User menu

Cwm Taf University Health Board – 201703374

Mrs A complained that the Health Board delayed in providing her son, Mr B, with appropriate and timely mental health and autism spectrum disorder (“ASD”) assessments. She also complained about the Health Board’s failure to provide her with a robust response to her complaints.

In 2015, a Crisis Team assessed Mr B’s psychiatric and psychological needs and referred him for both ASD and mental health assessments. My investigation found that the Health Board’s practice of referring patients for ASD assessment prior to a referral for a mental health assessment was contrary to guidance and good clinical practice. In Mr B’s case, his ASD assessment was not completed until May 2017. During this time, the Health Board failed to take any action to either consider, or provide for, Mr B’s mental ill health. It was therefore two years before his mental health needs were assessed.

The Health Board’s care fell below expected standards, good clinical practice and guidelines in terms of its lengthy delay in completing Mr B’s ASD assessment, its failure to consider Mr B’s co-existing mental health needs, and its failure to refer Mr B for a mental health assessment at the same time as his ASD referral. It was not possible to determine whether Mr B’s situation would have been different had the Health Board’s failings not occurred, but it caused him uncertainty and distress. His human rights under Article 81 were engaged as a consequence of the Health Board’s identified failings.

1 Article 8 of the Human Rights Act 1998 provides the right to respect for an individual’s private and family life, home and correspondence.

When the first Community Mental Health Team (“CMHT”) finally assessed Mr B’s mental health needs, it concluded that Mr B should be accepted for secondary mental health services. Mr B changed address soon after this assessment and had to be assessed by the second CMHT. This concluded that Mr B was not eligible for secondary mental health services. The investigation was unable to reconcile the differing decisions of the two CMHTs within the same Health Board and only six weeks apart.

 The Health Board’s complaints response failed to address some of Mrs A’s specific concerns.

The Ombudsman upheld Mrs A’s complaints and made recommendations which were accepted by the Health Board. These included:

a) Financial redress payments and appropriate apologies to both Mrs A and Mr B for the failures identified.

b) A review of current practice to ensure it follows guidelines to allow patients with dual ASD and mental health needs to be assessed concurrently.

c) An audit of a sample of patients who had been referred for ASD and mental health assessments to ensure others had not been similarly disadvantaged.

d) An audit of a sample of mental health assessments from both the first and second CMHTs for a consistent application of the criteria for access to secondary mental health services.

e) A reassessment of Mr B’s mental health needs and eligibility for secondary mental health care services.

https://www.ombudsman.wales/wp-content/uploads/2018/10/Cwm-Taf-University-Health-Board-201703374.pdf