A woman with learning disabilities waited three months for psychiatric appointment

What happened

Ms G has autism, mild cerebral palsy and a learning disability. Now in her forties, she has been cared for by her parents without the need for outside support, and has always taken part in conversation and led an active life. Ms G had been taking one specific antipsychotic for over 20 years for her diagnosis of childhood autism with agitation.

In early spring 2013 Ms G was referred by her GP to NAViGO Health and Social Care Community Interest Company, a healthcare provider. This was for a psychiatric evaluation of her medication because the antipsychotic was causing stiffness and rigidity in her limbs. As a result, this medication was stopped and a she was given a different antipsychotic. Ms G's health began deteriorating, and over the course of the next seven months the medication was changed twice more but her symptoms worsened.

NAViGO delayed a psychiatry appointment for Ms G by three months, leaving her parents with no option but to seek and pay for private psychiatric treatment. In late 2013 Ms G had a breakdown and needed to be admitted to a mental health unit where she was given her previous dose of the original antipsychotic. She has steadily but slowly improved since, but now requires antidepressants and tranquilisers to counter the effects of the health deterioration.

What we found

We partly upheld this complaint. The decision to change the medication was reasonable, owing to the negative effects the original antipsychotic was having. This was done over a three week period and while relatively quick, is in line with guidance.

The replacement antipsychotics were reasonable, in both the timeliness of their introduction, their type and their dosage.

Unfortunately Ms G suffered from both drug withdrawal and the new medication, but this was not unreasonable in light of the decisions to change her medication.

NAViGO did provide adequate access to support services for Ms G and her family.

While we understood that the psychiatric appointment was cancelled owing to the psychiatrist taking urgent leave, it was unreasonable that the appointment was rescheduled for three months later. Particularly in light of the symptoms Ms G was suffering, this left her family with no option but to seek and pay for private psychiatric care. It was unreasonable for them to have to wait three months.

We were satisfied that the NAViGO's responses did not cover up any aspect of the care, but agreed with Ms G's parents that it did not consider all aspects of the complaint.

Putting it right

NAViGO apologised and acknowledged its failings. It paid Ms G £1,400 to reimburse the costs of the private psychiatric care she had as a result of its rescheduling delay, and to acknowledge the worry, concern and distress caused.

It drew up three action plans to address its failure to properly inform Ms G and her parents about the potential side effects of medication; its failure to link the support team's actions with Ms G's specific needs; and its complaint handling failings.