge parents for critical childcare. The council told C that critical childcare should be free at the point of delivery and that C should not charge parents, however, they also advised that C could charge in certain circumstances. The council told C that they should use funding they received during the lockdown to cover costs when the nurseries reopened. C felt that the advice they received was in contradiction to advice that they received from the Scottish Government. C had previously raised a complaint with the council about funded hours (prior to the impact of the pandemic) and, in light of this, when C complained about the advice they were given, the council decided that the complaint should not be investigated via their complaints handling procedure. This office took an early view and asked the council to investigate the complaint and provide a further response. After a further response was issued, C remained dissatisfied and brought their complaint to us. We found that the advice given by the council was, at times, contradictory and did not appear to be in line with the guidance issued by the Scottish Government. We also found that the council did not appropriately investigate C's complaint at the time it was raised, or when this office asked them to undertake further work. In light of this, we upheld C's complaints.

C complained on behalf of their spouse (A) about the treatment they received from the board. A was originally referred to a consultant obstetrician and gynaecologist (specialist in pregnancy, childbirth and the female reproductive system) at a different health board. Following further investigations, A's case was discussed at a multidisciplinary team meeting (MDT) which includes specialists from health boards in the west of Scotland. As Glasgow has a subspecialty in gynaecological cancers, Greater Glasgow and Clyde NHS Board took the lead in determining A's treatment plan. A was diagnosed with probable ovarian cancer and was treated with chemotherapy and surgery. C complained about a delay in starting A's treatment, about the decision not to offer chemotherapy first and about how the board responded to their contacts during this time. We took independent advice from a consultant gynaecological oncologist (cancer specialist). Scottish Government guidance, NHS Scotland performance against Local Delivery Plan standards, says that 95% of all patients diagnosed with cancer are to begin treatment within 31 days of decision to treat. A's treatment was not provided until 40 days later (nine days more than the guidance). Greater Glasgow and Clyde NHS Board were responsible for meeting this target, and it was not met. We upheld this complaint. We found that while some clinicians would have treated with chemotherapy first, it was also completely acceptable practice, and indeed encouraged by relevant clinical guidelines, to provide surgery first. We did not uphold this complaint. We considered the communication between C, A and the board. We found that while not every contact was responded to as quickly as the board said it would, and some communication was passed on without acknowledgement, the board did respond to the substantive questions C and A raised and had appointed a single point of contact to help communication going forward. We did not uphold this complain

C complained on behalf of their spouse (A). A was urgently referred to a consultant obstetrician and gynaecologist (specialist in pregnancy, childbirth and the female reproductive system) at Forth Valley NHS Board. Following further investigations, A's case was discussed at a multidisciplinary team meeting (MDT) which included specialists from health boards in the west of Scotland. A different health board took the lead in determining A's treatment plan. A was diagnosed with probable ovarian cancer and was treated with chemotherapy and surgery. C complained about a delay in starting A's treatment, about the decision not to offer chemotherapy first and about how the board responded to their contacts during this time. We took independent advice from a consultant gynaecological oncologist (cancer specialist). Scottish Government guidance, NHS Scotland performance against Local Delivery Plan standards, says 95% of those referred urgently with a suspicion of cancer to begin treatment within 62 days of receipt of referral. From A's urgent referral to the start of treatment was 63 days, one day more than the guidance. As Forth Valley NHS Board was responsible for meeting this target but did not meet it, we upheld this complaint. We found that while some clinicians would have treated with chemotherapy first, it was also completely acceptable practice, and indeed encouraged by relevant clinical guidelines, to provide surgery first. We accepted this advice and did not uphold this complaint. We considered the communication between C, A and the board. We found that while not every contact was responded to as quickly as the board said it would, and some communication was passed on without acknowledgement, the board did respond to the substantive questions C and A raised. We did not uphold this complaint.

