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Barts Health NHS Trust

P-001308 · Statement · Decision date: 8 February 2022 · View Barts Health NHS Trust scorecard
Complaint (AI summary)
Patient complained about poor surgical outcomes from a hysterectomy in 2017, including bladder perforation, inadequate aftercare, early discharge, and unprofessional staff conduct.
Outcome (AI summary)
Complaint closed. The ombudsman determined that the complaint fell outside of their statutory time limits.

Full decision details

The Complaint

3. Ms I complains that Barts Health NHS Trust (the Trust):

· did not provide any counselling support before, or after, her hysterectomy on 23 February 2017 · perforated her bladder during the hysterectomy, and then sewed the wound ‘lopsidedly’ · did not provide adequate aftercare to her following her hysterectomy · made her walk too soon following the hysterectomy, less than 24 hours later · did not assess her home’s suitability before discharging her, following the hysterectomy, and refused to provide a bed for her at home · pressured her into going home after she requested a bed before being discharged · downgraded her cancer (womb) from stage three to stage one without adequate explanation after her hysterectomy · acted unprofessionally as the occupational therapist (OT) who assessed her before discharge did not provide their name, wrote dishonest things on the report, and a member of the OT team verbally abused her.

4. Ms I says she been left disfigured on the left-hand side due to surgery. She further explains she has been left traumatised, with restricted movement, and feeling confused about her progress as she has no medical support. She specifically noted her body is bending and her posture is poor, and she struggles with fatigue and incontinence.

5. Ms I would like the following outcomes:

· a financial remedy to reflect her suffering · the Trust to clarify matters regarding how it will resolve the medical issues it has caused · procedures to be put in place to prevent the Trust from carrying out the surgery poorly in future and to ensure it provides appropriate counselling and aftercare.

Findings

7. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so.

8. Ms I brought the complaint to us on 13 December 2020. Ms I complains about the surgery she had on 23 February 2017, as well as the lack of support provided to her before and shortly after the surgery. We are conscious she may not have been aware immediately of her concerns about the surgery itself, and the aftercare, but understand she became aware within weeks of the surgery.

9. In her complaint form, Ms I said she became aware of the issues in May 2017. Her initial complaint to the Trust, which was submitted on 20 September 2017, was also dated 17 May 2017.

10. It is understandable that Ms I would not become aware she was receiving little aftercare following the procedure until a number of weeks, or even months, after the procedure. As such, we can say she became aware of the latest issue, surrounding the lack of aftercare, around May 2017. This is in line with the date she has provided. We look at the date the person became aware of the matter as the starting point for considering our time limit.

11. As Ms I brought her complaint to us in December 2020, her complaint is at least two years and nine months out of our time limit. We therefore considered if there were any barriers to Ms I approaching our service earlier.

12. We started by looking at how long the complaints process took. The initial complaint letter is dated May 2017, but this was sent to the Trust in September 2017. In total, local resolution took around two years and eight months. We appreciate Ms I has said the length of complaint handling was a barrier to her coming to us sooner.

13. We appreciate there may have also been some initial delays accessing the advocacy service, which were outside of Ms I’s control. This may explain the May 2017 to September 2017 period.

14. However, Ms I did not respond to the Trust’s initial response (dated 13 November 2017) until 10 months later, on 26 September 2018, requesting a local resolution meeting. We note time was then spent arranging a meeting, although it changed to a written response at Ms I’s request. This was provided in March 2019. This response left the possibility of a local resolution meeting open at the end of the letter. The Trust then attempted to arrange a local resolution meeting with Ms I, her advocate, and the staff members involved in the complaint. It eventually completed this on 30 September 2019. The Trust sent the minutes from the meeting to Ms I on 5 December 2019. We appreciate the time the matter was with the Trust would be outside Ms I’s control.

15. Ms I’s advocate then responded to this letter on 11 March 2020, three months later, outlining some remaining concerns. The Trust responded to this on 5 June 2020.

16. Therefore, while the period of local complaint handling covered around two years and eight months, we have seen over one year and seven months of delay through the process which is not attributable to the Trust’s handling.

17. Specifically, we have seen it took Ms I ten months to write back to the Trust following its initial response, then a further three months to respond to its letter, on 5 December, then a further six months before approaching PHSO, following the Trust’s final response. Accordingly, there are significant periods of time which suggest the matter could have been brought to us earlier.

18. We appreciate complaint handling did cover a large period of time but note that did not cover all of it. We therefore considered if there were any other barriers to Ms I bringing her complaint sooner. Ms I explained there were also delays due to her poor health, further to the matters being complained about. She says she was also chasing records from the Trust, which it did not receive, and she had difficulties securing timely advocacy support.

19. We appreciate that Ms I’s health issues, including her previous brain tumour and surgery for endometrial cancer, will have caused her to provide slower responses than most people. This may explain some of the delayed responses. However, we would expect recovery from surgery to take a number of months at most and are pleased to note she felt well enough to start to pursue the matter in May 2017. We are also pleased to note she obtained advocacy help from a social worker in December 2017, which should have helped with this. In addition, we have analysed the communication records between Ms I and her advocacy support company, POhWER. We can see there were multiple occasions where it chased up responses from Ms I, with delays on her end totalling around 13 months.

20. Accordingly, while we sympathise for her health concerns during this period, we note Ms I was able to proceed and had advocacy support to help with this. As such, we have not seen barriers which account for the significant delays in Ms I not approaching our service sooner.

21. Therefore, we believe we have not seen enough to support setting aside our 12-month time limit, and we will close this case as being out of time.

Our Decision

1. We have carefully considered Ms I’s complaint about Barts Health NHS Trust. We have decided the complaint falls outside of our time limit.

2. We will explain the reasons for our decision below.

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