Mrs A complained about the care and treatment her late father (Mr B) received from Swansea Bay University Health Board. The investigation considered whether Mr B’s blood pressure was appropriately managed whilst he was an inpatient between 26 December 2022 and 4 January 2023, and whether, the decision to discharge him without re-instating ramipril (a type of antihypertensive medication, called an angiotensin-converting enzyme (“ACE”) inhibitor which works by widening the blood vessels making it easier for the heart to pump blood around the body), with a plan for review with the GP in 7 to 14 days, was clinically appropriate.
The investigation found that Mr B’s blood pressure was appropriately managed during admission. Given Mr B’s renal deterioration, it was appropriate that his antihypertensive medication was withdrawn, until he had begun to recover. The decision to recommence lacidipine (an antihypertensive medication that works by relaxing the blood vessels) during admission, but to continue to withhold ramipril was also appropriate.
The decision to discharge Mr B without re-commencing ramipril was clinically appropriate. It is normal and good clinical practice to defer blood pressure monitoring to a patient’s GP following discharge. The error in the discharge summary did not cause, and was unlikely to have caused, a clinical injustice to Mr B. The complaint was not upheld.