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The Scottish Public Services Ombudsman (SPSO) has told the health board to apologise after finding ‘unreasonable, sustained and significant failures in the diagnostic and testing process’ at NHS Lothian’s audiology service.
Health chiefs have also been ordered to review their diagnostic processes, and to overhaul its complaints handling process.
The SPSO investigated the health board after it received a complaint from the patient’s parents, who said NHS Lothian had failed to diagnose their child, despite numerous hearing tests between June 2012 and January 2018.
After repeated concerns were raised by the child’s parents and school, the patient was sent to another health board, where they were diagnosed with hearing loss. By that time, the child was eight-years-old.
Health chiefs have also been slapped on the wrist for their complaints handling procedures, with the SPSO saying their responses to the child’s parents ‘were very poor’.
A report from the SPSO, which refers to the child as ‘child A’ and their parents as ‘Mr and Mrs C’, reads: “Mr and Mrs C believed that Child A had a significant hearing impairment from two and a half to three years of age.
“They complained that this went undiagnosed, despite Child A undergoing multiple tests over a number of years with the board’s Audiology Service.
“Mr and Mrs C said that the board’s failure to diagnose Child A’s hearing impairment within a reasonable timescale affected Child A’s communication skills and, potentially, their ability to learn.
“Mr and Mrs C explained that Child A had complex needs, including cerebral palsy and learning difficulties, and was also non-verbal.
“Child A failed the initial hearing screening test and was referred to the board’s Audiology Service, who found that Child A may have some mild hearing loss in both ears.
“Child A was then seen by clinicians at the Board’s Audiology Service several times over the following years, and the audiologists told Mr and Mrs C that they frequently found it difficult to obtain reliable test results due to Child A’s communication difficulties.
“However, Child A was discharged from the Audiology Service twice as a result of staff being satisfied that they did not have any significant hearing loss.
“Mr and Mrs C did not accept the test results, saying that the audiologists were not taking into account Child A’s symptoms and additional needs during testing.
“Following continued concerns being raised by Mr and Mrs C and Child A’s school, Child A was eventually referred to audiologists at another health board for a second opinion.
“A number of tests were carried out and Child A was diagnosed with severe to profound hearing loss in both ears.
“Child A was eight years old at that point. Child A was subsequently fitted with hearing aids which Mr and Mrs C observed appeared to have helped their hearing.
As well as apologising to the child’s parents, NHS Lothian must now review its diagnostic processes, and prove to the SPSO it has carried out the audit and fed the findings of the investigation back to healthcare staff.
The SPSO also found ‘significant failings’ in NHS Lothian investigation and complaints handling.
The report continues: “We also found significant failings in the board's investigation of Mr and Mrs C's complaint.
“The board failed to identify even the most basic errors in the service they provided, as they should have done as part of their duty of candour, and the standard of their response to Mr and Mrs C was very poor.”
NHS Lothian must now prove to the SPSO it has reviewed its investigation and complaint handling processes.
In response, Dr Tracey Gillies, medical director at NHS Lothian, said: “As well as issuing a written apology directly to Mr and Mrs C, I would also like to take the opportunity to apologise for the failings in this case and for any distress this has caused.
“We accept the ombudsman’s recommendations in full and are working through a plan to address these in line with the required timescales.”