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Case ref:201803746
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Date:November 2019
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Body:Greater Glasgow and Clyde NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Mrs C complained that the board's decision to not provide her child (Child A) with an emergency appointment was unreasonable. Child A had been receiving treatment from the board's Child and Adolescent Mental Health Services (CAMHS). Mrs C's husband, and Child A's teacher and doctor, raised concerns with the clinical nurse specialist who was responsible for Child A, about an escalation in their behaviour and thought they should be assessed urgently. However, the decision was taken to wait until Child A's scheduled appointment a week later. Prior to that appointment, Child A's condition worsened and they were admitted to Stobhill Hospital. Mrs C also complained about the treatment Child A received over the course of a few years.
On reflection, the board said that they should have offered Child A an urgent appointment. They apologised for this and explained the steps they had taken to improve practice. With respect to the overall care, they considered that the records demonstrated appropriate assessments and care throughout. Mrs C was not satisfied with this response and brought her complaint to us.
We took independent advice from a registered nurse experienced in child and adolescent mental health. We found that, on the basis of the records existing at the time, the actions of the clinical nurse specialist in not arranging an urgent appointment, were reasonable. The expressions of concern made by Child A's family and teacher, whilst in hindsight could be reflected on and improvements made to the board's service, would not have suggested to a reasonable clinician that Child A was experiencing a psychotic crisis. We considered that the concerns expressed could have supported the existing understanding of their mental health. Therefore, we did not uphold this aspect of Mrs C's complaint. With respect to Child A's treatment and diagnosis, we found that the level of support offered was reasonable and the tools used to assess Child A were reasonable. We did not uphold this aspect of Mrs C's complaint.