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NHS Devon Clinical Commissioning Group

P-001347 · Statement · Decision date: 22 March 2022 · View NHS Devon ICB scorecard
Complaint (AI summary)
Miss T complained about delayed GP referrals by NHS Devon CCG, a hospital declining a rheumatology appointment, and the CCG refusing to address complaints older than a year.
Outcome (AI summary)
Closed. No serious failings were found regarding referral times. The hospital decision was not the CCG's, and the complaint about refusal to address old complaints was not ready for investigation.

Full decision details

The Complaint

6. Miss T complains her GP made referrals to an ophthalmologist and a dietician in June and July 2019. She says the CCG delayed these referrals.

7. Miss T also complains about a local hospital declining to offer her a rheumatology appointment. She also says the CCG declined to respond to complaints about incidents that happened more than a year ago.

8. Miss T says she has experienced prolonged health problems and the cause of her problems is unresolved. She wants the CCG to make changes to its procedures so other patients are not affected.

Background

9. Miss T attended appointments with a rheumatologist in 2012 and had a second opinion in 2013. In February 2019 the CCG wrote to Miss T with details of how she could arrange a rheumatology consultation. On 5 March a member of staff from the CCG advised she could not attend the hospital of her choice. This was because she had attended appointments for the same issues in 2012 and 2013. It said this would effectively be a ‘third opinion.’

10. On 17 June 2019 her GP made a referral for Miss T to see an ophthalmologist, using the NHS ‘It’s your choice’ system via the CCG’s Referral Support Services. Miss T was unhappy with the wait for what she considered to be urgent problems. On 29 July 2019 the GP made a direct booking for an ophthalmologist. On 7 August 2019 Miss T attended an appointment with an ophthalmologist and started treatment for double vision.

11. Miss T saw a matron at a local hospital on 19 July 2019. The matron made a referral for Miss T to see a dietician via the CCG. Miss T complained to the CCG about the long wait in August 2019. The referral service arranged an appointment on 22 December 2019.

12. Miss T first complained to the CCG in August 2019 about the ‘It’s your choice’ system. She sent further letters before the CCG replied to her complaint. The CCG replied on 8 January 2020. It sent its final response on 29 January 2020.

Findings

Delayed referrals for ophthalmology and dietician

15. Miss T says failures by the CCG’s referral support team have left her with unresolved medical conditions and needs. She describes how she has been housebound for many years. She says the failures have left her with additional pressures and stress which have worsened her health problems.

16. We can see Miss T’s GP made a referral for an ophthalmologist on 17 June 2019. When there had been no response from the referral support team by 29 July, he made a direct referral because of her double vision. This led to Miss T attending the relevant appointment a few days later, but her vision problem continued after that appointment and was not resolved.

17. A matron at the local hospital made a referral for Miss T to see a dietician on 19 July 2019. It appears there was a delay of over twenty weeks before this appointment took place. We cannot see that the wait for a dietician was the cause of Miss T’s health problems during 2019 as there is no suggestion these were linked to her nutrition.

18. It is possible these delays were not in line with the CCG’s policies or national guidelines. But we have decided not to investigate these issues further. This is because we cannot see any indications the wait for the ophthalmology or dietician referrals had any negative impact on Miss T’s health. We can see, though, how these would have been frustrating for her at a time when she was worried about her wellbeing.

19. We have decided to focus on more serious complaints that people bring to us, where they have faced a big impact. For example, they may be about a potentially avoidable death. These types of complaints are where we can often make the biggest difference. This will allow us to provide the right level of service to those people as quickly as possible. It means we are not looking at complaints where we consider there has been a smaller impact. The frustration Miss T experienced would be considered a smaller impact.

20. We have decided not to investigate this issue further because we cannot see indications any delayed referrals would have had a significant impact on Miss T’s health.

Decision about the hospital on 5 March 2019

21. Miss T complains about a decision by a hospital not to offer her a rheumatology appointment because she had attended similar appointments several years earlier.

22. The CCG explained how this was not its decision. If Miss T has a complaint about the decision, she would need to raise this with the organisation in question in the first instance. The CCG is not responsible for overseeing complaints about that hospital.

23. Miss T should bear in mind the time limits for making NHS complaints. The organisation concerned could decide that her complaint is out of time. If Miss T remains dissatisfied following any response from the organisation, she could return to us. However, we would also consider the time limit and may decide not to investigate.

Complaints time limit

24. Miss T told us the CCG advised her it could not look at complaints about events that happened more than one year ago.

25. The NHS Complaints Regulations say NHS complaints must be made not later than twelve months after the date of events or the date when someone became aware they had a reason to complain.

26. We have seen no evidence to suggest Miss T complained to the CCG about complaints time limits. We can only see how she compared the hospital ‘barring’ her rheumatology referral to the NHS Complaints Regulations. She asked why the same time limits could not apply to previous referrals so that after one year a new referral could be made to an organisation. This is not something we can comment on. We only consider whether organisations have followed the relevant standards and guidelines.

27. This complaint is not ready for us, because it has not been raised with the CCG as a complaint. It is possible a member of staff referred to the time limit for complaints. If they did so, then they were correctly quoting from the NHS Complaints Regulations. We hope this clarifies the position for Miss T.

Conclusion

28. We recognise Miss T has experienced a long period of ill health. We can see how difficult it has been for her to request care and support. However, we have not seen any indications of significant failings leading to a significant impact on her health in the areas we have considered. We do not intend to investigate further.

Our Decision

1. We have carefully considered Miss T’s complaint about NHS Devon Clinical Commissioning Group (the CCG). We have seen no indication that anything went seriously wrong and cannot link the events complained about to her unresolved medical conditions. We are sorry to hear about her ongoing health problems.

2. Miss T complains about two referrals her clinicians made using the CCG’s referral service in 2019. We cannot not see how the time taken for these referrals had a significant impact on Miss T’s health.

3. Miss T also complains about a decision by a local hospital not to accept a referral because she had already been referred for the same issues some years ago. This was not a decision the CCG made, and Miss T would need to complain to the organisation responsible in the first instance.

4. Miss T is also unhappy the CCG told her it could not address complaints about incidents that happened more than a year ago. We have seen no evidence Miss T has put this complaint to the CCG. This means this issue is not ready for us. However, NHS organisations are expected to follow the timescales in question when handling complaints.

5. We have decided not to carry out a detailed investigation of Miss T’s complaint.