Decision Report 201508442

Summary

Ms C, who works for an advocacy and support agency, complained on behalf of Mrs A about the care and treatment given to Mrs A's husband (Mr A), who had been diagnosed with chronic liver disease. Ms C said that despite regular testing since his diagnosis, there had been a failure to pick up Mr A's deteriorating condition and she was concerned that he had not been offered a liver transplant. Mr A died following discharge from hospital. Ms C also complained about a delay in receiving a response from the board.

We took independent advice from a consultant gastroenterologist (a doctor who specialises in the treatment of conditions affecting the liver, intestine and pancreas). Mr A had been regularly monitored and checked but the nature of his disease was unpredictable and his diagnosis had not always been clear. We also found that Mr A's case had not been appropriate for liver transplant as the severity of his illness (based on an established scoring system) had not been high enough to justify it. We therefore did not uphold this aspect of Ms C's complaint. However, the adviser said that the board should have involved the Macmillan palliative care team at an earlier stage to provide symptomatic help for Mr A and support for his family.

We found that there was an unreasonable delay on the part of the board in responding to Ms C's complaints and in addressing her concerns.

Recommendations

We recommended that the board:

• ensure that the medical staff involved in Mr A's care are informed of the outcome of this complaint;
• review the advice they provide to patients and their families about the hepatocellular carcinoma (liver cancer) surveillance programme and consider providing a relevant leaflet;
• make a formal apology and provide full information of how they intend to address the concerns identified;
• ensure that staff involved in Mr A's care are reminded of the necessity of adhering to the stated complaints policy; and
• confirm to us that they are satisfied that the Macmillan referral process used is fit for purpose.