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Norfolk and Suffolk NHS Foundation Trust

P-001240 · Statement · Decision date: 17 December 2021 · View Norfolk and Suffolk NHS Foundation Trust scorecard
Complaint (AI summary)
Mrs A complained the Trust's mental health and ASD services failed to effectively engage with her son T, address his difficulties, and maximize his potential, impacting his schooling and life chances.
Outcome (AI summary)
The ombudsman closed the case without detailed investigation because the complaint falls outside their time limit.

Full decision details

The Complaint

2. Mrs A complains about the mental health services provided by the Norfolk and Suffolk NHS Foundation Trust (The Trust) to her son, T, from 16 October 2017 onwards.

3. She says the Trust, and in particular the Autistic Spectrum Disorder (ASD) Team, has not done what it should have to address T’s refusal to engage with services. It failed to make a meaningful difference to his difficulties and failed to maximise his potential.

4. Mrs A says as a result of the Trust’s failings, T did not attend school for most of his time at secondary school and remained isolated at home. He has missed so much education, his life chances will be diminished. Both his life and her own are dominated by his behavioural issues.

5. As an outcome to her complaint, she seeks help with the application for T’s entitlements and an earlier appointment for T with the ASD team. She also seeks service improvements, particularly in the method and time frame of the evaluation of children for the service. As the two diagnoses are completely different, she would like a second opinion to confirm if he has Autistic Spectrum Disorder (ASD). This is a group of developmental disabilities that can cause significant social, communication and behavioural challenges.

Background

6. Mrs A explains that T has had behavioural difficulties since 2006. On 26 July 2017, he was referred to the Trust mental health services with suspected ASD. Based on the information in the referral, the team decided T did not meet the criteria for a diagnosis of ASD. They said that as it was unlikely he met the criteria, they did not consider it was in T’s interests for him to wait for an assessment. In November 2017, Mrs A paid for a private assessment where T was diagnosed with ASD.

Findings

Provision of Mental Health Services

9. Mrs A says over the previous four years, the Trust has not provided appropriate services, or access to the right professionals for her son, T. This lack of support has resulted in T not attending school and isolating in his room. The Trust say they have provided services, but T has declined to engage.

10. Mrs A made this latest complaint to the Trust in June 2019. The Trust responded to her complaint in April 2020. The Trust caused a delay of ten months. Mrs A went back to them in June 2020 to say she was not satisfied with the response. She also sent her complaint to us, which we processed in July 2020.

11. At Mrs A’s request, the Trust provided an additional response on 24 July 2020, which we also hold. In this, the Trust explained they were unable to safely offer any appointments currently due to the COVID crisis (lockdown began in March 2020) and an appointment was booked for T in the next few months. He has since had this appointment.

12. Mrs A’s complaint, in June 2019, to the Trust was generated by this latest wait for a referral, which the Trust say was due to COVID. However, she told us her key complaint is that over the previous years, T did not receive the support he should have, or saw the experts he should have. She says he has missed almost all of his secondary education and he is now nearing the end of secondary schooling. This indicates a time scale of four or five years, from around 2015. On her complaint form she documents becoming aware of his symptoms in 2006, so his condition was long standing.

13. The 1993 Health Service Commissioner’s Act (the law) says a person must bring a complaint to us within one year from the day the person affected first becomes aware they have reason to complain. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so. We have discussed this with Mrs A to understand the reasons why she could not do so. We have also taken into consideration the time the organisation has taken to respond to her.

14. Records show Mrs A has complained to the Trust twice before. These were about T not being assessed for ADHD. Our records also show a letter dated 12 July 2017, from the autism referral service, which refers to her concerns about T being excluded from school. This indicates the Trust provision for T had been a concern of hers for a long time. In November 2017, Mrs A paid for a private assessment and T was diagnosed with autism.

15. Although this latest complaint was made to the Trust in June 2019, we consider the date of knowledge for the key concerns of the complaint to be much earlier. Mrs A says T has missed nearly all of his secondary education and at the time of the complaint he was nearing the end of his secondary schooling.

16. We see Mrs A had concerns about the Trust’s services earlier, because she also complained in 2017 and 2018. In her complaint to us, Mrs A says the date of her first complaint to the organisation was 16 October 2017, and that she complained again in 2018. After careful consideration, we consider the date of knowledge to be at the latest November 2017, when T was diagnosed with autism. Mrs A did not complain to the Trust until 1 June 2019. Even when considering the delay caused by the Trust, this makes the complaint two and a half years out of time.

17. We asked Mrs A why she had not complained sooner. She explained she was dealing with T’s behaviour and general life commitments. Also, she did not understand the process of complaining and thought the right support for him was just around the corner. In exceptional circumstances we have the discretion to put aside the time limit.

18. We considered if there was reason to put aside our time limit on this occasion. We recognise the challenge of dealing with a young person’s behavioural difficulties and understand the complaints process can be complicated. However, we consider Mrs A had notice to complain earlier when T was diagnosed in 2017. This date could be earlier, as he started secondary education in about 2015, and had been routinely missing education since then. She was very aware there were problems regarding his support.

19. We see Mrs A understood the complaints process enough to make two earlier complaints to the organisation. There are also a range of advocacy services available for support, details of which are routinely shared with complainants by organisations when they complain. Mrs A also had links and frequent contact with numerous other organisations: CAMHS (Children and Adolescent Mental Health Services), the Local Authority, and the school who could have steered her.

20. While this was clearly a very difficult and challenging period for Mrs A, we cannot see there was a specific barrier to her complaining sooner. We have decided we cannot look at this complaint as it is outside of our time limit. This decision is not intended in any way to detract from Mrs A and T’s experience, which we were truly sorry to learn about.

Our Decision

1. We have carefully considered Mrs A’s complaint about the Norfolk and Suffolk NHS Foundation Trust. We were very sorry to hear of her concerns and to learn that her son (T) has missed out on schooling. However, we have decided not to take the complaint forward for detailed investigation. This is because the complaint falls outside of our time limit.

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