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Case ref:202203211
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Date:July 2023
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Body:Borders NHS Board
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:Clinical treatment / Diagnosis
Summary
C complained about the actions taken by Borders NHS board in relation to diagnosing their child (A) with attention-deficit hyperactivity disorder (ADHD, a condition that affects people's behaviour, including restlessness and impulsiveness). C said that A’s initial referral was rejected and when an assessment did take place it failed to diagnose A’s ADHD. Requests for second opinions were then refused. C said that A was diagnosed with ADHD but not until some years after the initial referral and this was an unreasonable length of time.
We took independent advice from a consultant child and adolescent psychiatrist. We found that while the initial refusal of the referral and first assessment were reasonable, the decision to refuse the request for a second opinion and further assessment was not. This led to an unreasonable delay in diagnosing A with ADHD. As such we upheld the complaint.
Recommendations
What we asked the organisation to do in this case:
- Apologise to C and A for the failings identified. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
What we said should change to put things right in future:
- Where a request for a second opinion is made and the initial assessment demonstrated some indicators of a developmental disorder e.g. ADHD, then a second opinion should be carried out, particularly for developmental disorders where changes may have occurred in the intervening time period.
In relation to complaints handling, we recommended:
- Responses to complaints should be clear and accurate.
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.