Summary: We will not investigate this complaint about the circumstances surrounding Dr A’s detention under Section 2. The Trust and Council have already investigated the matter and acted to improve their services. It is unlikely an Ombudsmen’s investigation would achieve more.

The complaint

1. Dr A complains about Oxfordshire County Council (the Council), Oxford Health NHS Foundation Trust (the Trust) and Woodlands Medical Practice (the Practice). Specifically, she complains:
• She was wrongly placed under Section 2 of the Mental Health Act 1983 because professionals wrongly interpreted information and used it to build a false picture of her and her baby son.
• They did not provide enough information about what was happening.
• They did not provide her partner with support for his wellbeing, this led to him making inaccurate statements which they used against her.
• They did not consider other causes of her son not gaining weight, such as Cows Milk Protein Allergy.
2. Dr A explains she and her partner suffered significant distress. Pursuing the complaint has meant they have had to relive the events. She says the family dynamic has been upset and this is taking time to repair. Dr A worries the Section 2 on her record will cause her problems with employment in the future.
3. Dr A wants a face-to-face apology from the individuals, the sectioning removed from her medical records and her GP to agree to make prompt referrals based on need rather than bias against the family.

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The Ombudsmen’s role and powers

4. The Ombudsmen have the power to jointly consider complaints about health and social care. Since April 2015 a single team has considered these complaints acting on behalf of both Ombudsmen. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
5. The Ombudsmen investigate complaints about ‘maladministration’ and ‘service failure’. We use the word ‘fault’ to refer to these. If there has been fault, the Ombudsmen consider whether it has caused injustice or hardship. (Health Service Commissioners Act 1993, section 3(1) and Local Government Act 1974, sections 26(1) and 26A(1), as amended)
6. The Ombudsmen cannot question whether an organisation’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended, and Health Service Commissioners Act 1993, sections 3(4)- 3(7))
7. The Ombudsmen do not investigate every complaint which they receive. We consider if an investigation would find evidence of significant fault, and whether an investigation would result in a meaningful and worthwhile outcome.

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How I considered this complaint

8. I have considered information provided by Dr A and complaint responses from the Council, the Trust and the Practice.
9. I considered Dr A’s comments on my draft decision statement.

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What I found

10. In mid-April 2021 two doctors and an Approved Mental Health Professional (AMHP) visited Dr A in response to a referral from a professional about how she was caring for her baby son. The assessment took place late at night, 23:55. They detained Dr A under Section 2 of the Mental Health Act (MHA) 1983 the next day. Professionals assessed her and released her without treatment a couple of days later.

Relevant legislation and guidance

11. Under the MHA, if it is thought someone is putting their own or someone else’s safety at risk, professionals can detain them in hospital. Usually, three professionals need to agree if there is a need to detain the person in hospital. These are either an AMHP or the nearest relative, plus a doctor who is approved for MHA detentions and another doctor. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person and their nearest relative about this. Admission should be in the best interests of the person, and they should not be detained if there is a less restrictive alternative.
12. Sections 14.30 to 14.76 of the MHA Code of Practice (2015) provide directions and guidance about how professionals should assess people before applying to detain them under the MHA.
13. The Ombudsmen cannot make or remake professional judgements about if detention under the MHA is right. The LGSCO’s role is to consider if the AMHP followed the steps set out in the MHA and the associated Code of Practice. Where an AMHP has followed process, we would not question the judgements they made at the end of it. In this instance the evidence we have seen suggests the AMHP completed the relevant and necessary steps before completing their assessment, including taking account of medical recommendations and considering less restrictive alternatives. We understand that Dr A does not agree with this.

Findings

14. Dr A made a complaint to the Trust, the Council and the GP. She received responses from all and each has apologised and taken learning from the complaint.
15. The Trust has acknowledged it did not fully explore all alternatives to an MHA assessment, it could have used clearer language and it could have offered more support which may have helped build a clearer picture without the need for escalation. It apologised and has taken learning. The team has been asked to reflect on Dr A’s experience to consider alternatives in the futures.
16. The Council has acknowledged that Dr A being assessed at night was not ideal and agrees with the Trust’s finding that some of the information used was inaccurate. It apologised for the distress caused and has taken learning to improve its processes.
17. The Practice has apologised if the language it used was unclear. It has taken learning to consider how language could be misread if not clarified.
18. Dr A is seeking outcomes which the Ombudsmen cannot achieve. She asks for a face-to-face apology, the record of the Section 2 removing from her records and a guarantee the GP will refer as soon as they identify need.
19. Dr A received a written apology, and this is what we would ask for if we found fault. We consider this an appropriate outcome.
20. The Ombudsmen cannot remove information from medical records, even if we found fault. We could ask for a note to be added to Dr A’s records, but she could do this herself. Dr A could also speak to the Information Commissioners Office about the right to rectification of her data.
21. We would expect a doctor to refer when they identify need in their daily practice, this is not something we can consider further. Dr A also has the option to register with a new GP of her choice should she wish.
22. In summary, we cannot achieve the outcomes Dr A is seeking through further investigation and she should pursue her concerns through other resolution bodies.

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Final decision

23. The Ombudsman will not investigate this complaint. I recognise the distress the events caused Dr A, but I consider it unlikely an investigation by the Ombudsmen would achieve more for her than the organisations have already provided. Dr A can pursue her desired outcomes through other resolution bodies.

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Investigator's decision on behalf of the Ombudsman