Five signs that a vulnerable adult is not receiving the care that they deserve

Health think-tanks, the Nuffield Trust, the King’s Fund and the Health Foundation, have warned that social care is in a ‘critical state’.

Lady Altmann, former pensions minister, says that Britain is in danger of sleepwalking into a social care crisis and care has been left to cash-strapped councils who keep cutting services.

Care homes and community health services have an increasingly challenging role in society but this area of healthcare is underfunded and understaffed. Social care services run by councils are widely regarded as out-dated for an aging population that is living longer with multiple conditions and dementia. These pressures will impact on care quality.

The winter will only bring with it further strain on care home and community services, with staff shortages due to sick leave and the Christmas holidays. Temporary or undertrained staff will be used to plug the gap, which is when errors, omissions and neglect can occur.

The Serious Injury Helpline is making family members, friends, neighbours and carers aware of five conditions that are a sign that a vulnerable adult is not receiving the care that they deserve.

Pressure Sores

Pressure sores develop where a patient’s skin is in contact with the bed or chair for extended periods of time. Regularly changing the body’s position is an effective way of preventing pressure ulcers, as well as eating healthily and checking the skin on a daily basis. These are basic care standards that should not be neglected. Elderly patients who are ill, immobile, diabetic and have poor skin condition are vulnerable to this serious condition, which can lead to infection and permanent pain.

Medication errors

Elderly people will usually suffer from a number of different illnesses each requiring multiple prescriptions. This makes them vulnerable to medication errors and omissions. Lack of trained staff and dementia symptoms will compound the issue and old people will be more vulnerable to the effects of a wrong medication or dosage.



Fractures from falls and handling errors within a care home environment are common. This is especially the case when staff are undertrained and without experienced supervision, and residents do not have the right mobility aids, such as a wheelchair. Elderly people are vulnerable to slips and trips, and not all injuries are cause by neglect, but some injuries can be avoided with good care.

Late referrals for treatment

Delays in referrals to hospital and treatment can have serious consequences for vulnerable elderly residents. For temporary or untrained care home staff, it can be hard to recognise serious symptoms when a resident has many illnesses. Or, in some extreme cases a person’s concerns or protests about pain and discomfort are simply dismissed.

Dehydration and malnutrition

In rare cases it can be wilful neglect but where a person is unable to communicate their needs – due to illness or dementia – and the care home is mismanaged and understaffed, a resident can go without something as basic as a glass of water. Symptoms of a lack of food and water include headaches, extreme tiredness, lack of concentration, dizziness, confusion, constipation, diarrhoea, strong smelling urine, and dry or sore mouth, tongue or gums.

It is vital to seek expert legal advice to check an elderly person’s legal rights and whether they have been a victim of medical negligence. A successful claim for compensation, if the person has been injured, can be important to the future quality of their life. Settlements can help fund private medical treatment, speed up rehabilitation, pay for extra care, changes to the home and car, replace earnings of a family carer, and help with the practical everyday expenses that inevitably come with illness.

The standard of care in a home or community setting has a huge impact on both the elderly person and their family. The Serious Injury Helpline knows how negligence or abuse can cause untold upset and damage for everyone involved. The helpline specialise in care home neglect and mistreatment, and can help deal with both the technical and emotional side of a complex area of law.

Anyone who needs confidential advice or help in the aftermath of medical negligence is advised to contact the Serious Injury Helpline on FREEPHONE 0800 230 0573.

Health Secretary admits winter ‘challenge’ for NHS services

The Health Secretary, Jeremy Hunt, has acknowledged that this winter could be “very, very challenging” for the NHS, which means already stretched services will be tested to the limit.

He made the comments on the BBC’s Andrew Marr Show and it is reported that throughout the winter the Department of Health will be monitoring the situation closely.

While relatively mild winters have helped the NHS cope over the past few years, the Met Office recently warned of periods of very cold weather between now and Christmas. It may only take an extended period of bad weather and flu for hospitals to be pushed beyond capacity.

