NHS Ayrshire and Arran Ordered to Compensate Patient for Private Surgery

A patient has received a formal order for compensation from NHS Ayrshire and Arran after being wrongly discharged, which forced them to seek private surgical treatment in England. The decision followed an investigation by the Scottish Public Services Ombudsman (SPSO), which found that the health board failed to adequately investigate or diagnose the underlying causes of the patient’s serious symptoms.

The patient presented with significant weight loss, severe abdominal pain, nausea, vomiting, and altered bowel habits. Despite these alarming symptoms, they were discharged from the gastroenterology service without a proper diagnosis. The situation left the patient with “no option” but to pursue treatment privately, leading to a diagnosis of mesenteric ischaemia, a condition characterized by restricted blood flow to the intestines. Following surgery in England, the patient reported significant health improvements but expressed concern over the necessity and costs incurred.

NHS Ayrshire and Arran acknowledged the shortcomings in their patient care. They issued an apology for delays in investigations and communication breakdowns. Despite this, the board maintained that their clinical decisions regarding the patient’s investigation and management were appropriate.

The SPSO report highlighted critical failures in the handling of the case. It stated that mesenteric ischaemia should have been considered a strong possibility based on the patient’s symptoms. Furthermore, a CT scan conducted during the patient’s care failed to report the narrowing of the blood vessels supplying the gut. The decision to discharge the patient was deemed “unreasonable,” particularly given their ongoing weight loss and persistent symptoms.

In light of these findings, the health board has been directed to formally apologize to the patient and to reimburse them for their private treatment costs. This reimbursement includes travel expenses to and from London for the necessary surgery, contingent upon the submission of receipts. The calculation for reimbursement will be based on what the treatment would have cost the NHS, rather than the total amount paid by the patient.

In a statement, the SPSO emphasized the importance of careful consideration when discharging patients displaying ongoing symptoms, especially those with unexplained weight loss. They noted that a high level of suspicion for mesenteric ischaemia should be maintained when patients exhibit post-prandial abdominal pain and weight loss without a clear diagnosis.

Jennifer Wilson, the executive nurse director at NHS Ayrshire and Arran, expressed regret over the patient’s experience. She stated, “We are sorry that the care experienced by patient C did not reflect the high standards of care we aim to deliver in NHS Ayrshire & Arran.” Wilson confirmed that the board accepts the findings and recommendations set forth by the SPSO and is committed to making necessary improvements in patient care.

The health board is actively working to implement the SPSO’s recommendations and ensure that lessons learned from this case are disseminated across the organization to prevent similar incidents in the future.