BackThe Northern Ireland Public Services Ombudsman investigated a complaint about a fall in the standard of care given to a young woman with complex medical needs when she turned 18.
Through her childhood years the Belfast Health and Social Care Trust delivered an effective care package to the young woman, who had learning difficulties and a life limiting illness. Her mother, who was the main carer, said she wanted the existing arrangements to continue, but when the care transferred to an adult care provider it got worse, causing distress and anxiety to both her daughter and herself.
After investigating, the Ombudsman expressed surprise at the removal of the package. She was further surprised to find a gap in the Trust’s policy and procedures for governing the process of transferring care of a child under 18 to adult care. The Trust admitted that ‘unfortunately there do not appear to be any policies and procedures in Children’s or Adult Services in relation to Transitioning to Adult Services.’ The Ombudsman said that this represented a significant and unacceptable gap, requiring urgent remedy.
She also found the Trust failed to prepare for the transition as early as it should have done. The earliest record the Trust provided of Adult Services involvement in the young person’s case is dated one month before her 18th birthday. Noting that this transition was not a movement between different organisations but simply across two different teams, she considered opportunities were lost for decision makers to build relationships with the young woman and her family, and to observe how care was being delivered, in order that appropriate health professionals might be fully informed when assessing risks in care provision.
The investigation also found care plans that were incomplete and insufficient at the commencement of the new care package, with many gaps in documentation.
She concluded there were a number of failures in the care and treatment provided, and those failures caused the injustice of lost opportunity, distress and anxiety for the service user, the complainant, and the other immediate family members over several months.
Sadly, due to the subsequent death of the service user, those disruptive and anxious months were among the last that the family had with their precious daughter and sister.
The Ombudsman recommended that the Chief Executive apologised to the complainant, and said that the Trust should policy and procedures to govern the transition between child and adult services, both to fill the existing gap in policy and to ensure this challenging time of change is managed sensitively, empathetically, and as effectively as possible for service users and their families.
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Source: The Office of the Northern Ireland Public Services Ombudsman, UK
