York and Scarborough Teaching Hospitals NHS Foundation Trust

3. Ms O complains about the following care and treatment she received from the Trust regarding her bowel issues, with specific reference to incidents in 2020. She is upset at the stress this put on her during her pregnancy.

4. She states:

• Dr U, a gastroenterologist, did not take her bowel issues seriously, believing they were psychosomatic • Dr U unnecessarily medicated her with laxatives, when they could have performed the same tests a private gastroenterologist did, which showed an alternative physical issue • in her August 2020 appointment with another gastroenterologist at the Trust, Dr I, they were unprepared and did not have the private gastroenterologist’s notes • in the same appointment, Dr I was rude and abrupt • the Trust did not take her complaint seriously and badly handled it.

5. Ms O says as Dr U did not treat her properly, she was left uncomfortable and frustrated at the lack of resolution to her health issue. She also says this meant she needed to pay for private treatment.

6. Ms O says she was extremely upset the Trust did not take her seriously at her August appointment, both through Dr I’s attitude and their lack of having the private notes. Ms O says she is extremely disappointed at the Trust’s lack of effort to resolve her complaint.

7. Ms O would like financial compensation and an apology from the doctors involved

8. Ms O has been dealing with long-term bowel problems under the care of the Trust, specifically under the care of Dr U. Ms O said she has long had concerns about the standard of care she received from Dr U, such as high use of laxatives to manage the problem.

9. When she fell pregnant and faced an uncomfortable term of dealing with her bowel issues without painkillers, she sought alternate advice from Professor S, a private medical expert, in February 2020. Professor S identified a muscular issue with her bowel and recommended alternate treatment to her, writing to Dr U to advise them of their findings.

10. On 19 August 2020, Ms O had a telephone appointment with Dr U’s colleague, Dr I, while Dr U was on leave. She found this appointment extremely frustrating, as Dr I did not appear to know anything about the appointment with Professor S, or their recommendations. Ms O also found Dr I rude and difficult to talk to.

11. Shortly after, Ms O made a complaint over the telephone to the Trust, specifying her issues with Dr I. The Trust responded on 22 October 2020, advising that Dr I did not recall being rude, but promised to reflect on and learn from the incident. The Trust also said it did not have any records from Professor S but would write to them to clarify their advice.

12. Ms O appealed this, feeling it was not a fair response to her complaint. The Trust responded on the same grounds, on 25 November 2020, detailing it now had access to Professor S’s records, and Dr I had taken Ms O’s position on board. On 4 December 2020, Ms O contacted the Parliamentary and Health Service Ombudsman with her complaint.

Records and awareness of the actions of Professor S

15. Before we decide if we should investigate a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. Having done this, we have not found any indications something has gone wrong.

16. Ms O says that in her appointment with Dr I on 19 August 2020, they had no idea about her appointment with Professor S in February 2020. She says Dr I had no notes of Professor S’s recommendations. Ms O found this extremely frustrating.

17. The Ombudsman’s Principles of Good Administration say: ‘public bodies should handle and process information properly and appropriately in line with the law.’

18. When the Trust responded on 22 October 2020, it advised it did not have Professor S’s notes but would write to them to get them. In the following letter, dated 25 November 2020, the Trust advised it now had the records.

19. We have reviewed Ms O’s medical records in detail. The records support the Trust’s response. The only indication the Trust had that a private appointment had taken place was a letter from Professor S in April 2020, asking Dr U to see Ms O for an appointment. The Trust did not seem to have information of any tests, diagnoses, or treatments provided by Professor S.

20. When Ms O made the Trust aware of the details of this appointment, in August 2020, and following her complaint about same issue, the Trust took steps to obtain the records and complete her file.

21. The Trust did not provide the private care. We understand it would only have access to information the private provider sent it. The evidence indicates the Trust acted based on the records it had received by August 2020. When the Trust became aware there were records of Ms O’s private care that it might need, it gathered those. Based on this evidence, we consider the Trust followed the Ombudsman’s principles by handling information properly. We have not seen indications of any failings.

The attitude of Dr I during the teleconference on 19 August 2020

22. Ms O has advised that during her appointment, Dr I was rude to her. She said Dr I regularly interrupted and was abrupt. Ms O said, added to the fact she did not have her records, this added up to a difficult conversation.

23. We appreciate Ms O was unhappy with Dr I’s attitude. We have considered Ms O’s account carefully. In the response to the complaint, the Trust said Dr I’s recollection was that they did not behave in the way Ms O described. We do not discount Ms O’s account. We have attributed equal weight to what she told us and what the Trust said.

24. Regrettably, there does not appear to be independent evidence to help us form a view on what happened. Ms O’s medical records do not tell us how Dr I behaved. We have no recording of the telephone call, only a complainant and a doctor who have opposing views on how the conversation was.

25. We have carefully considered the evidence. We do not think we can say what is more likely to have happened. We do not think a detailed investigation would give us more independent evidence to base a finding on. In these circumstances, we do not think an investigation would be practical or provide a satisfactory conclusion. Based on this, we do not think we should take any further action on this issue.

26. We have noted the Trust, while not apologising, has advised that Dr I will reflect on Ms O’s concerns and learn from them. We cannot see how we would be able to obtain anything further for Ms O’s concerns, and so we will close this matter.

Complaint Handling

27. Ms O advises that she was very disappointed in the way the Trust handled her complaint. She says the Trust did not engage with the substance of her complaint, that the complaint was not dealt with in a timely manner, and that Dr U did not engage with a formal complaint.

28. The Ombudsman’s Principles of Good Complaint Handling say organisations should: ‘investigate complaints thoroughly and fairly, basing their decisions on the available evidence, and avoiding undue delay.’

29. We have no record of a formal complaint against Dr U, so are unable to comment on this last point.

30. We cannot see there has been any failings in relation to the timescale of this complaint. From Ms O’s complaint to PALS (Patient Advice and Liaison Service), on 20 August 2020, the Trust provided a final response on 22 October 2020, just over 2 months later. The Trust sent a further final response to Ms O’s appeal a month later on 25 November 2020. It is our view that this timeframe avoided undue delays, in line with the Ombudsman’s Principles.

31. We cannot see any lack of engagement from the complaint handlers at the Trust. Ms O complained on 20 August 2020 regarding her appointment on 19 August, and the responses of 22 October and 25 November engaged with the points she raised. Although we understand that these responses may not have been the responses Ms O wanted.

32. Overall, the evidence in the complaint file indicates the Trust looked into the points Ms O raised in a reasonable level of detail. We consider the Trust gave a fair response based on the evidence we have seen in Ms O’s medical records. This seems to have been in line with the Ombudsman’s principles. We have seen no indications of failings in the Trust’s complaint handling.

1. We have carefully considered Ms O’s complaint about York and Scarborough Teaching Hospitals NHS Foundation Trust (the Trust). We have seen no indication of failings in how the Trust handled Ms O’s records and dealt with her complaint. For her complaint about a gastroenterologist’s attitude, we do not think a detailed investigation would reach a satisfactory conclusion.

2. We appreciate Ms O experienced difficult symptoms and suffered distress as a result. We recognise she has a number of concerns about the service she received. We are sorry to hear about how everything has affected her.