AYRSHIRE'S health board has been ordered to apologise to the partner of a patient suffering from kidney failure who complained about poor treatment by medical staff in the final days of their life.

A decision report by the Scottish Public Services Ombudsman (SPSO) upheld parts of the complaint by a person known only as 'C', who raised concerns over the care and treatment provided to their spouse - known as 'A' - when they became unwell with severe lower abdominal pain and vomiting.

According to the report, A was visited and examined by an out-of-hours (OOH) GP, who administered an injection for vomiting and left some medication.

A's condition worsened and a different OOH GP attended the same evening.

The patient was then taken to an unspecified NHS Ayrshire and Arran hospital by ambulance and was found to have a perforated bowel (hole in the large intestine) and kidney failure.

The report said: "Medical intervention was not considered appropriate and A's care was redirected to palliative care. A died in hospital two days later."

The complainer claimed that the first OOH GP missed important aspects of their partner's condition during their home visit, adding that when the patient was admitted to hospital, they were left in pain and discomfort for many hours and it was only when the complainer raised concerns that their partner was given stronger pain relief.

Assessing the complaint, the SPSO said it took independent advice from a GP adviser, as well as a registered nurse and a general physician in acute medicine.

The report said: "We found that overall, the assessment and examination carried out by the first OOH GP was reasonable and appropriate.

"It was determined that there was nothing suggestive of an acute abdomen (sudden, severe abdominal pain) which would have necessitated admission to hospital."

The ombudsman did not uphold this part of the complaint, however, recommendations were made regarding other aspects of the allegations.

The complainer stated that their spouse was given unreasonable care and treatment in the hospital, in relation to managing the patient's pain.

While the SPSO adjudged the overall approach to the patient's pain management by nursing staff to have been "reasonable", improvements could have been made.

The report said: "Nursing staff identified A's level of pain from first admission and throughout and took appropriate action to try and address this.

"However, we found that given the very high doses of morphine administered, medical staff should have checked the medication prescribed to see if it was working, and review or prescribe something else.

"Furthermore, given that the medical team would have been aware that A was on the ward round for comfort care, a palliative care referral could have been made earlier.

"We considered that an earlier referral may have supported better comfort care for A in the final stages of life. As such, we upheld this aspect of C's complaint."

The SPSO asked the health board to apologise to the complainer "for the failings identified".

A further recommendation noted: "Pain medication prescribed for patients should be appropriately checked by medical staff to see if it is adequately working.

"Referrals to palliative care should be made in a timely way without delay."

Joanne Edwards, director of acute services at the health board, said: "I am sorry that we did not meet the high standards of care we strive for in NHS Ayrshire and Arran for this patient, and offer my deepest condolences to their family.

"In cases like this, we always accept the recommendations in the Scottish Public Services Ombudsman report, address the issues highlighted and make the appropriate changes.

"To ensure learning across the organisation, we also share the findings from these reports with staff, in particular with those responsible for the operational delivery of the service and with our clinical governance teams."