Trust diagnosed Alzheimer's disease in reasonable time

What happened

Mrs T's GP first referred her to the Memory Clinic (which is run by the Trust and helps people with dementia), in spring 2011. The Clinic offered her an appointment shortly after, but Mr T, acting on his wife's behalf, declined this.

Her GP referred Mrs T to the Clinic again four months later. A consultant psychiatrist saw her after two weeks and carried out an initial assessment of her condition. His first impression was that she had mild dementia caused by vascular (blood vessel) changes and Alzheimer's disease. He asked for an MRI (magnetic resonance imaging) scan of Mrs T's brain as well as blood tests, and an ECG (electrocardiogram, a test that measures the electrical activity of the heart). The plan was to review her once these investigations had been completed.

Unfortunately, due to ongoing issues with her lungs, Mrs T was not able to have the MRI scan. When the consultant knew this in autumn 2011 he asked for a CT (computerised tomography) scan of her head instead. Staff did this a few weeks later.

Shortly afterwards, Mr T contacted the Trust to ask for an appointment with the consultant. The consultant offered Mr and Mrs T an appointment for a week later, to discuss the results of Mrs T's investigations and her ongoing care. However, Mr T declined this appointment as he said he had lost confidence in the consultant.

Mrs T's GP subsequently contacted the Trust to ask for a second opinion. The Trust turned down this request as it said it would complicate matters for another clinician to become involved at that stage, as the consultant had not even provided a diagnosis.

The consultant psychiatrist saw Mrs T early the next year and confirmed a diagnosis of dementia caused by vascular changes and Alzheimer's disease, and he prescribed her rivastigmine, an anti-dementia medication. Mrs T passed away one week after the appointment.

Six months later, in summer 2012 Mr T complained to the Trust about how long it had taken to diagnose his wife's Alzheimer's disease and begin her medication. He did not believe that she received appropriate care and he said that as a result of this he had to see her suffer. He also complained that the consultant ignored his requests for support, guidance and a second opinion about his wife's condition. He said that he was left feeling frustrated and 'out on his own'.

Mr T and the Trust corresponded until summer 2014, but Mr T was unhappy with the Trust's responses and came to us.

What we found

We did not uphold this complaint. The Trust had not failed in the time it took to assess, diagnose and give Mrs T medication. Her care and treatment was reasonable and in line with established good practice.

About six months passed from Mrs T first seeing the consultant to receiving a diagnosis and medication. While there were some delays during this time, these could not reasonably be attributed to the Trust. Delays occurred because of matters outside its control, or by Mr and Mrs T's lack of engagement.

The Trust had given a good reason for not offering Mr and Mrs T a second opinion, and gave them support and guidance.