NHS Borders has apologised to a female patient after doctors in the accident and emergency (A & E) department at the BGH twice failed to diagnose a fractured bone in her foot - twice.

The apology was ordered by the Scottish Public Services Ombudsman (SPSO) after an independent investigation.

The watchdog has upheld a complaint lodged on behalf of the patient, referred to as Ms A, alleging that the correct diagnosis was missed on two separate occasions at A & E and that she not been provided with adequate treatment.

It was also claimed that Ms A’s pain had persisted for months thereafter and her GP had referred her to an orthopaedic specialist when a scan revealed the fracture.

“We took independent medical advice…and found there had been failings by the A & E locum doctors who had reviewed Ms A,” states the SPSO report.

“Specifically their record-keeping and assessments were below a reasonable standard given the background to Ms A’s injury and [her] inability to bear weight.

“We were critical that the A & E department had not reviewed the radiology reports which were abnormal. Furthermore, we found that both X-rays [taken on each visit] did show the fracture.

“We also considered it was unreasonable that on each occasion she attended A & E, Ms A, given her inability to bear weight, was not provided with crutches or given a follow-up appointment to check that her symptoms were resolving.”

Upholding the complaint, the watchdog has recommended that NHS Borders should contact the locum doctor on duty during the first visit “in order that they [NHS Borders] may reflect on their practice at their annual appraisal for personal learning and practice improvement”.

The SPSO also wants evidence of what action the health board has taken in relation to the locum doctor and the radiologist on Ms A’s second visit to ensure they are informed of the watchdog’s findings regarding assessments and record-keeping.

In addition, NHS Borders has been told to ensure the process for reviewing imaging reports and X-rays in A & E is effective and in line with national guidelines.

Finally, the health authority is asked to consider issuing guidance to the A & E team at the BGH on the necessity for a follow-up of patients who are unable to bear weight following an injury.

Responding to the SPSO report, a spokesperson for NHS Borders told the Border Telegraph: “We fully accept the recommendations from the SPSO and recognise that the care provide to Ms A was not of the standard that we expect for our patients.

“We have apologised to Ms A for this and the failings identified. The actions recommended in the SPSO report have been implemented.”