A complaint that staff at Borders General Hospital put in place a do-not-resuscitate order for a patient without consulting relatives has been upheld.
The patient’s son, named only as Mr C, had welfare power of attorney for his mother, but medics at the Melrose hospital failed to speak to him about putting in place an order not to attempt cardiopulmonary resuscitation (DNACPR).
Mr C took his complaint to the Scottish Public Services Ombudsman, Jim Martin.
He also complained about his mother’s feeding, the general nursing care she received and the NHS Borders board’s response to his complaint.
After taking independent advice, the ombudsman criticised the board for “failing to properly involve Mr C in discussions”.
However, Mr Martin concluded that Mrs A’s nutritional intake was correctly monitored and that “Mr C was appropriately consulted and involved in decisions in this regard”.
He also decided that the nursing care Mr C’s mother received was “of a good standard” and did not uphold that part of the complaint.
NHS Borders board’s response to Mr C’s complaint was criticised by the ombudsman, saying it had generally been of a reasonable standard but there were shortcomings.
“In addressing Mr C’s concerns surrounding the DNACPR decision, they provided some information that was not supported by the medical records,” said Mr Martin.
“While the board acknowledged and apologised for a failure to prescribe some of Mrs A’s usual medication, they did not identify a subsequent gap in the prescribing chart.
“We upheld this aspect of Mr C’s complaint.”
Recommendations made to NHS Borders by the ombudsman include making an apology to Mr C for failing to properly involve him in discussions about Mrs A’s DNACPR status and for its inadequate response to his complaint, reminding medical staff of the importance of involving patients and their carers in discussions about end-of-life care and of documenting such discussions, and reviewing processes for checking and prescribing medication following admission.
The ombudsman also asked to be kept informed of any action taken.