A medical practice in the Norfolk area

3. Miss E complains about the care and treatment she received from the Practice between 21 December 2015 and 15 September 2017. She complains that:

· the Practice did not take her injuries seriously during appointments on 21 December 2015 and 15 September 2017 · the Practice failed to properly document information in her medical records · accurate records and documents were not kept following these appointments, and Miss E believes this was intentional and prejudicial. She says that Practice records contain many errors and misleading information.

4. Miss E says she has found the events profoundly disturbing, and that it has put her under extreme levels of stress.

5. She says she has an injury which she can describe and understand but feels it has been distorted and misrepresented in her medical records.

6. She has lost trust in the medical profession and has no confidence that she will be safe in future encounters.

7. She has had to adapt her life according to tasks she can and cannot do and has not been able to work as much as she would like to do.

8. By bringing the complaint to us, Miss E is seeking an acknowledgment of failings from the Practice.

9. Miss E also feels that she is entitled to compensation. However, she understands that compensation is not easy to grapple with in this context, and so decided that her priority is a thorough examination of the Practice’s motives and behaviours. She says she wants the truth of what happened to be brought out into the open.

10. Miss E experienced a significant head injury, which also damaged her neck, on 17 December 2015. She had appointments with her GP on 21 December 2015 and 15 September 2017.

11. She was referred to Norfolk and Norwich University Hospitals NHS Foundation Trust (the Trust) for treatment, and due to claimed failings there, subsequently raised a complaint about the care provided. During this process, Miss E reviewed her medical records, including the notes from the two appointments with the GP. Miss E says that she discovered evidence that showed that her injuries had not been taken seriously by the Practice.

13. The law says we should only look at complaints that are brought to us within 12 months of the complainant becoming aware of the issue(s) they are complaining about. If a complaint is brought to us after 12 months, it will be at our discretion whether to conduct a detailed investigation, and we will need to understand the reasons for the complaint not being brought to us sooner.

14. Miss E told us she became aware of a reason to complain on 6 July 2018. We call this the date of knowledge. However, a complaint was not raised to the Practice until 11 October 2019.

15. While the appointments being complained about were in 2015 and 2017, Miss E explained that her date of knowledge was 6 July 2018 because that is when she saw the records following her complaint to the Trust. It was only at this point that she found the issues that led to her complaint. In our view, this is an acceptable explanation for why the date of knowledge was not at the time of the appointments.

16. However, it is harder for us to reconcile why a complaint was not then raised to the Practice until 11 October 2019, or 15 months and five days after the date of knowledge.

17. Miss E has explained that there were also issues with the Trust regarding the same injuries, and she was dealing with this complaint first. She said she could not make the complaint to the Practice until she understood what the Trust’s involvement had been.

18. Miss E explained that in 2018 the Trust forwarded her complaint to NHS England and asked them to investigate the Practice, telling Miss E they would not do it themselves.

19. NHS England accepted the complaint in late 2018, but Miss E said they changed the wording and meaning of the complaint, so it had to be rewritten.

20. Miss E’s mother was hospitalised in October 2018. She almost died and had serious and dangerous health problems for months afterwards. Miss E was taking care of her at the time, and she says it was a very stressful period.

21. When Miss E sent the rewritten complaint to NHS England, they said it was too late, and outside of the time limit for NHS complaints. At this point she spoke to the Parliamentary and Health Service Ombudsman. We then asked NHS England to reconsider her complaint, which led to them investigating it.

22. However, despite these explanations, we have still not been able to reconcile why the actual complaint to the Practice was not made until 11 October 2019. This could have been made while the Trust complaint was ongoing and could also have been made while NHS England was investigating other matters.

23. We appreciate that this has been a very lengthy and difficult process for Miss E, particularly in the first few years following the accident, as she suffered very severe injuries which had a profound impact on her.

24. We consider if Miss E was overwhelmed in trying to deal with the complaint sooner, she could have reached out to family or friends for assistance. If none were available, she could have contacted an advocacy service for assistance.

25. We must also consider what evidence would be available for a detailed investigation. Given that the appointments being complained about happened five and seven years ago, it is not reasonable to expect that we would be able to gather credible recollections from witnesses. As such, we would be relying solely on the written record. This would seriously hamper our ability to conduct an effective detailed investigation. We would not be able to consider all the points raised, especially the points about inaccuracies in records.

26. In remaining impartial, we must be fair to all parties. This includes consideration for the Practice that any complaint should have been raised with them at the earliest opportunity, and that does not look to have been the case here.

27. We have given careful consideration to the injuries Miss E suffered and the other mitigating factors she raises. However, the practical difficulties we would have in conducting a robust investigation, have led us to take the decision to consider the case out of time.

1. We have carefully considered Miss E’s complaint about a medical practice in the Norfolk area (the Practice). We have decided her complaint falls outside of our time limit.

2. We recognise that this has been an extremely difficult time for Miss E. She experienced severe injuries and has been through a very lengthy ordeal. However, we consider that the complaint could have been raised to the Practice sooner, and for that reason we are declining to conduct a detailed investigation into this complaint.