Torbay and South Devon NHS Foundation Trust

4. Mr V has complained to the Trust about aspects of his care and treatment. He has also complained to the Trust about its complaint responses, as he said the Trust had not answered the questions he asked in his letters of complaint.

5. Mr V complained to us about the Trust’s response to his complaint, and about the care and treatment he received from the Trust following admission on 17 November 2019. Mr V told us he only wants answers to his points and questions.

6. Mr V also complained that the Trust were not providing him with all eight pages of the care planning summary (CPS). Mr V does not believe the Trust’s explanation that the document is only three pages long and wants to be provided with the remaining pages.

7. On 17 November 2019, Mr V was admitted to the Trust after suffering two seizures at home. The Trust prescribed medication for the seizures which Mr V says caused him to suffer side-effects he was not warned about.

8. Mr V discharged himself from hospital. He underwent further investigations as an outpatient into the cause of the seizures. He says he was told by the Trust to not drive as a safety precaution, which he adhered to. He also says the Trust told him continue taking the medication prescribed, despite the negative effects it was having on him.

9. The Trust took 25 and 45 working days to communicate the test results to him. He says it was only at this point he was able to drive and stop the medication prescribed to him. He says the delays led to him having approximately four months without work because he could not drive.

10. He says he suffered negative side-effects from the drug prescribed. He says if the results been communicated to him sooner, the impact on his mental health would not have been as severe. He says he would also have undergone further investigations to understand the cause of his seizures before the COVID-19 pandemic lockdown occurred.

11. Mr V says he contacted the Trust several times to request the test results. He says he also asked for further examinations and for a second opinion. He says his correspondence was ignored and there were delays to the further investigations. A second opinion was arranged, and further investigations were undertaken, but the cause of his seizures was not found.

12. Mr V’s first complaint letter dated 20 September 2020 puts questions he has listed A-I to the Trust. The Trust’s complaint response letter dated 12 February 2021 has responded to each of his questions.

13. In his second complaint letter dated 15 February 2021, Mr V asked the Trust further questions, listed i–ix. The Trust replied to Mr V’s second letter. However, it has only addressed questions listed i-ii in its response. In response to the other questions, the Trust said there was nothing further it could add to its previous response.

The Trust failed to answer Mr V’s questions and provide adequate answers

16. Mr V was ‘extremely disappointed’ with the Trust’s response. He said the Trust left his questions inadequately answered, or unanswered. He told us he wanted the Trust to provide adequate answers to his questions.

17. We have considered Mr V’s complaint letters to the Trust, the Trust’s complaint response letters, and Mr V’s complaint form. We have also considered emails received from Mr V to clarify his complaint, in addition to an email from the Trust explaining its reasoning.

18. Our Principles say organisations should ‘give clear, evidence-based explanations, and reasons for their decisions. When things have gone wrong, public bodies should explain fully and say what they will do to put matters right as quickly as possible’.

19. Organisations should also ‘investigate complaints thoroughly and fairly, basing their decisions on the available facts and evidence’.

First letter of complaint

20. We considered Mr V’s first letter of complaint and compared it with the Trust’s first response. In our view, the complaint response answered each question asked by Mr V, apart from one.

21. The question we feel was left partially unanswered is listed as ‘G) Why was the clinician unwilling to respond to my correspondence further increasing the effect he had on my mental wellbeing?’.

22. The Trust said there was evidence of a number of correspondences between Mr V and the clinicians. It apologised if Mr V felt there was any unwillingness to respond. It also said it was not its intention to delay any communication or place any further stress on Mr V’s mental wellbeing.

23. It was unclear why Mr V felt his questions were left unanswered. We therefore wrote to Mr V to clarify this. Mr V told us the Trust had failed to answer the questions he had put to them, as it ‘side-stepped’ the questions and provided an answer to a question he had not asked.

24. We recognise Mr V is frustrated the Trust has not provided him with the answers he wanted. However, it is our view the Trust has answered Mr V’s questions in his first letter of complaint. Limits to our powers mean we cannot make individuals answer questions. As the clinician is the only person who can answer question ‘G’, we cannot investigate this question any further.

25. The Trust appears to have provided clear, evidence-based explanations and reasons in response to the questions asked. This appears in line with Our Principles. We do not think there is anything further the Trust can add to its first letter of response.

