Complaints about the treatment of a frail patient who died after being discharged from hospital, poor end of life care and the refusal of reconstructive surgery for an assault victim have been upheld.

All three incidents happened within the NHS Ayrshire and Arran’s boundaries and were brought before the Scottish Public Services Ombudsman this month.

The first saw a complaint that NHS Ayrshire and Arran had failed to provide reasonable care to the complainer's parent, who had died soon after being admitted to hospital for a third time. The Ombudsman said that the patient was originally discharged just one day after being admitted to hospital for the first time, despite their heart issues, age and frailty.

The report stated: “[They] should have remained in hospital given that a deterioration in their condition was very likely to occur, and as they also required further detailed assessment of their mobility.”

It added that the patient should have been kept in hospital, even if they had previously been healthy as the problems were ‘profound and life threatening’.

The report added: “We found that the board failed to take account of the evidence in A’s records that they had struggled with their mobility and had needed supervision and support.

“Given the severity of A’s illness, age, and the difficulty with walking, there should have been a specific and detailed assessment of A’s mobility prior to their discharge.”

The second upheld complaint came about as a result of the end of life care provided to the complainer’s spouse by an Ayrshire medical practice.

The patient had ‘Lewy’ body dementia, which affected their movement, thinking, moods, memory and behaviour and received care from their spouse at home.

The patient’s partner said that the GP failed to visit the patient when their condition began deteriorating.

They also complained that there had been a delay in initiating their end of life care plan, which would have allowed access to pain-relieving medication and to community palliative care.

The practice admitted there was no home visit, but insisted doctors had been in constant contact with the district nursing team about their care and medication.

The Ombudsman said: “We found that the practice had not provided a reasonable standard of end of life care.”

The practice should have carried out an earlier assessment of palliative and end of life needs, the investigation found.

It added that there was an ‘unreasonable delay’ in providing pain relieving medication, and noted that staff ‘lacked awareness of the community palliative care team and the referral process’.

The third case involved a patient with a history of ‘multiple facial trauma’ who had undergone surgery over the last ten years to treat the issues.

The Ombudsman was told that the patient had been assaulted and had injured their nose.

The patient said that the health service had refused to investigate or carry out reconstructive surgery, despite a number of referrals by doctors.

They claimed that the decision not to provide further treatment was the result of a historic psychological assessment that had suggested it would be damaging to the patient.

The patient ‘strongly objected’ to the assessment.

The investigation found that, while it was reasonable to take a psychiatric assessment into account, the length of time since it was produced, together with the new injury, meant they should have been reassessed.

In all three cases, the service was asked to apologise to the complainer and ensure that the failures are not repeated in the future.