Investigation reports

We found that a pre-admission assessment for a care home resident did not accurately record her mobility, meaning that the home was ill-prepared for her arrival.

This investigation found that the system for communicating with patients on healthcare waiting lists is in ‘disarray’, and concluded that significant and repeated failures across the system amounted to ‘systemic maladministration’.

It urged the Department of Health to work with Health Trusts, GPs and others to address the failings.

A patient who died three days after visiting his doctor for a routine medical review received treatment that was 'appropriate and in accordance with relevant guidance' according to an investigation by the Ombudsman.