Report Date


Case Against

Cardiff and Vale University Health Board


Clinical treatment in hospital

Case Reference Number



Voluntary settlement

Ms A complained that the Neurologist’s clinic letter to the GP did not reflect accurately the telephone consultation that she had with him and the medication treatment plan that was agreed. She also complained about the accuracy of the Health Board’s complaint response when it came to aspects of the consultation.

The Neurologist accepted that Ms A’s audio recording of the consultation was accurate. The Health Board agreed to the Ombudsman’s settlement proposal that it apologise to Ms A for the inaccuracies in its complaint response and that it remind clinicians of the need for accurate records of consultations with patients.