Source · PSOW (Public Services Ombudsman for Wales)

Cardiff and Vale University Health Board

PSOW (Public Services Ombudsman for Wales) Other Reference PSOW-202301971 Sector Health Category Clinical treatment in hospital Decided 15 March 2024

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Full decision

Mr A complained about the way in which the Health Board communicated with the family during his late wife’s inpatient stay from 1 June 2022, given the family had a Lasting Power of Attorney (LPA). Mr A also had concerns about the X-ray changes in his wife’s shoulder region following a fracture and whether this had been caused by the mishandling of his wife by Health Board staff.

From a review of Mrs A’s medical records, the Ombudsman found it disappointing that the level of engagement with the family between 3 June to 12 July did not suggest that due consideration had been given to their legal LPA status and the implications of this, particularly given Mrs A’s later poor prognosis. This would have caused the family an injustice. The first demonstrable consideration of the LPA in the records had not occurred until 13 July.

The Ombudsman noted the Health Board’s comments that there was no indication that the care provided had an adverse effect on Mrs A’s shoulder fracture. The Health Board also acknowledged that a meeting with another orthopaedic consultant to consider Mrs A’s X-rays had been suggested but regrettably not progressed. It added that its Orthopaedic Team had offered their apologies for this omission and for the poor impression the family had been left with as a result.

The Health Board as part of a settlement agreed that it would write to the family to arrange a meeting with them and the Clinical Director of Trauma and Orthopaedics. The meeting would discuss the X-rays and address questions that the family might have. In addition, the process and timescale for the family to receive the X-ray images would be provided to the family. The Health Board also agreed to provide details of the changes in the LPA process that it had introduced as a result of Mr A’s complaint. It would also review how it documented LPAs to improve their visibility on a patient’s medical records as well as identifying a system for ensuring LPA documentation is followed up and present on the records. Finally, if it did not already do so, the Health Board would arrange appropriate training for staff around LPAs and its relevance in terms of clinical decision-making.

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Other decisions involving Cardiff and Vale University Health Board

Reference Date Summary Outcome
PSOW-202410002 30 Apr 2026 Ms C complained about the care and treatment provided to her late mother-in-law, Ms D, when she was investigated and … Partly Upheld
PSOW-202502189 23 Apr 2026 The investigation focused on whether Ms A’s waiting time for gallbladder surgery was appropriately managed in line with the Welsh … Partly Upheld
PSOW-202510196 23 Apr 2026 Mr A complained that the Health Board inappropriately submitted three Multi Agency Referral Forms (“MARFs”) to the Council in relation … Resolved / Early Resolution
PSOW-202501454 16 Apr 2026 Mr C complained that Cardiff and Vale University Health Board had not provided him with the mental health care and … Resolved / Early Resolution
PSOW-202509648 15 Apr 2026 Mrs A complained that the Health Board had not responded to all her concerns in its complaint response, and that … Resolved / Early Resolution
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