C complained that the Scottish Government failed to deal with their complaint over an extended period. C said they repeatedly had to chase the Scottish Government for a response. When C first approached this office, they had not completed the Scottish Government's complaints procedure. Although we received assurances from the Scottish Government that the case was being progressed, C repeatedly informed us that they were not receiving updates, or responses to their correspondence. We chose to exercise our discretion and proceed to an investigation, even though C had not completed the Scottish Government's complaints procedure. We found that the Scottish Government had failed to handle C's complaint in line with their published complaints procedure. They had not complied with the time scales set out in their complaints handling procedure, records had not been kept appropriately and C had not been kept informed of developments, nor had the Scottish Government responded to correspondence. We upheld C's complaint, but because of a similar case, concluded just before theirs, further recommendations were not made to the Scottish Government who have since taken significant steps to improve their complaint handling. Related reading View Decision Report 201803981 as a PDF (24.26 KB) Updated: May 19, 2021

C complained the Scottish Government had repeatedly failed to provide them with accurate information about agricultural grants that they were entitled to apply for. C said they had repeatedly visited the local office without receiving accurate information. C had complained about their experience but they had not received a response for a year. C said the Scottish Government response would not have been issued had they not repeatedly chased it up. We found that there was very little evidence of the Scottish Government's complaint investigation. It was a matter of fact that C was responsible as the business owner for confirming that they had applied for all the entitlements they were eligible for. There was no evidence C had done this. In addition, for some of the years, C said they were poorly advised, the application had to be completed online, and C could not have been assisted with a paper application. We found the Scottish Government were not responsible for ensuring C applied for the correct entitlements. Therefore, we did not uphold this aspect of C's complaint. The Scottish Government's response to C's complaint had, however, fallen below a reasonable standard. Appropriate records had not been kept and there was no evidence the Scottish Government had followed their complaint handling procedure. We upheld this complaint, and asked the Scottish Government to continue to provide evidence they were monitoring their complaints effectively and were able to identify delays. The Scottish Government were able to provide evidence showing the steps they had subsequently taken to improve their complaint handling.

C made an application to the council for a row of trees neighbouring their property to be removed or reduced in height under the High Hedge (Scotland) Act 2013. This application was refused, as the council did not consider that the trees constituted a hedge under the terms of the Act. Following new guidance issued by the Scottish Government in 2019, C contacted the council, as they considered this guidance was relevant to their circumstances and suggested that the trees in question should be considered a hedge. The council did not signpost C into the high hedge process, responding that they did not agree and that the original decision should stand. C then complained to us, as they considered that the council had not had due regard to the new guidance and because there was an inaccuracy in the council's ongoing position regarding the number of trees present. We found that the council had failed to follow due process, effectively pre-judging their decision before carrying out investigations into the circumstances, and also considered that the council had failed to reasonably explain their position. The evidence also supported C's claim that the council's assessment of the number of trees present was inaccurate. We upheld C's complaint.

C joined the Fair Start Scotland programme (an employment support service which aims to help voluntary participants find work). Fair Start Scotland is delivered on behalf of the Scottish Government. C complained about the service they received while on the programme. We noted that there were gaps in the records (particularly regarding the offer of opportunities and placements and the qualifications requested by C), and that the service C received under the Fair Start Scotland programme was not in line with the standards of the programme (specifically the requirement to ensure the records detail the level of support offered and outcome of discussions). Therefore we upheld C’s complaint. As the Scottish Government had already apologised to C for the failings and had taken appropriate action to address the failings identified, we did not make any further recommendations regarding this particular complaint. C also complained that the Scottish Government (and their providers) did not take into account their legal requirements under health and safety and equalities legislation. We did not find any failings regarding the health and safety legislation. However, we found that there was no evidence that C was offered IT adjustments to support their job searching activities. The Equality Act 2010 places a legal duty on service providers and public authorities to make reasonable adjustments. This duty is anticipatory and organisations should proactively offer adjustments (rather than waiting for the individual to request an adjustment). We noted that the Scottish Government acknowledged that Fair Start Scotland should have offered to make IT adjustments to support C’s job searching activities and there was no record this happened. We considered that, where appropriate, participants on the Fair Start Scotland programme should be proactively offered reasonable adjustments to enable them to participate in the programme and this offer should be recorded. We upheld C’s complaint in

