CONCERN that hospitals have neglected the rights of some of Scotland's most vulnerable patients have been raised after a series of complaints.
Jim Martin, Scottish Public Services Ombudsman, highlighted repeated failures in the care of people less able to speak up for themselves, including pensioners suffering dementia.
In one case an 87-year-old with Alzheimer's was discharged from an NHS Greater Glasgow and Clyde hospital two days after a hip operation following a fall, despite tumbling again on the morning she was due to be released. Within one week she fell again and died some time after being re-admitted to hospital.
Last night her son-in-law, who did not wish to be named, said: "It was a very sad ending to a very nice lady's life."
In another case, NHS Lanarkshire staff removed a feeding tube from a patient (Miss A) suffering from Down's syndrome and dementia even though she was not feeding herself adequately. Staff also put an order in place not to resuscitate her without any discussion with her carers.
Describing the gravity of this second case, the ombudsman's report says: "These complaints raise serious concerns about the quality of decision-making, consideration of capacity issues and recording of these issues with respect to a most vulnerable member of society, namely an adult with life-long learning difficulties and dementia.
"There are a number of legal safeguards that should have been in place for Miss A precisely because of her degree of vulnerability, and it is of considerable concern there were significant delays in enacting these."
The ombudsman, who probes complaints about public services, also raised questions about the way both health boards responded when concerns about what happened were raised.
Among a number of errors, NHS Lanarkshire claimed one of the consultants who saw Miss A had known her since 2004. In fact he had never treated her before.
NHS Greater Glasgow and Clyde, who failed to assess the cognitive ability of the Alzheimer's patient during her stay, told her daughter that healthcare inspectors had praised their standards of care. In fact, the ombudsman noted, the inspectors had highlighted the need for improvements in the areas of assessment and care-planning.
NHS GGC is also criticised for not talking to the patient's daughter (Mrs C) or the care home where Miss A was living. The report says: "We considered that a lack of meaningful consultation with Mrs C and the nursing home led to a significant personal injustice to Miss A, as her discharge was ineffectively planned and co-ordinated and failed to ensure her needs were met."
An NHS Lanarkshire spokesperson said the board had fully accepted the ombudsman's recommendations and will develop an action plan to address them. Work to implement the National Dementia Strategy has progressed since the patient was looked after in the summer of 2001.
NHS GGC said: "We acknowledge the communication with the family of Mrs A could have been better and we are working to improve local communication processes at ward level to support patient care by encouraging active involvement of relatives or carers at all stages in planning care for their family member."
A Scottish Government spokesman said: "We want all patients to be confident they will get the best possible care and treatment from the NHS in Scotland and where improvements can be made.
"It's vital lessons are learned quickly."
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