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Case ref:201707340
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Date:September 2018
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Body:Lothian NHS Board - Acute Division
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Miss C complained about the care and treatment provided to her by the board. She complained that the board did not identify that she had an anal fissure (cut or tear in the tissue inside the anus) during an examination under anaesthetic. She also complained about the length of time she had to wait for that examination.
We took independent advice from a consultant colorectal surgeon (a surgeon who specialises in conditions in the colon, rectum or anus). We found that it was reasonable that the board did not identify an anal fissure because it was in remission at the time of Miss C's examination under anaesthetic. However, we found that there was a delay in Miss C receiving the examination and that this exceeded the national waiting time standards. We considered that this was unreasonable given the amount of pain she was experiencing. We upheld Miss C's complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to Miss C for the amount of time she had to wait to receive an examination under anaesthetic. The apology should meet the standards set out in the SPSO guidelines on apology available at: www.spso.org.uk/leaflets-and-guidance.
What we said should change to put things right in future:
- Patients with a suspected anal fissure should be treated within national wait time standards and the board should consider mechanisms to allow patients with severe anal pain to be seen as soon as possible. The board should consider advising patients in a timely manner that they may not be seen within waiting time targets.
We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.