C was referred to the board's plastic surgery department with a suspected sebaceous cyst (a common non-cancerous cyst of the skin) as a routine referral. It was found that C had a squamous cell carcinoma (a type of skin cancer). After diagnosis of the cancer C subsequently underwent treatment to remove it. After surgery the board's district and community nurses managed C's wound in the community. C complained about the treatment provided by the board and subsequent wound care. We took independent advice from a consultant plastic surgeon. We found that the board's investigation, diagnosis and treatment of C was reasonable and met the waiting times specified by the Scottish Government in 'Better Cancer Care, An Action Plan'. While there had been some communication failings, the treatment provided was reasonable. We did not uphold this aspect of C's complaint. We took independent advice from a nurse regarding C's wound care. We found that the wound care provided by the board was unreasonable. It was not evidenced that C's wound had been seen and assessed by an appropriate clinician before agreeing how the wound would be cared for. The board accepted there was a lack of documentation relating to C's wound care. We upheld this aspect of C's complaint.

Miss C was referred by her GP to a health board in Scotland for gender reassignment. However, although she was assessed as being eligible and referred to the board's gender identity clinic, she is still waiting for some treatment including surgery. Miss C said that the delay in treatment has had an adverse effect on her mental health, which has been exacerbated by the failure to keep her informed about the delays in a reasonable way. We considered the relevant Scottish Government protocol, which requires health boards to ensure their gender reassignment service is provided in an effective way and within a reasonable time. We also considered the evidence from Miss C's clinical records about her contact with the clinic. We found that the board do not yet have a functioning gender reassignment pathway. We recognised the continuing difficulties the board experienced in providing some aspects of their gender reassignment service and noted the steps they had taken to re-establish this and address the remaining gaps identified. Even so, the board are still not in a position to provide a full gender reassignment service, which has a far-reaching impact on transgender patients. In relation to communication, we found that the standard of communication between staff and Miss C and her family was unreasonable and noted it was likely the impact of delays on transgender patients would be compounded by any communication failings. In addition to staff failing to respond at all to communication, there was a failure to be open and transparent about the difficulties the board had in providing a gender reassignment service. We upheld the complaints.

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

C and their partner became kinship carers to their grandchild when the child's parent died. C complained that the social work department failed to provide the appropriate information and advice regarding kinship care payments. The council advised that C did not meet the criteria for kinship care assistance as set out in the Scottish Government's guidance. We found that the council had fulfilled their obligations. They had given the correct advice about C's eligibility for kinship care payments each time C was in contact with them. We found that the council had provided C with adequate information and support in respect of their grandchild's kinship care. Therefore, we did not uphold C's complaint. Related reading View Decision Report 201903195 as a PDF (24.03 KB) Updated: June 17, 2020

Mr C complained about the council's handling of a planning application for a new development. Mr C said that the council did not undertake an independent transport assessment, and did not fully take into account the numerous objections raised, particularly about traffic and road safety. Mr C said that the council used the wrong guidance in assessing the traffic capacity of the road, and did not take into account relevant Scottish Government policy. The council said that the consultation responses were considered in detail in the report of handling, and they also met with objectors (including Mr C) to discuss his concerns. They said that the relevant policies had been taken into account, and the guidance used to assess road capacity was appropriate. We took independent advice from a planning adviser. We found evidence that the written consultation responses had been taken into account, and objectors (including Mr C) also had the opportunity to speak to the planning committee who made the decision. We considered that the guidance used to assess traffic capacity was appropriate, and there was evidence that the council had also taken into account relevant Scottish Government policy. While the transport assessment was carried out by the developer (not the council), this is standard practice, and the council had agreed the scope and reviewed the result. Therefore, we did not uphold Mr C's complaint. Related reading View Decision Report 201810995 as a PDF (24.32 KB) Updated: June 17, 2020

