Hull University Teaching Hospitals NHS Trust

3. Mrs A complains the Trust delayed fitting a pacemaker for her father, Mr O, in June 2021.

4. Mrs A believes her father would not have had a stroke leading to his death if the pacemaker had been fitted sooner.

5. Mrs A would like the Trust to make service improvements and to apologise. She would also like a financial payment as her father cared for her mother. Since his death, they have had to pay for her mother to be in a care home.

6. Mr O was admitted to the elderly assessment unit (EAU) at the Trust on 29 May 2021 for clinical investigations after he collapsed at home. He was transferred to the cardiology department on 3 June.

7. Mr O had been waiting for a procedure to fit a permanent pacemaker (PPM) but had a stroke. This meant the PPM procedure did not go ahead.

8. Mrs A contacted the Trust on 2 July 2021 to raise concerns about her father’s care and treatment. In August 2021, Mr O died.

9. The Trust replied to Mrs A’s complaint on 25 October 2021. Mrs A raised outstanding concerns with the Trust on 3 December 2021. The Trust replied to these on 18 January 2022. Mrs A brought her complaint to us on 16 January 2023.

13. Before we decide if we should do a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened (based on relevant standards and guidelines) with what did happen. We have done this and have not seen any signs that something has gone wrong.

14. The Trust’s complaint response explains that Mr O was noted to have loose stools (bowel movements that are softer than normal) when he was admitted to the EAU on 29 May 2021. He was transferred to the cardiology ward on 3 June. The next day it was decided by the cardiology consultant that a PPM would be fitted at the earliest opportunity. Mr O had diarrhoea on 4 and 5 June. It was decided that the risk of infection was too high to do the PPM procedure.

15. The Trust added that Mr O’s diarrhoea had resolved on 6 June. But, there was not enough capacity to do the procedure on 6 or 7 June due to emergency admissions to the hospital. Mr O had a stroke on 8 June and could not have the PPM fitted.

16. Our adviser says it was in line with the GMC guidance to delay fitting the PPM because of the risk of infection when Mr O had diarrhoea. GMC guidance says a doctor should ‘adequately assess the patient’s conditions, taking account of their history’ including the symptoms and give quick advice or treatment. The Trust assessed Mr O’s condition and decided to wait to do the procedure because of the infection risk.

17. NHS England advice says that ‘potential for transmission of infection must be assessed when a patient enters a care area’ and continuously reviewed throughout the period of care if in hospital. We have found no failing with this part of the care and treatment.

18. On 6 June, it was decided that Mr O was well enough to have the PPM fitted. The Trust say Mr O was put on the list for a PPM and was prepared for the procedure.

19. The Trust adds there was not enough capacity for Mr O to have the procedure at that time. Our adviser said it is in keeping with the GMC guidance for clinicians to prioritise cases based on clinical assessment and judgement.

20. Our adviser made clear that the fitting of a PPM would not have reduced the chance of Mr O having a stroke, because a PPM is used to treat bradycardia (a slow resting heart rate). Even if a PPM had been fitted earlier, it would not have reduced the chance of Mr O having a stroke (a condition where the blood supply to the brain is cut off or compromised).

21. It was clearly distressing for the family while Mr O waited to have the procedure. We understand their concerns.

22. It is our role to be impartial and transparent in explaining our decision. We hope Mrs A understands the reason for our decision. We appreciate how difficult it has been for Mrs A to speak about what happened and we thank her for sharing her complaint with us.

1. We have carefully considered Mrs A’s complaint about Hull University Teaching Hospitals NHS Trust (the Trust). We have seen no sign that anything went seriously wrong.

2. We recognise the grief Mrs A has experienced with the death of her father and understand she is concerned that if a pacemaker had been fitted sooner, he may not have died.