Report Date


Case Against

Hywel Dda University Health Board


Clinical treatment outside hospital

Case Reference Number



Voluntary settlement

Mrs A’s complaint against Hywel Dda University Health Board (“the Health Board”) centred on whether during times of pressure Withybush General Hospital’s Emergency Department had put in place reasonable adjustments for individuals with learning disabilities, autism and epilepsy particularly where they exhibit behaviour that is challenging.
Mrs A’s complaint against Welsh Ambulance Services NHS Trust
(“WAST”) related to:
• the extent to which it had made reasonable adjustments for individuals with learning disabilities, autism and epilepsy when it comes to its paramedic service, particularly in terms of pain assessment and communication.
• record-keeping by the paramedics who attended Mrs A’s home on 23 February 2020, especially regarding the mental capacity assessment and her son’s discharge of care.
The Ombudsman discontinued his investigation into Mrs A’s complaint relating to the paramedics’ attendance at her home.
However, as part of the settlement it was agreed that senior officers in the Health Board and WAST would meet to look at patients living with learning disabilities/autism and complex needs, such as Mrs A’s son, journey through the various stages of their patient care from primary care up to secondary care. The meeting would identify ways in which patients’ journey can be improved by way of reasonable adjustments and through the use of technology and help develop action plans to take forward any initiatives. The settlement also set out ways of engaging with Mrs A and that feedback would be provided to Mrs A and the Ombudsman’s office regarding the outcome of the meeting. The Health Board and WAST were given 3 months to carry out the settlement.