NHS Borders has been made to apologise to a woman after her GP was told by a consultant psychologist that any of her suicide threats were ‘not to be tolerated’.
The woman’s complaint to the Scottish Public Services Ombudsman (SPSO) was upheld after it found that NHS Borders had failed to involve the woman in her care and failed to record her involvement.
The woman, named only as ‘Ms C’ in the SPSO report, had been diagnosed with a histrionic personality disorder, a condition in which people act in a very emotional and dramatic way that draws attention to them.
She was known to frequently appear at the Borders General Hospital’s A&E department and at her medical practice. The report said her consultant wrote to the services advising that they should “manage her behaviour carefully” and “should not entertain threats of self-harm or suicide”.
Ms C complained that the consultant’s advice to these services meant that she was prevented from receiving treatment for other conditions, in particular, for nerve pain in her legs.
She also said that the consultant did not make her aware of her diagnosis or of the fact that he had written to other healthcare services about her behaviour.
The SPSO found it reasonable for the consultant to send the letters and ruled that the content of the letters was appropriate.
However, the report stated: “In one of his letters to Ms C’s GP, the consultant made what we felt was a clear instruction that threats of suicide should not be tolerated. As good practice guidance says that all threats of suicide should be taken seriously and investigated, we did not find this instruction to be appropriate.”
The ombudsman also found that there was no written record of any discussion between the consultant and patient over her diagnosis or the letters, although advice from NHS Borders and a SPSO mental health adviser suggested that she would have been informed of her diagnosis.
The ombudsman’s report said: “It is an underpinning principle of mental health care that patients are involved in decisions about their care and treatment. We considered that the board had failed to involve Ms C in her care or to record her involvement.”
The SPSO recommended that the NHS Borders board apologise to Ms C and also draw the consultant’s attention to the comments about the letter.
Calum Campbell, chief executive of NHS Borders said: “We accept the recommendations of the Scottish Public Services Ombudsman in this case. We have acted upon the recommendations in the SPSO report, including offering our sincere apologies to Ms C and bringing the adviser’s comments to the attention of the consultant.
“NHS Borders takes every complaint very seriously. The lessons we have learned from this experience have been implemented and provide us with valuable opportunity to improve our services.”