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Health board criticised for failing to meet clinical needs of autistic teen

20 Oct 2021 4 minute read
Public Service Ombudsman for Wales Nick Bennett. Photo PSOW

Katy Jenkins, local democracy reporter

“Significant injustice” was caused to a mother and her 17-year-old son by Hywel Dda University Health Board the Public Services Ombudsman for Wales has found.

A public interest report published on October 19 details an investigation launched by the Ombudsman following a complaint from an unnamed woman, Ms B, that Hywel Dda University Health Board “failed to provide her son, Mr C, with appropriate psychology services and as a result failed to meet his clinical needs”.

Mr C, a 17-year-old boy, who is autistic, non-verbal and displays challenging behaviour, was identified as not having his needs met by the health board itself but the Ombudsman report finds it did not “put any plan in place to meet those needs”.

The report states that “the Health Board failed to take prompt steps and make arrangements to meet the clinical needs of Mr C following the closure of a psychology service”.

It adds that as a result Ms B, as main carer for Mr C, was “left without sufficient support to manage his challenging behaviours.”


“The Health Board’s communication with Ms B was inadequate, which left her uninformed at a time when Mr C’s challenging behaviours were further complicated by the impact of the restrictions due to the Covid-19 lockdown.

“In addition, the Health Board’s complaint responses to Ms B were also inadequate and not in line with the relevant regulations,” the report continues.

“There was also no evidence found of contingency planning should the psychology service come to an end leaving patients “unprepared for the abrupt end.”

A number of recommendations were made to the health board including providing a written apology for the clinical, communication and complaint handling failings identified, reference the impact had on Mr C and his family, and reminding relevant staff of the importance of investigating complaints and producing complaint responses in line with relevant complaint regulations and guidance.

It is also recommended to review to identify any other patients with unmet clinical needs as a result of the closure of the specialist services and ensure steps are taken to meet those needs as well as commission and complete its planned review of its child psychology services and report the findings back to the Ombudsman.

Public Services Ombudsman for Wales, Nick Bennett, said: “This is a highly concerning case where a mother felt as if “her family had been destroyed” and that she was “on the verge of putting Mr C into care because of this lack of support” by the Health Board.

“The ending of the Specialist Service left a huge gap for Ms B and all families with children with learning disabilities in the Health Board’s area. Ms B does not want other families to go through what she and her family had experienced, and I share this concern.”

Hywel Dda University Health Board’s Chief Executive Steve Moore said: “We are very sorry for the failings identified and we have written to the family to apologise.  We accept the recommendations the Ombudsman has proposed.

“The Health Board is in no doubt that there is a need to continue to provide a dedicated psychological service to our children and young people. There is a very high focus from the Board in delivering an effective children and young person’s service which meets the requirement of the ‘no wrong door’ report issued by the Children’s Commissioner.

“A Children’s and Young Person’s Working Group has been established to ensure the voice of children and young people is embedded in what we do and one of the priorities of work is to undertake a clinically led review of child psychology services to ensure the identified need is fully met.

“This was a very challenging period for the Health Board’s Learning Disability Team and the Psychology Service in particular, due to high levels of staff absence, vacancies and unsuccessful recruitment initiatives; and we regret that this caused the family duress during an already difficult time for them. Measures have been introduced to ensure appropriate communication is in place to respond to concerns and complaints.”

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