Mr F complained about whether the action taken by the Health Board regarding treatment decisions for his sister, Mrs C, was appropriate, timely and in keeping with relevant guidance and whether the decision not to insert a feeding tube during Mrs C’s admission to hospital was appropriate and in keeping with relevant guidance.
The investigation found that the case for not inserting a feeding tube may have been strong from the outset, becoming stronger as Mrs C’s condition deteriorated. However, determinations of Mrs C’s capacity and why decisions were considered to be in her best interest were not fully documented. The lack of proper documentation of these very important decisions means that the appropriateness of these decisions cannot be fully established. This was an injustice. To this extent Mr F’s complaints were upheld.
The Health Board agreed to apologise to Mr F and his family for the failings identified by the investigation. It also agreed to review its documentation standards for clinically assisted nutrition and hydration decisions in patients with acute stroke and decreased consciousness levels, ensure that clinicians that make decisions regarding NG tubes are aware of the need to document the reasoning for decisions and to ensure that there is a clear process in place to address disputes about treatment.