Report Date


Case Against

Powys Teaching Health Board


Clinical treatment outside hospital; Other

Case Reference Number



Upheld in whole or in part

Mrs A complained about the delay in her adult daughter, Miss B, receiving her first appointment with the Integrated Autism Service (“IAS”) in 2018 following an autism diagnosis. She also referred to the fact that her daughter had more than one initial assessment appointment with the IAS as well as the level and quality of support provided during those initial assessments. In addition, Mrs A was dissatisfied with the robustness of the Health Board’s complaint responses.

The Ombudsman’s investigation concluded that organisationally, communication within the IAS could have been better in informing service users and their family about the delayed appointment timescales. The Ombudsman concluded that Mrs A and her daughter were caused an injustice as their anxiety about the diagnosis would have been exacerbated by the delay. He upheld this part of Mrs A’s complaint.

The Ombudsman did not uphold Mrs A’s complaint regarding the number of assessments carried out, given it is good practice to do so in order to ascertain need. The lack of documentation detail hindered the extent to which it was possible to evaluate the support provided at each stage. The Ombudsman was critical of aspects of the support provided, although the initial post diagnostic assessment appeared more appropriate than the later separate support sessions provided.

The Ombudsman found for example, a considerable delay in the initial support assessment appointment taking place and evidence of episodes of poor communication within the IAS. The Ombudsman found Miss B was caused an injustice, although there was a degree of uncertainty as to whether the delay meant that there was a missed opportunity to address Miss B’s support needs sooner. The failure to clarify the role of the Support Worker in contact Mrs A had with IAS had also added to Mrs A’s mistrust and concerns about IAS. The Ombudsman upheld this part of Mrs A’s complaint.

Finally, the Ombudsman upheld Mrs A’s complaint regarding the robustness of the Health Board’s complaint responses and in doing so referred to inconsistencies and inaccuracies in the Health Board’s complaint responses. These had served to undermine Mrs A’s confidence and trust in IAS and had also caused her an injustice.
The Ombudsman recommendations included the Health Board apologising, paying financial redress of £250 in recognition of the time and trouble caused due to the failings around complaint handling. In addition, the Health Board was asked to evidence an addendum correction of the clinical records which also confirmed the Support Worker’s role as well as reviewing for wider learning its complaint handing in this case.