Mrs C complained about the care and treatment provided to her late husband (Mr A) who had a rare and aggressive form of bladder cancer. Mr A received care and treatment at the Royal Infirmary of Edinburgh and the Western General Hospital. We took independent advice from urology (specialism that deals with the male and female urinary tract, and the male reproductive organs), oncology (cancer) and general surgery advisers. We found that the time taken to investigate and begin treatment for Mr A's bladder cancer was reasonable and in accordance with the Scottish Government's cancer waiting time targets. We also found that chemotherapy treatment commenced within a reasonable timescale. The level of information about treatment options, including their risks and benefits, provided to Mr A was also reasonable. This included sufficient information about the specific risk of pulmonary embolism (a clot in the blood vessel that transports blood from the heart to the lungs), a complication Mr A subsequently experienced. In the context of Mr A's rapid deterioration, the level of planning for end of life care was reasonable. When Mr A subsequently experienced bowel obstruction, it was reasonable that he was treated on a surgical ward. While Mr A's pain was difficult to manage, the attempts by the clinical team were reasonable, as was the aim to discharge Mr A home. When Mr A's condition deteriorated, he was transferred to a hospice without unreasonable delay. We did not uphold Mrs C's complaints. Related reading View Decision Report 201806790 as a PDF (24.5 KB) Updated: March 18, 2020

Mr C manages a direct payment on behalf of his son and he complained to the council about their procedures. Mr C complained that the council's financial monitoring procedures were not sufficiently robust to ensure that he can manage the direct payment appropriately. He said he was wrongly accused of spending the money inappropriately and that the council's monitoring procedures are not 'light touch' as the Scottish Government advises they should be; he also said that the council failed to make reasonable support and guidance available to him as a personal assistant employer. Mr C said it was not clear what he could and could not spend the direct payment budget on and that the council were not keen to fund a membership for a support service, which he required. The council said that it is not always possible to list every item that might be permitted in a person's support plan, however, there is a system in place whereby if the finance department wanted to query an item of expenditure they would contact the allocated social worker. The council also provided details of the different ways they support personal assistant employers. We took independent social work advice and found that the policies and procedures the council had in place were reasonable and there was clear information provided about the support that was available. The council's financial monitoring procedures were appropriate and reasonable, and there was evidence that the council provided the appropriate funding for support services to Mr C. We did not uphold the complaints. Related reading View Decision Report 201803480 as a PDF (24.04 KB) Updated: November 20, 2019

Mr C is a kinship carer and he approached the council to apply for kinship care allowance. The council approved his application to the date of application; however, they did not agree to backdate his payment to the date that the Scottish Government introduced a change to the eligibility for kinship care assistance. The council explained they were not required to backdate the payment as the Scottish Government did not legislate on the matter and only issued guidance, therefore they had discretion as to whether to follow that guidance. Mr C complained that the council unreasonably failed to follow national guidance when considering his request to backdate kinship care payments and that they failed to provide the appropriate information about entitlement to kinship care assistance in line with their obligations. We found that while the council are required to consider the guidance, they do have discretion as to whether they apply it as it is not statutory legislation. We found that the council failed to provide contemporaneous evidence which they based their decision on to not backdate Mr C's application for kinship care assistance. The council only provided retrospective accounts of how those decisions were made. We considered that decisions about whether to follow Scottish Government guidance should be carefully documented and in this case it was not. We upheld this aspect of the complaint on the basis that the council failed to clearly record the rationale for their decision. However, our investigation found that the council provided appropriate information about entitlement to kinship care assistance in line with their obligations when the Scottish Government introduced changes to the legislation. We did not uphold this aspect of the complaint.