North West Anglia NHS Foundation Trust

3. Miss E complains about the care and treatment she received from the Trust. She says:

· on 2 August and 25 October, the consultant was rude and extremely nasty

· the consultant failed to diagnose a bulging disc in her neck

· PALS did not pass her complaint to the appropriate party to be investigated until February 2020

· The registrar made a comment that Miss E ‘managed to get some injuries’ in a letter sent to her GP after her consultation on 2 August .

4. Miss E says that she has been extremely distressed, and it has caused depression and anxiety. Miss E says she has had to have counselling and has been referred to a psychologist. She says it has caused prolonged pain, due to not being diagnosed in a timely manner. This delay has meant she was not offered physio and she has lost confidence in the Trust.

5. By bringing this complaint to us Miss E is seeking an apology and explanation as to what went wrong.

6. On 27 June Miss E was involved in a car accident. Miss E was a passenger and the car she was travelling in was rear-ended while stopped at a junction.

7. Miss E attended a walk-in centre on 14 July and was told her shoulder appeared to be dislocated. The walk-in centre referred Miss E to the Acute Fracture Clinic at the Trust.

8. On 2 August Miss E attended an appointment at the Trust and was seen by the consultant and registrar. Miss E said the consultant shouted at her and asked if she was making an insurance claim. The consultant arranged an X-ray of Miss E’s shoulder and collarbone. The results showed no abnormality.

9. An ultrasound was also requested on 2 August. This showed a defect in one of the tendons in the shoulder.

10. The registrar sent a follow up letter to Miss E’s GP and said Miss E had ‘managed to get some injuries’.

11. On 12 August the consultant ordered an MRI of Miss E’s cervical spine, and the Trust did this on 23 September. The MRI showed degenerative changes in the discs of the neck between the fourth and seventh vertebrae. This predominantly affects the nerves in the left arm. As Miss E’s symptoms were to the right, she was referred to the Pain Management Clinic to receive injections around the affected nerve to dull the pain.

12. Miss E saw the consultant again on 25 October during a follow-up appointment. She says they were unprofessional and rude and again questioned her about her insurance claim.

13. In October and November, Miss E was seen by her GP. She says her GP informed her she had a bulging disc in her neck, which she says the consultant never told her about.

14. Miss E complained to the Trust on 11 November 2019. Miss E attended the PALS office on 31 December 2019 and was told that her complaint had not been processed but they would process it now. In February 2020 Miss E’s complaint was passed to the appropriate team and the Trust responded on 5 and 10 March 2020.

17. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so. We have started by considering whether Miss E’s complaint falls inside the time limit.

18. In this case, we think Miss E would have reasonably known on 2 August and 25 October 2019, following the appointments, that she was unhappy with the way the consultant spoke to her.

19. For the complaint to be inside the time limit, Miss E should have brought this part of the complaint to us by August and October 2020. Miss E complained to us in February 2022. This part of the complaint is therefore 16 to 18 months outside of the time limit.

20. Further, Miss E would have known that PALS had not processed her complaint on 31 December when she attended the PALS office. For the complaint to be inside of the time limit, Miss E should have brought this part of the complaint to us by December 2020. Miss E complained to us in February 2022. This part of the complaint is therefore 13 months outside of the time limit.

21. Miss E would have known that a diagnosis of a bulging disc had been missed in October and November 2019 when her GP told her about this. Miss E would also have known she was unhappy with the comment made by the registrar when she requested her medical records before making a formal complaint to the Trust on 11 November 2019.

22. For these parts of the complaint to be inside of the time limit, Miss E should have brought this to us by November 2020. She complained to us in February 2022. This part of the complaint is 15 to 16 months out of time.

23. As set out above, each part of Miss E’s complaint falls outside of our time limit. We have therefore gone on to consider whether there are any good reasons why we should put the time limit to one side. We have discussed this with Miss E to understand the reasons why she could not bring her complaint to us sooner. We have also considered the time the organisation has taken to respond to Miss E.

24. Miss E initially raised her complaint with the Trust on 11 November 2019. Her complaint was passed to the appropriate team in February 2020. The Trust responded on 5 and 10 March 2020.

25. Miss E did not contact the Trust again until 31 May 2021. A local resolution meeting (LRM) took place on 16 July. The Trust sent a post meeting letter on 22 July. Miss E responded to this on 14 September and the final response from the Trust was sent 28 September.

26. Considering the above, we can see the Trust took four months to respond to Miss E’s initial complaint. It arranged a LRM within two months of her second complaint, and it responded within two months of her further complaint. Overall, we consider the Trust responded in a timely manner and this is therefore not a significant reason for the delay in bringing this complaint to us.

27. There is a 14 month delay between the Trust’s response in March 2020 and Miss E’s further complaint in May 2021. In an email to us on 15 March 2022, and during a phone call with us on 14 September 2022, Miss E provided reasons for the delay.

28. Miss E explained that following this experience, she was feeling distressed, extremely low, and at the end of her tether. She said that after receiving the final response from the Trust on 28 September 2021 she contacted Citizens Advice for help. She says they put her in touch with Voiceability (an advocacy service), and she contacted them twice but did not hear back.

29. Miss E also explained she thought the Trust’s Operations Director would contact her again. Miss E told us she is self-employed and was trying to keep her business going while injured throughout this time. Miss E also explained that she has lost her confidence due to this experience and that she thought it would be difficult to complain to us.

30. Miss E told us her mother sadly died in September 2021. She told us this was another significant reason for the delay in bringing the complaint to us. Importantly, this was after the 14 month gap in her contact with the Trust. This reason does not account for the delay in bringing her complaint to us.

31. Miss E was signposted to us by the Trust in its complaint response dated 10 March 2020, where it says it enclosed a leaflet. This would have provided details on how to complain to us. Our website also has detailed instructions on how to complain and what the process is. Miss E told us she contacted Citizens Advice and Voiceability after September 2021 when she received the Trust’s final response.

32. We have considered the reasons that Miss E has provided for why she was unable to bring her complaint to us sooner. It is clear Miss E has been deeply affected by the actions of the Trust, and we understand that this was a difficult time for her. However, between March 2020 and May 2021 there is a 14 month gap when Miss E did not contact the Trust and did not take any action in relation to the issues she complains about.

33. Given the particularly long period of time when there was no action, We do not believe these reasons are a good enough to put the time limit to one side. After considering the reasons Miss E has provided, We have seen no indication she could not have brought her complaint to us sooner.

34. We do not have sufficient evidence to explain why Miss E was not able to raise her complaint with us earlier. Taking all this into account, We do not consider it appropriate to set our time limit to one side.

1. We have carefully considered Miss E’s complaint about North West Anglia NHS Foundation Trust (the Trust). We are sorry to hear Miss E’s concerns that the consultant was rude and unprofessional towards her and that they missed a diagnosis of a bulging disc in her neck. We are also sorry to hear the registrar sent a letter to Miss E’s GP with inaccurate information, and that the Patient Advice and Liaison Service (PALS) did not pass her complaint to the appropriate team in a timely manner. We appreciate this must have been a difficult time for her.

2. The complaint falls outside of our time limit, and we have decided there is no good reason for us to put our time limit aside to consider the complaint further. In making this decision, we do not wish to diminish the deep distress Miss E has felt because of her experience.