Decision Report 201305901

Summary

Mrs C's child had a history of behavioural problems, and was referred to the board's community paediatric department for assessment. A number of developmental disorders were considered and ruled out and a plan put in place to seek further information from the child's school before deciding what follow-up action might be required. Due to staff leaving the department, a period of eight months went by before the case was progressed, and it was a further two months before the board contacted Mrs C telling her that no concerns had been raised about her child, who had been discharged. Mrs C continued to be concerned about her child's behaviour and sought a further assessment. This ultimately led to the child being diagnosed with high functioning autism / Asperger's syndrome.

Mrs C complained to us about the delay in diagnosis and about poor communication from the board. We upheld her complaint about delay. We found that the initial assessment of her child was not in line with national guidance for the assessment of children and young adults with autism disorders. Autism should have been considered and developmental disorders should not have been ruled out before information was gathered from the school. We found the eight-month delay before the case was progressed unreasonable, and there was a further excessive delay after Mrs C's child was referred back to the community paediatric department.

We were critical of the board for not communicating with Mrs C for ten months while the case did not progress, but overall found their communication to be reasonable.

Recommendations

We recommended that the board:

• apologise to the family for the delay in diagnosis;
• draw our findings to the attention of their community paediatric staff and remind them of the relevant guidelines; and
• review their practices for providing staff cover in instances of planned retirement to ensure that services to patients are not unreasonably disrupted.