NHS England figures have already revealed that attendances at A&E units and emergency admissions are up nearly 4% over the past 12 months. Demand on A&E services will only increase as the winter draws in.

What could be of bigger concern is the impact on social care. During the Christmas holiday period community healthcare tends to shut down. This can cause delays in transferring patients out of hospital beds and into social care in the community, which puts more strain on hospitals and creates a backlog.

The health think tanks, Nuffield Trust, the King’s Fund and the Health Foundation, have warned of the “critical” state of social care. Funding cuts and the availability of accessible care have resulted in “significant human and financial costs on older people, their families and carers”. This has left people stranded in hospital and it will only get worse during the winter.


The impact on hospitals this winter is a worry – staff are already under severe pressure and the winter strain on a busy, underfunded and short staffed NHS can lead to errors and missed diagnosis – but social care is often the invisible casualty.

Social services run by local councils are widely regarded as out-dated and unfit for an aging population with people living longer, often with multiple conditions and dementia. Dementia and Alzheimer’s have overtaken heart disease as Britain’s biggest killer.

Care homes and community health services now have a more challenging role in society but this area of healthcare is underfunded and understaffed. This will affect quality of care and the winter will only bring with it further staff shortages with sick leave and the Christmas holidays. Temporary or undertrained staff will be used to plug the gap, which is when errors, omissions and neglect can occur.

The most common consequences in social care cases of negligence that we deal with are pressure sores, medication errors and falls. We’ve also dealt with cases of late referrals for treatment, dehydration and malnutrition. Family members, neighbours, friends, carers and others should be vigilant over the winter period and report any concerns to their local council social services.

The standard of care in a home or community setting has a huge impact on both the elderly person and their family. We know how negligence or abuse can cause untold upset and damage for everyone involved. We specialise in care home neglect and mistreatment, and we can help deal with both the technical and emotional side of a complex area of law.

The Serious Injury Helpline will be with you every step of the way if you decide to take action on behalf of a loved one who did not receive the standard of care they deserved.

Contact us on 0800 230 0573 to speak to one of our Clinical Negligence specialists.

Laparoscopic surgery: the benefits and the risks

In the right experienced hands, laparoscopic procedures can be beneficial to patients as they reduce the extent of surgery required and shorten the recovery period.

There are many benefits of these types of procedures including smaller surgical scars, reduced blood loss during the surgery, less pain due to the smaller incision, a reduced risk of infection as well as a shorter stay in hospital and a quicker recovery.

Laparoscopic surgery, more commonly known as keyhole surgery, is when an operation is performed via one or several small incisions to the skin. Once the incisions are made, a tiny camera is fed into the body and the image is transferred on to a screen for the surgeon to see. The surgeon can then insert his laparoscopic surgical tools and carry out the necessary procedure, using the camera for guidance, and all without the need to make a large incision in the patient’s abdomen.

Unfortunately, there are instances where keyhole surgery can go wrong and these incidents have increased in the past few years as the keyhole technique has become more popular.

In 2014, three NHS surgeons were banned from using a keyhole technique to operate on cancer patients after the procedure led to at least five deaths. The three surgeons worked for Maidstone and Tunbridge Wells NHS Trust, which referred itself to the Royal College of Surgeons (RCS) after a number of “unexpected” and “potentially avoidable” deaths following keyhole surgery in 2012 and 2013. The RCS held an investigation and warned that the surgeons had “not been able to demonstrate sufficient attention to the detail of surgical outcomes or clinical decision-making to provide a safe service to patients” with regard to keyhole procedures.

While such cases are rare, there are different ways in which keyhole surgery can go wrong and the risks depend on the type of procedure. For example, the surgeon may miscalculate the location of an organ or artery on the screen in front of him when in reality there are organs close by at risk of perforation.

Mistakes are most commonly made as a consequence of a surgeon’s heavy handedness or errors in judgement when calculating the location of nearby organs and arteries.

In our experience, most laparoscopy claims arise out of damage to the gall bladder, urinary tract, bowel and bladder during surgery. In some of the most serious cases we have seen, some patients have been left incontinent as a result of negligence during a laparoscopic procedure, which is of course completely life changing for the patient.

