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.