The patient had complained over the psychiatry service at NHS Highland (file image).
A “significant delay” in assigning a new psychiatric nurse to a patient has earned NHS Highland a rebuke from an ombudsman.
The health board has been told to apologise to the patient after the Scottish Public Services Ombudsman (SPSO) ruled that it was “not sufficiently supportive” of them when they had requested a change in psychiatrist.
The patient, referred to only as ‘C’, has had their complaint upheld after raising concerns about the mental health care provided by a locum psychiatrist and their subsequent request to NHS Highland for them to be changed.
But the SPSO has dismissed C’s claims of unprofessional behaviour by their psychiatrist or of any unreasonable failure to change their medication, saying that there was “insufficient evidence” for either claim.
In its investigation, the SPSO said that C had alleged that consultations were “rushed”, concerns about medication “were not properly addressed”, a referral was delayed, and a diagnosis was not communicated.
C also claimed that their request to change psychiatrist was “handled poorly” and led to a prolonged period without care; and that they were discharged from the Community Psychiatric Nurse (CPN) service as a result of their request.
Making its ruling, the SPSO said that after receiving independent advice from a consultant psychiatrist, “we found insufficient evidence of unprofessional behaviour on the part of the psychiatrist, or of any unreasonable failure to change C’s medication”.
It continued: “However, we found failings in how the consultations were conducted overall. Specifically the failure to inform C of a diagnosis, and a significant delay in authorising a CPN referral.
“Therefore, we upheld this part of C’s complaint. The board had acknowledged and apologised for these failings, and taken appropriate steps to feed back to staff, however, we did not consider the learning action was sufficiently robust or clearly linked to the issues arising in the complaint.
“We also found that there were shortcomings in how the board handled C’s request for a change in psychiatrist. We considered that the board’s approach was not sufficiently supportive and did not adequately recognise C’s preference. C was left for a prolonged period without an allocated clinician.
“We found no evidence, however, to support that C was discharged from the CPN service as a result of this request. We considered that the board’s overall handling of C’s request for a change of psychiatrist was unreasonable and, on balance, we upheld this part of C’s complaint.”
Following the ruling, it has told NHS Highland to apologise to patient C for “leaving them without psychiatric care for a prolonged period, and the unsupportive handling of C’s request for a change in psychiatrist”.
It also told it to ensure several other steps were actioned to prevent similar situations, including that locums are “supported and engaged with the local governance processes”, and that patients under the care of the secondary mental health services “have a responsible medical officer throughout their care”.
NHS Highland should also ensure it responds to clinic letters within its usual timeframes.
Attempts by staff to restore “the therapeutic relationship” with a patient should also “consider [their] needs and explore appropriate support.”
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