Another common risk of a laparoscopic procedure is herniation at the wound site. When the incision is made, part of the abdominal wall is cut through which, even once healed, leaves the area in a weakened state and means that person is more susceptible to protrusion of an organ and formation of a hernia in future. Developing a hernia post-laparoscopic procedure is usually not life threatening and can be managed with a further surgical procedure to repair the hernia, usually placing a mesh insert to the area to prevent the protrusion occurring in future.


Whether a laparoscopic procedure is right for a patient will be decided by a medical professional in consultation and their decision will be based on the patient’s previous medical history, current health condition, the nature of the procedure and the patient’s wishes. While a laparoscopic procedure has many benefits, like all medical treatments, it must be balanced against the risks and a patient should be made aware of the risks to be able to make an informed decision. A patient should also ask who their surgeon will be, what is the surgeon’s experience, how many laparoscopic procedures has he or she performed and what are the alternative treatments.

A patient should make it clear as early as possible if they do not wish to have a laparoscopic procedure.

There are many reasons a patient may wish to pursue a claim for clinical negligence following a laparoscopic procedure. They may feel like the medical professional responsible for their care nominated them to undergo a laparoscopic procedure which was not the appropriate method of treatment for them and has caused them to suffer post-operatively. A patient may feel like the surgeon who performed the laparoscopic procedure did not have the sufficient skill and experience to perform it and in doing so has made a mistake and caused injury to them. A patient might not even realise something is wrong until hours, days or weeks post-operatively and may feel there was a delay by the medical professionals in diagnosing and treating the problem, which may cause them further injury.

How do I make a complaint if I am not happy with the care provided by my GP or GP surgery?

Making a complaint about medical care can seem difficult, distressing and intimidating, but there are plenty of people who can help with free advice and information.

Do not hesitate to get help

If you are thinking of making a formal complaint about a GP or GP surgery, do not hesitate to consult a medical negligence legal expert at this early stage. If they are genuine specialists, the solicitor will be happy to help and answer questions on a no fee, no obligation basis. They can help identify who to complain to, give you the right questions to ask, and put you in touch with people and organisation that can help you fill in the forms and write letters.

Why should you complain?

You can and should complain about a GP or other healthcare professional within a practice if they do not provide a good standard of care. It is often perceived as a hassle and time consuming. Patients worry that the complaint will not be taken seriously, it could affect their future care or it could mean the patient is struck-off the GP’s practice list. But in the vast majority of cases these fears are unfounded and highlighting poor care, errors and omissions by medical professions is important for your health and the health of other people.

Each individual healthcare professional must provide a good standard of care. It is a legal duty and it is required by medical regulatory bodies. In the case of a practice nurse at your GP’s surgery it is the Nursing and Midwifery Council and The General Medical Council for GPs.

A duty of candour recently came into effect for GP practices, which means GPs are under a duty to inform patients when things have gone wrong. They have to be transparent if someone suffers severe harm, moderate harm or prolonged psychological harm as a result of a failure in care. They must inform patients, provide reasonable support, provide truthful information and write an apology.

In many cases, a GP or GP surgery will welcome the feedback that a formal complaint provides. A frank and open approach can help them review personnel, services and procedures that will ultimately improve their service and care.

What to do before you complain?

Before deciding to make a complaint it is important to consider what you want to achieve. Do you want an apology, action to be taken against a member of staff, or a change to their medical procedures? You will have to make this clear when you register an official complaint.

A complaint can take a while to resolve, and you might be asked to verify information at a later stage. Even if you intend to make your complaint verbally, it is recommended that you make notes before and during the complaint procedure. It is important to secure the following information:

Ask for your medical records

Write down an account of what happened to you and when

Record dates and times of appointments and treatments

Write down the names of everyone involved in your treatment, GP and practice nurses

Make notes of any verbal conversations you had regarding your diagnosis and treatment

Safe keep and copy any correspondents to and from the GP surgery

Keep a diary of the effects the failure in care has had on your daily life, physical, emotional and financial

When you make a complaint in writing, keep a copy of everything you post, and make a note of when you sent it.