26. We recognise Mr V is dissatisfied with the Trust’s answers. We can see the Trust has answered the questions asked by Mr V. We cannot ask the Trust to provide different answers simply because Mr V is dissatisfied. We cannot see the Trust has done anything wrong in respect of the first letter of complaint.

Second letter of complaint

27. Our Principles say organisations should ensure that ‘decisions are proportionate, appropriate and fair’.

28. Mr V responded to the Trust’s complaint response with a further letter. Within this letter, he raised a mixture of comments and questions listed i-ix.

29. The Trust responded to Mr V’s points listed i-ii. However, the Trust did not address any of the points listed iii – ix. The Trust said it had given Mr V all the available information and there was nothing further it could add to the answers it had already provided.

30. We contacted the Trust and asked for its reasoning for not addressing the remaining points in Mr V’s letter. It said it felt Mr V had not raised anything new, and it felt there was nothing further it could add.

31. We have considered the points raised in Mr V’s second letter of complaint.

32. In its second complaint response, the Trust picked out the new questions asked by Mr V and provided further explanation. It did not to answer several other questions or points as it felt these did not raise new issues.

33. We recognise that Mr V found the Trust’s response disappointing. We cannot ask the Trust to provide a different answer simply because Mr V considers the answers to be ‘inadequate’. In our view, we think the Trust answered the questions asked in its first response to the complaint. It provided further answers in the second letter of complaint, where the Trust felt new issues were raised.

34. Having reviewed all the available evidence, we believe the Trust acted in line with Our Principles. We believe the questions and comments the Trust did not directly respond to have been appropriately addressed in its first letter of response.

35. We do not believe it is proportionate or fair for the Trust to be required to provide further explanations when it has already provided an answer. We think the Trust has acted proportionately and fairly, in line with Our Principles. We therefore do not think the Trust has got anything wrong here.

Care and treatment

36. Mr V has complained to us about the care and treatment he received. He said the Trust did not provide him with appropriate medication on admission to hospital to prevent him from suffering further seizures. He also complained he was not advised of the side effects of the medication he was prescribed following discharge from hospital.

37. Mr V said his complaint was about both the care and treatment he received and about how the Trust had handled his complaint. However, he told us that in order to resolve his complaint, he wanted the Trust to provide a response to his complaint.

38. As we have set out above, we think the Trust’s response to Mr V’s complaint was in line with Our Principles. Taking this into account, we think there is nothing further for the Trust to respond to, and nothing further we can achieve here.

39. We recognise Mr V is unhappy with the answers the Trust provided. We also appreciate he wants to find the cause for the seizures he is suffering from. This is understandably frustrating for Mr V.

40. We are sorry to hear of the circumstances which led Mr V to complain to our service. We hope our explanations clearly set out the reasons for our decision.

Missing information

41. Mr V asked the Trust why there were missing pages of a CPS report. He said these pages had not been provided to him and that the Trust was deliberately not providing him with information and concealing the truth. Mr V wants the Trust to provide the missing pages.

42. The CPS is a template document which shows on the computer as containing eight pages. However, not all these pages are populated with information.

43. The Trust said Mr V’s CPS only had the first three pages of the document populated. It explained these pages contain all the information relevant to his admission and the remaining pages of four to eight do not contain information and are blank.

44. The Trust said it is restricted by the system from reproducing or printing unpopulated pages. It said it was therefore physically unable to provide him with the five blank pages.

45. We are grateful Mr V raised his concerns about this issue to us. We can understand why Mr V was concerned by the discrepancy here.

46. Our Principles say organisations should be open and honest, giving clear explanations for decisions. We asked the Trust to provide evidence of the CPS containing only three pages. The Trust provided screenshots of the CPS which shows the document to contain only three pages, despite displaying as eight pages.

47. We have considered the evidence supplied to us by the Trust. Despite the physical document displaying as eight pages, we accept the Trust’s position that it is an unfortunate system limitation. It is clear the CPS only contains three pages.

48. We do not think there is any indication the Trust has got something wrong here.

1. We have carefully considered Mr V’s complaint about Torbay and South Devon NHS Foundation Trust (the Trust). We were sorry to hear about Mr V’s concerns. We recognise these events have caused him considerable distress.

2. We have decided not to consider this complaint further. This is because, based on the evidence we have seen, we have not seen indications the Trust has done anything wrong.

3. Having considered the available evidence, we are satisfied the Trust’s response to the complaint was in line with Our Principles of Good Complaint Handling. These states organisations should ensure that ‘decisions are proportionate, appropriate and fair.’