A medical practice in the Birmingham area

6. Ms B complains Nurse A told her and Mrs R to leave the Practice on 8 October 2020, when they attended to have flu vaccinations. Ms B says Nurse A told them they had not completed their self-isolation period, after they had both tested positive for COVID-19. Ms B says she tried to explain they had in fact both completed their ten days of isolation but were not listened to and were not able to have their flu vaccinations.

7. Ms B also complains the Practice has still not responded to her complaint after she wrote to them on 12 October 2020. She says she has chased a response multiple times but has still not heard anything.

8. Ms B says she and her mother were very hurt and upset by Nurse A’s comments and they were made to feel like they were lying and putting other people’s lives in danger. She says they have lost confidence in the Practice.

9. Ms B says not having her complaint dealt with has added to her and her mother’s stress and they feel like the Practice is not taking them seriously and is trying to ‘sweep it under the carpet.’

10. Ms B would like an apology and an explanation for why Nurse A thought she and her mother had not completed their isolation period. She would also like an explanation for why her complaint was not responded to, and she wants the Practice to take steps to ensure that the Practice’s complaint procedure and Government guidance is followed correctly in the future.

11. What follows is a brief summary of events to put the complaint in context. We have not included all the details as all parties are aware of these.

12. Ms B and her mother Mrs R attended the Practice on 8 October 2020, for flu vaccinations. They had their temperatures taken, which were normal, and were then called in to the nurse’s room. The nurse took a call and then asked them if they had recently had COVID-19. Ms B confirmed they had but they were both now out of the self-isolation period. Ms B and Mrs R were asked to wait in reception again.

13. Ms B and her mother were waiting in reception when a different nurse (Nurse A) came over to them and told them they should not be there as they had just had COVID-19. Ms B explained they had both completed ten days of isolation, but Nurse A said they should have been isolating for 14 days, and this period was not over.

14. Ms B and Mrs R were made to leave the Practice and could not have their flu vaccinations.

15. Ms B complained to the Practice in writing on 12 October 2020. She did not get any form of acknowledgement or response and so wrote again on 26 October 2020. She once again did not receive a response, so she chased this a few times in person when she attended for appointments. When enquiring about the progress of her complaint, Ms B was informed verbally by reception staff that the Practice was waiting for various matters before it could issue a response. Ms B then made enquiries to pursue her complaint in April 2021 and received no response.

16. Ms B came to the Parliamentary and Health Service Ombudsman in April 2021. We attempted to seek a resolution to matters and approached the Practice.

17. In January 2022, the Practice confirmed to us they would be willing to resolve matters. By March 2022, Ms B was back in touch with us as she had heard nothing from the Practice.

18. We then tried to gain a response from the Practice on 8 March 2022, but heard nothing. We also asked the Practice for a response in April and June 2021, but we also did not receive anything back form the Practice.

Ms B and Mrs R being told to leave the Practice because they had not completed the self-isolation period

21. Ms B says the Practice asked her and her mother to leave because they said they had not completed their isolation period after they both tested positive for COVID-19. The Practice did not respond to her complaint, and they have not responded to us, so we do not have a written response.

The timeline of events is as follows: • Tuesday 22 September 2020 – Ms B’s mother, Mrs R, has COVID-19 symptoms. The whole family begins a 14-day self-isolation • Wednesday 23 September 2020 – Mrs R goes for a COVID-19 test • Thursday 24 September 2020 – Ms B’s symptoms start • Friday 25 September 2020 – Mrs R receives a positive test result via text message. Ms B goes for COVID-19 test herself • Saturday 26 September 2020 – Ms B receives her positive test result via email • Thursday 1 October 2020 – Mrs R ends her period of isolation • Saturday 3 October 2020 – Ms B ends her isolation • Thursday 8 October 2020 – Ms B and Mrs R attend the surgery for their flu vaccinations

22. Ms B has sent us a copy of the email she received from the NHS and the text Mrs R received that let them know their test results were positive.

23. Government guidance at the time was to isolate for ten days following the beginning of symptoms, or a positive test result if the person was asymptomatic. This is explicitly stated in the email and text they both received: ‘Self-isolate for 10 days from your symptoms starting. If you’ve not had symptoms, self-isolate for 10 days from your test.’

24. If we count the days Ms B and Mrs R isolated, even from the latest point (the date of the test), they were still over the ten days by the time they attended the appointment on 8 October. Ten days from Mrs R’s test takes us to 3 October, ten days from Ms B’s is 5 October.

25. Based on this, we do see there is a failing in the two of them being asked to leave the Practice on 8 October 2020, because the Practice said they had not completed their isolation period. We know this was not the case and the Practice was not acting in line with the Government guidance that applied at the time.

