Trust discharged outpatient without recent clinical review

What happened

Mrs F had annual reviews at the Trust's rheumatology department, which is a centre of excellence. The Trust is over 200 miles from Mrs F's home. Mrs F was due to have an annual review at the Trust in autumn 2012. However, in summer 2012, the Trust cancelled the appointment because it decided that she could be reviewed by a haematology service nearer to her home. Mrs F had already booked travel and accommodation for the appointment. She decided to request a private referral for future care as she was not happy with the NHS services available locally.

What we found

It was not in line with good practice for the Trust to discharge Mrs F without a further review, because her last review had been ten months earlier. This affected her continuity of care and caused her undue stress. However, it was reasonable for the Trust to decide that Mrs F's condition could be managed locally and that this could be through a rheumatology or haematology service.

In addition, the consultant who discharged Mrs F gave a poor explanation of her diagnosis, which seemed to call it into question.

The failing did not lead to Mrs F's financial expenses for the cancelled appointment, because she chose to travel to appointments rather than use a local service. We also did not find that this led to Mrs F's expenses for future private appointments because she could have used NHS care locally.

Putting it right

We asked the Trust to draw up an action plan that showed what it had done to make sure transfer of care is safe.