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Nottingham University Hospitals NHS Trust

P-001429 · Statement · Decision date: 29 June 2022 · View Nottingham University Hospitals NHS Trust scorecard
Complaint (AI summary)
Mr O complained about delayed and incorrect medication (IVIG, Azathioprine) and inappropriate comments/threats from doctors. He also alleged a doctor falsely claimed presence at his knee operation/X-ray and left consultation doors open.
Outcome (AI summary)
Closed. The complaint was outside the one-year time limit, and no good reason was provided to waive this time limit.

Full decision details

The Complaint

3. Mr O complains about the following care and treatment he received from the Trust on 13 September 2018 after he was admitted with knee pains and tingling in his hands and feet. He complains that: • Doctor A delayed prescribing intravenous (IV) immunoglobulin (IG) therapy (antibody treatment to treat his health condition) • Doctor B incorrectly reduced his dosage of immunoglobulin from 90ml to 40ml. When Mr O asked for an explanation, Doctor B made an inappropriate comment and said ‘did he know how expensive it was’ • Doctor B ‘threatened him’ and told him ‘they would get rid of him’ if he ‘continued to be awkward’. Further, he says Doctor B incorrectly kept him on the same treatment of Azathioprine (medication used to treat chronic inflammation) for three months • Doctor C incorrectly said he was present for his knee operation and a nurse later confirmed Doctor C refused to do the operation. Further, Doctor C said they had signed being present at his Xray which did not take place, and they left the door open during his consultations.

4. Mr O believes the poor treatment he received has impacted his mobility as he cannot lift his feet and his knees ‘feel strange’. He says he also suffered distress because of the way Trust staff spoke to him.

5. Mr O is seeking financial compensation and an explanation from the Trust for its poor care and treatment.

Background

6. Mr O had a right knee replacement (a procedure which removes worn bones from the knee and replaces it with metal or plastic parts) on 13 September 2018. He was discharged on 17 September 2018.

7. On 25 October, Mr O told Trust staff he felt ‘weaker’ since the knee replacement. He decided to raise a formal complaint in July 2019. The Trust agreed to investigate his complaint and arranged a meeting in the same month to discuss his concerns.

8. Mr O raised a second complaint about the same knee treatment on 17 July 2020. The Trust agreed to investigate it and provided a further response on 17 November 2020. One week later, Mr O asked Trust staff to have a further meeting with him about the same complaint. The Trust did not agree to a further meeting and told Mr O on 22 February 2021 that it had fully investigated his complaint. Mr O sent his complaint to us on 11 August 2021.

Findings

11. The law says we can only investigate complaints which have been brought to us within one year of the person becoming aware of the issue in question. We can put this time limit to one side, but only if we see a good reason to do so.

12. In this case, we consider Mr O has two dates of knowledge for his complaints. Firstly, he would have known in September 2018 that he was unhappy about the way Trust staff spoke to him, that they gave him conflicting information, and that Doctor C left the door open during his consultations. Further, we can see he questioned his immunoglobulin medication during this admission. This suggests he had concerns about this medication in September 2018. Mr O submitted his complaint form to us on 11 August 2021. This means these complaints are one year and eleven months out of time.

13. We note Mr O feels he was incorrectly prescribed Azathioprine for three months. At the latest, his date of awareness for this complaint would be December 2018. This is when Mr O’s prescription would have ended, and he would have known the medication had not helped his knee pains or mobility. This means this complaint is one year and eight months out of time.

14. We asked Mr O to explain the reasons for the delay in bringing this complaint to us. We also considered how long it took for the Trust to investigate this complaint and provide its response.

15. The records show Mr O did not submit his initial complaint to the Trust until July 2019. We asked him to tell us the reasons for this. He explained the Trust told him to try his medication for his knee for six months to see if it would get better, so he wanted to wait before he submitted an official complaint.

16. We recognise Mr O would have initially wanted to focus on his recovery. We are sorry to hear he continued to experience pain and mobility problems and we appreciate this has had a significant impact on his life.

17. As outlined above, we consider Mr O would have known in September 2018 that he was unhappy about the way Trust staff spoke to him and prescribed his immunoglobin medication. Further he would have known in December 2018 that he had concerns about his Azathioprine medication. Mr O could have submitted these complaints whilst completing his course of treatment. Mr O did not tell us of any other reasons or barriers which prevented him from raising his complaints earlier. Therefore, we consider he could have complained much sooner.

18. The Trust held a local resolution meeting for Mr O in July 2019. He then approached them with a second complaint about the same knee treatment in July 2020. This caused a significant delay of 12 months.

19. We asked Mr O why he did not approach the Trust or us sooner with his outstanding concerns. He explained he was waiting for his advocate to tell him what to do next. We also spoke to Mr O’s advocate. They said from 21 August 2019, Mr O was receiving treatment for his knee and had ongoing consultations. Further, in March 2020, the complaints services were impacted by Covid19.

20. We recognise Mr O wanted to get further advice from his advocate about how to escalate his complaint. We are sorry to hear he continued to experience poor health in these twelve months and needed further treatment from the Trust.

21. Mr O’s records suggest he attended regular appointments for his knee from 15 August 2019 to 7 July 2020. During these appointments, he continued to raise verbal concerns about his knee treatment. This suggests he was able to engage with Trust staff about his complaint whilst he was receiving active treatment. On this basis, we consider he had several opportunities to ask Trust staff or his advocate about how he could escalate his concerns sooner. As such, we do not consider his explanation gives us a strong reason to set our time limit to one side.

22. Once Mr O submitted his second complaint in July 2020, the Trust took four months to investigate it and provide a further response. Mr O then asked for a further meeting in November 2020. The Trust declined this request on 22 February 2021. We recognise it took an additional seven months to complete this part of the complaints process and the delays caused by Covid19 were outside of Mr O’s control.

23. Finally, Mr O did not submit his complaint to us until August 2021 (six months after being signposted to us). His advocate told us this delay was caused because Mr O was unwell.

24. We carefully considered this explanation. We could see Mr O first made enquiries with our office in April 2021. This suggests he knew he wanted to submit a complaint to us at this time. We did not receive his complaint form until August 2021 (approximately three months later). Mr O and his advocate have not explained why Mr O did not submit his complaint form in April, when he was able to engage with our office. We consider this to be a further unreasonable delay.

25. In summary, we have identified Mr O’s complaints fall outside of our one-year time limit. We have not seen a good reason to set our time limit to one side, so we have decided not to consider these complaints further.

Our Decision

1. We have carefully considered Mr O’s complaint about the care he received from Nottingham University Hospitals NHS Trust (the Trust) for his knee pains in September 2018. We are sorry to hear he feels Trust staff did not prescribe his medication correctly, gave him conflicting information about his treatment, and spoke to him in a poor manner. Mr O told us he has struggled with long lasting mobility issues, and this has had a significant negative impact on his life. We can only imagine how difficult this must be for him.

2. This complaint falls outside of our one-year time limit. We have not seen a good reason to put our time limit to one side, so we have decided not to consider this complaint further. In making this decision, we do not wish to diminish in any way the pain and distress Mr O has experienced because of his poor mobility.

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