Complaint handling

26. Ms B wrote to the Practice with a formal complaint on 12 October 2020. When she had not received a response by 26 October 2020, she wrote again to chase a response, but did not get one. She says she asked about it a few times when she attended appointments and was always told they were waiting for something, for example Nurse A to get back with her response. Ms B informs us the last time she chased it in person was 19 April 2021, when she was again told they were waiting for the Nurse A’s response. We also wrote to the Practice on 23 April 2021 and 11 June 2021 to try to get the Practice to respond to Ms B, but it did not send a response.

27. The Practice’s own complaints policy states clearly: ‘The Practice will acknowledge your complaint within two working days and aim to have looked into your complaint within ten working days of the date you raised it with us. At this stage you should be offered an explanation or a meeting with the person(s) involved.’

28. Our own Principles of Good Complaint Handling (guidance which sets out how public bodies should respond to and handle complaints) state that organisations should: ‘Deal with complaints promptly, avoiding unnecessary delay, and in line with published service standards where appropriate. Resolving problems and complaints as soon as possible is best for both complainants and public bodies.’

29. By not responding to Ms B’s complaint, the Practice was not acting in line with its own complaints policy or with our Principles of Good Complaint Handling. There is therefore a failing around complaint handling that led to further stress and frustration for Ms B.

30. Ms B says the failing in the Practice not following relevant Government advice and telling her and her mother she needed to leave then led to them both feeling embarrassed and like they were putting other people at risk. She also felt hurt and upset. She says the failing in complaint handling led to her feeling more stressed.

31. The Practice has not done anything to put things right for Ms B. It did not respond to her complaint and did not respond to us when we asked them to provide her with a response.

32. With our intervention in January 2022, the Office Manager did agree to put things right. At the time we considered this attempt at a resolution was fair and proportionate, but these actions were not carried out despite efforts to remedy. We will therefore be making recommendations to put things right for Ms B.

1. Our decision is to uphold this complaint. Based on the evidence we have seen, we have found that a medical practice in the Birmingham area (the Practice) did not follow Government guidance when it told Ms B and her mother, Mrs R, that they had to leave the Practice because they had not completed their ten day isolation period. We have also found that the Practice did not follow its own complaints procedure or act in line with our Principles for Remedy when it came to dealing with Ms B’s complaint.

2. We consider the failing in telling Ms B and her mother to leave the Practice would have led to Ms B and her mother feeling embarrassed and upset over a short period of time. We found the failing around complaint handling would have added to Ms B’s stress over a longer period of time. We were sorry to hear of the difficulties faced by Ms B and her mother in trying to get their flu jabs, and by Ms B in trying to have her complaint resolved. We have proposed some recommendations we are asking the Practice to carry out. These recommendations are to help put things right for Ms B and her mother.

3. We are recommending the Practice write to Ms B and her mother to acknowledge the hurt and embarrassment caused when they were incorrectly told they needed to leave the Practice because they had not completed their isolation period. The Practice should also provide a written explanation why Nurse A did not think they had completed their isolation period.

4. Regarding the failing in complaint handling, the Practice should also apologise to Ms B and acknowledge how this caused her further stress and made her feel like her complaint had been ‘swept under the carpet’

5. These recommendations are explained in further detail at the end of the report.

33. In considering our recommendations, we have referred to our ‘Principles for Remedy’. These state that where poor service or maladministration has led to injustice or hardship, the organisation responsible should take steps to put things right. We have also referred to our own Severity of Injustice Scale. This is further guidance that allows the Ombudsman to make fair and consistent recommendations on injustices considered not remedied.

34. Our Principles say that public organisations should look for continuous improvement and should use the lessons learnt from complaints to make sure they do not repeat maladministration (fault) or poor service. Further to this we consider the injustice and impact lasted for over a year. Using our severity scale, we would consider this to be an injustice of level three as the injustice around complaint handling has been ongoing for more than a year.

35. Lastly, we have considered if a remedy for application of guidance in managing patients in the practice is relevant. We recognise COVID-19 has caused an unprecedented demand on service, and has been fast moving with different periods of Government guidance on isolation, lockdown, and process. For those reasons, and in line with our own Service Model, the policy which underpins the work we do, we have not made any recommendation for how the Practice conducts business in relation to COVID-19 guidance. This is because a remedy specific to matters around October 2020, would have been set aside by changes in guidance and policy several times since. For these reasons we do not recommend anything relating to applying COVID-19 guidance to patients visiting the Practice.

36. In line with this, we propose to make the following recommendations, in line with our Principles of Good Complaint Handling: • By 8 September 2022 the Practice should write to Ms B and Mrs R to acknowledge how they felt hurt and embarrassed when they were incorrectly told they needed to leave the Practice because they had not completed their isolation period. The Practice should also explain why Nurse A did not think they had completed their isolation period.

• The Practice should also apologise and acknowledge the extra stress caused to Ms B by the failing in complaint handling, and her complaint being ignored making her feel like it had been ‘swept under the carpet.’