NHS Fife has been ordered to apologise to a patient's family for a lack of communication.

A complaint was made to the Scottish Public Services Ombudsman (SPSO) by Mr C about the care provided to his late father, described as Mr A, during his admission to Victoria Hospital.

The patient had appointed his son as power of attorney for his care and Mr C complained that the board failed to give Mr A appropriate treatment for his heart attack and questioned why more invasive treatment was not considered.

He also complained about a lack of communication with him over the care and treatment Mr A was given, despite having power of attorney.

In their response to the complaint, the board accepted that Mr A lacked capacity and that there were failings in their communication with Mr C.

The ombusdsman took independent advice from a consultant geriatrician – a doctor who specialises in medicine of the elderly – who considered that it was reasonable that more invasive treatment was not considered appropriate for Mr A, given his age and pre-existing health conditions.

"We considered that the care provided to Mr A was reasonable, and we did not uphold this aspect of Mr C's complaint," stated the SPSO report. "The adviser considered that there was an unreasonable failure to discuss Mr A's care and treatment with Mr C, as power of attorney. The adviser also said that there was a failure to follow the required Adults with Incapacity process after Mr A's admission, as an Adult with Incapacity certificate and treatment plan were not prepared.

"We accepted this advice, and upheld this aspect of Mr C's complaint."

The SPSO told NHS Fife to apologise to Mr C for the failure to communicate appropriately with him. They also said that in the future, decisions about care and treatment should be discussed with a welfare power of attorney, in the same detail they would be discussed with a patient who has capacity to understand the decision themselves.

It recommended that An Adult with Incapacity certificate and treatment plan should be prepared for all patients who lack capacity and asked the board to provide evidence that this had been implemented.