• Whether the Commissioning Team appropriately considered requests received on her behalf between 2022 and 2023 • Whether it was clinically appropriate that she was repatriated to the Spinal Team in June 2022 and whether this decision was communicated to her appropriately and whether the Health Board’s monitoring/follow-up was appropriate following this decision (up until May 2023) • Whether the Health Board’s complaint response was compliant with Putting Things Right1 and whether the Spinal Team’s action post-complaint response (in reviewing Miss C and compiling a treatment plan) was undertaken in a timely manner.
The investigation found that the Commissioning Team appropriately considered the funding requests made on behalf of Miss C and so this aspect of the complaint was not upheld.
It would have been more appropriate for Miss C’s treatment to have continued at the Specialist Hospital in England and Miss C should have been informed about the decision to repatriate in June 2022 rather than May 2023. During this period no action was taken to arrange follow up locally. This delay undoubtably caused Miss C additional stress and anxiety. This aspect of the complaint was upheld.
The investigation found that the Spinal Team’s actions post complaint response were undertaken in a prompt and appropriate manner with relevant investigations carried out and communicated to Miss C. However, the complaint response omitted to deal with Miss C’s overarching concern. Whilst it was factually accurate, it did omit to include the June 2022 request for repatriation which led Miss C to question the openness and transparency of the Health Board. The Health Board also failed to arrange a meeting as requested by Miss C which could have been beneficial in describing the bureaucratic and complex procedures and this could have led to an earlier resolution of the complaint. This aspect of Miss C’s complaint was upheld.
The Health Board agreed to apologise to Miss C for the failings identified within the report, pay Miss C a financial redress sum of £250 for the complaint handling failures identified and the time and trouble in making this complaint and offer to convene a meeting with Miss C to discuss the failings outlined within the report.
Additionally, the Health Board agreed to review the Standard Operating Procedure to ensure that it is meeting national guidelines (specifically the NHS, Prior Authority Procedure) for continuing care across geographical boundaries and to review and strength the process around decision making in relation to repatriation, including considering how and when the decision is relayed to the patient and what actions are taken in the interim whilst awaiting formal repatriation.