Ms A, on behalf of 7 complainants, complained that Hywel Dda University Health Board had stopped providing an appropriate specialist service to epilepsy patients who had a learning disability (“LD”). All 7 complainants had adult children who had been using the service. They said that the Health Board failed to make adequate provision for their care after the service had ended in June 2021, and that there was still no adequate plan in place to meet the needs of LD epilepsy patients within the Health Board.
The investigation found that when the Health Board’s LD Epilepsy Service ceased in June 2021, the Health Board did not review the patients on its lists in a timely manner, nor did it provide adequate alternative provision to meet their needs. The Ombudsman also found that, 4 years later, there was still no appropriate and accessible pathway in place to ensure that the needs of this group of patients was adequately met.
The Ombudsman upheld the complaint. The Ombudsman was concerned that the shortcomings identified affected a very vulnerable group of patients. An appropriate service was still not in place and this potentially affected more than the 7 complainants who approached the Ombudsman’s office.
The Ombudsman made a number of recommendations, which the Health Board accepted.
a) Take immediate steps to progress its plans to implement a clear and accessible LD Epilepsy care pathway, in line with the External Review findings, so that all patients within its area can access care and support appropriate to their needs. It should obtain an external professional clinical review to ensure the adequacy of the pathway and proposed provisions. It should update the Ombudsman about the action it has taken within 4 months of the date of this report.
b) Ensure that there are timescales attached to any action plan and that there is Board oversight of progress, in line with the stated timescales.
Within 2 months:
c) For each of the 7 complainants, provide a written apology for the lack of communication and lack of alternative provision put in place for the care of their relatives following the end of the LD Epilepsy Service.
d) Provide a comprehensive breakdown to each of the 7 complainants about the current care that is being offered to their relatives, the status of and responsibility for any ongoing monitoring/ care reviews/ risk plans, and who to contact for advice or concerns.
Within 4 months:
e) Conduct a thorough review of its LD epilepsy patient lists to ensure that all have up to date care plans/risk assessments and emergency medication plans, and that there are no LD epilepsy patients who have been missed or are currently still waiting for a neurology appointment. There should also be Board oversight of this audit to ensure that it is appropriately completed.