Clinical treatment outside hospital; Other: Hywel Dda University Health Board

Mrs A, with the support of her son, Mr B, complained about the care and treatment that her late husband, Mr A, received from Hywel Dda University Health Board (“the Health Board”). Specifically, Mrs A complained that Mr A was prescribed a series of inhalers which had caused severe and damaging reactions, and that Mr A had also been given concerning and conflicting advice on how to deal with his Chronic Obstructive Pulmonary Disease (“COPD”) health issues by respiratory consultants during a number of outpatient appointments. The investigation also considered the complaints that the Health Board inappropriately withdrew both the support of the Respiratory Nurse Specialist and Palliative Care Team, and that the Health Board had failed to respond to Mr A’s formal complaints about his care and treatment in a timely manner.

The Ombudsman concluded that the inhalers prescribed to Mr A were appropriate ones to trial for severe COPD and that there was no evidence to indicate that they caused lung damage and accelerated a deterioration in Mr A’s condition. The Ombudsman also concluded that Mr A was given appropriate advice by respiratory consultants and that differences in their suggested approaches to try to manage his symptoms were not unreasonable. Furthermore, the Ombudsman found that the support of the Respiratory Nurse was not inappropriately withdrawn in March 2022, as standard follow-up for oxygen therapy monitoring was planned. As a result, the Ombudsman did not uphold these complaints. The Ombudsman also did not uphold the complaint about complaint handling.

However, although the Ombudsman concluded that it was reasonable for Mr A to have been discharged from the Palliative Care Team, the way that this was communicated to him was not appropriate as he was not fully informed of the decision to discharge him. This lack of explanation caused additional distress to Mr A, which was an injustice to him. To that limited extent, the Ombudsman upheld this complaint.

The Ombudsman recommended that the Health Board apologise to Mrs A for this failing and for the investigation report to be shared with the Palliative Care Team in order for it to reflect on its findings and to remind it of the importance of clear discussions with patients when discharging them from its services.