NHS Borders has been told to apologise to a patient after complaints were upheld by an ombudsman.
The Scottish Public Services Ombudsman (SPSO) published its decision report this month.
It found that there had been confusion around the patient’s diagnosis and whether they had been informed.
The complainant – referred to as C in the report – said that their parent – or A – had not had a psychiatric assessment for years.
An SPSO spokesperson said: “They [A] had a diagnosis of paranoid and antisocial personality disorder for several years before it was changed to paranoid schizophrenia. ‘A’ later received an occupational therapy assessment but did not receive support and was referred to social work. A few months later, ‘A’ was referred to mental health services by their GP due to confusion. ‘A’ failed to attend two appointments and was discharged.
“The following year, ‘A’ was admitted to hospital with confusion and left-side weakness. A CT head scan showed an established infarct (an area of necrosis (tissue death) due to blood vessel blockage, often caused by a stroke). ‘A’ was discharged from hospital and mental health services two months later.
“’A’ did not receive a psychiatric assessment prior to, or following, discharge and did not receive any community support. C complained that ‘A’ had not received appropriate support, had not received a psychiatric assessment for several years, and was unsure of their diagnosis. C requested a second opinion but this was refused.
“The board said that A had received consultant psychiatric assessments, including two prior to their discharge.
“They advised that the diagnosis was paranoid and antisocial personality disorder and refused to offer a second opinion.”
The spokesperson added: “We took independent advice from a consultant psychiatrist.
“We found that the board’s response could not be verified by the records and seemed to contradict the diagnosis of paranoid schizophrenia that was given previously.
“The records did not offer a clear clinical rationale for changing the diagnosis to paranoid schizophrenia and it was not clear that the A had been informed.
“Given the confusion around A’s diagnosis and lack of psychiatric assessment, we considered that it was unreasonable not to offer a second opinion.
“Therefore, we upheld C’s complaints.”
The SPSO asked NHS Borders to apologise to A for the “inconsistencies and contradictions” in the complaint response.
It said an apology should also be issued for the lack of clear diagnosis, the lack of psychiatric assessment, the lack of rationale in not offering mental health input following A’s stroke and the refusal to offer a second opinion.
An NHS Borders spokesperson said: “We have accepted the recommendations identified by the SPSO and have implemented an improvement plan. We are sincerely sorry for the effect that this experience had on C and their family and we have issued them with an apology."
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