Who do you complaint to?

If you’re unhappy with your GP or GP surgery, you can make a formal complaint to the practice directly, or to the NHS in your region.  If your complaint isn’t resolved at this level, you can contact the Health Service Ombudsman.

Complain directly to your GP surgery

It can be confusing to work out who is responsible and who you can raise your concerns with. Most GPs are not employed directly by the NHS. They have a contract to provide NHS services. Surgeries employ their own staff and therefore if you have concerns about a member of staff at the GP surgery (including a doctor), you can complain to the GP surgery that employs them.

Many problems can be dealt with on the spot if they are raised informally with staff at the GP practice. However, if you would like to make a formal complaint then each GP surgery will have its own complaints procedure. Ask for a copy from the practice manager and make sure you follow it to ensure your complaint is dealt with quickly and appropriately.

Again an experienced medical negligence solicitor will be happy to give you 30 minutes of their time to advise you on how to complete any forms or put you in contact with organisations that will help, such as Healthwatch, The Patient Association or NHS Advocacy.

Under the NHS Constitution you have a right to have your complaint properly investigated. Your complaint should be acknowledged within three working days, and you should also be told about the outcome of the investigation.


Complain to the NHS

If you do not wish to complain directly to your GP surgery then you can contact the NHS within you region.

It is important to ensure that you direct your complaint to the correct NHS organisation so that your concerns can be investigated properly. All GP practices now belong to a Clinical Commissioning Group (CCG) and you can direct your complaint to the local CCG. To find your local CCG click here and enter your post code. The complaint can be made by email, letter or verbally, but make sure you make a note of your complaint and the response you receive by phone or face-to-face.

If you have already complained to your service provider, in this case the GP surgery, then the CCG will not be able to reinvestigate the same concerns. However, if you are unhappy with the response to your complaint or they are being too slow, you can refer the matter to the Parliamentary and Health Service Ombudsman.

Complain to the ombudsman

The Parliamentary and Health Service Ombudsman (PHSO) is independent of the NHS and free to use. It can help resolve your complaint, and tell the relevant NHS service how to put things right if it has got them wrong.

The PHSO only has legal powers to investigate certain complaints and it has very strict criteria to meet before they will investigate. In the first instance you must have received a final response from your GP practice or the appropriate CCG, or at least given them a reasonable time to respond, before the ombudsman can look at your complaint. You must give the care provider an opportunity to put things right first.

The ombudsman will generally not look into your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.

It is advised to make your complaint in writing using a designated form but you can also email or phone the PHSO about your concerns. Again, do not hesitate to approach a specialist solicitor for advice about the PHSO process.

Act quickly

When making a standard complaint about your care to a service provider (GP surgery or CCG) or the PHSO you have 12 months from the date of the incident, or from when you were made aware of the incident, to start a complaint. If they are still able to investigate a complaint after a year they may still consider it, but they are under no obligation to do so.

They may consider investigating a complaint if there are exceptional extenuating circumstances. For example, a patient has experienced major trauma and it took a long time to recover.

But it is always better to make a complaint as soon as possible, to avoid any facts being disputed and the process taking longer to resolve.

Write to your MP

GP services are there for us when we need them. GPs and practice nurses do an extraordinary job in high-pressured, often life or death situations, in busy, underfunded and short staffed surgeries. They have just 10 minutes with each patient to make a diagnosis from often complicated symptoms and also help us with our lives in general.

With government cuts taking hold, GPs are working longer hours for more patients, with less support staff, and less time to make a diagnosis, which means during even routine medical consultations and procedures, an error or omission, can happen.

So, it is not always in the power of the GP or the GP surgery to improve their standard of care. Certain concerns and complaints that you may have about a GP service could ultimately be about wider policies and funding. Highlighting those concerns and complaints with your local Member of Parliament is an important and constructive way of voicing issues regarding the standard of care that your local GP and GP practice are able to provide.