Health board ordered to pay part of patient's private surgery

The patient was forced to go private for surgery after being discharged by NHS Ayrshire & Arran

A health board has been ordered to pay for part of a patient's private treatment in London after failing to properly investigate their condition.

The Scottish Public Service Ombudsman ruled that NHS Ayrshire & Arran unreasonably discharged the patient - who remains anonymous - despite the fact they were suffering constant weight loss and intense abdominal pain.

The patient was later diagnosed as suffering from mesenteric ischaemia, which restricts blood flow to the intestines.

They underwent surgery privately but complained of the cost. NHS Ayrshire & Arran was ordered to apologise and cover some of the cost.

According to the report, the patient - known as C - had been suffering significant weight loss, intense abdominal pain, vomiting, altered bowel habit and nausea.

They were discharged from the board's gastroenterology service - which specialises in disorders of the stomach and intestines - despite symptoms being ongoing.

C said that they were left with no option but to obtain private care and treatment in England, where they were diagnosed with mesenteric ischaemia.

The board acknowledged and apologised for issues over its investigations and communications, but argued that the clinical decisions made were appropriate.

NHS Ayrshire & Arran apology

The ombudsman made its decision following advice from from a consultant gastroenterologist and a consultant radiologist.

It found a diagnosis of mesenteric ischaemia should have been considered as a strong possibility based on the symptoms.

A CT scan also failed to report the narrowing of the blood vessels supplying the gut, and therefore it found the decision to discharge C was unreasonable.

The health board was told to apologise to C and also reimburse them in relation to private treatment, including the cost of travel to and from London.

The calculation will be based on what the treatment / surgery would have cost the NHS, rather than the full cost of the treatment, and what proportion of that C had to pay.

It recommended that care be taken when discharging patients with ongoing and persistent symptoms, that mesenteric ischaemia should be considered in cases of weight loss with no apparent symptom, and that here should be interdisciplinary working between teams to reduce the risk of a missed diagnosis.

A spokeswoman for NHS Ayrshire & Arran said: "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.

"The board accepts in full the findings and recommendations of the Scottish Public Services Ombudsman (SPSO) and will be offering a formal apology to the patient."

They added that work was underway to implement each recommended action.