3. Mrs C complains the Practice incorrectly diagnosed her on 7 May 2020. She also complains the Practice did not call her back when she said her symptoms, including her left arm being numb, could be due to her heart.
4. Mrs C said she suffered a heart attack. She was in a lot of pain, and was emotional, depressed and not sleeping. She does not feel confident calling the Practice.
5. Mrs C would like an apology, service improvements and a financial remedy.
6. Mrs C had a telephone consultation with her GP on 7 May 2020. Her GP records on this date show she had shoulder pain and a fever. Mrs C had a heart attack on 8 May 2020.
7. Hospital A admitted and transferred Mrs C to Hospital B on the 8 May for treatment for her heart attack.
8. Mrs C complained to the Practice on 13 October 2021. The Practice responded on 19 November 2021.
Telephone consultation and no call back on 7 May 2020
11. The Health Service Commissioners Act 1993 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.
12. In reaching our decision, we consider all delays in the complaint process. This includes consideration of how long the complainant and the organisation took, and if the reasons for any delays are justified.
13. Where we see justification that prevented a complainant from progressing their complaint, we may then consider waiving the time limit if the reasons are fair and exceptional. Our starting expectation is that a complainant is responsible for making sure a complaint is brought in time.
14. We discussed this with Mrs C and her advocate to understand the reasons why she could not complain to us earlier. We also considered the time the Practice has taken to respond to Mrs C, and any other relevant information.
15. The issue happened on 7 May 2020 when Mrs C had a telephone consultation with the Practice about her symptoms. Mrs C told us she became aware of the issue around 6 or 7 May 2020. From review of the information, we consider Mrs C would have become aware of the problem from 7 to 8 May 2020, soon after she suffered the significant event of having a heart attack. We recognise this would have been very upsetting and distressing for her.
16. In line with our time limit, we would have expected a complaint to the Parliamentary and Health Service Ombudsman within twelve months on or before May 2021. Mrs C emailed her concerns to the Practice on 13 October 2021, around 17 months after knowing she had a reason to complain.
17. We have seen the Practice’s final response was issued on 19 November 2021. They signposted her to us as the next stage of complaining. Mrs C contacted us on 8 December 2021, and we sent a blank complaint form to her on the same date.
18. Mrs C’s complaint was dated 17 December 2021. Mrs C instructed an advocate on 22 December 2021. Mrs C then submitted the complaint form to us by email on 6 January 2022.
19. In summary, we did not identify any significant delays in the Practice progressing and responding to the complaint. Mrs C was fairly prompt at bringing her complaint to us after the Practice’s final response.
20. We consider it was reasonable for Mrs C to take approximately three weeks from her first point of contact in December 2021 to submit her complaint to us, as it was around the Christmas period. At the point of complaining to the Practice, the complaint was 17 months from the date Mrs C knew a reason to complain and five months out of time. By the time she brought the complaint to us it was seven months out of time.
21. We spoke to Mrs C to better understand the delay. Mrs C said she had a very stressful time since her heart attack. She said during the national lockdown she was depressed. She struggled with side effects from medication and did not have enough sleep. She received no aftercare and did not know what she could do.
22. Mrs C’s advocate told us some of the delays were due to them. They said Mrs C first approached them on 22 December 2021 and left a voice message saying we advised her to instruct an advocate to assist in completing our complaint form. The advocate said they do not know why there was a delay from their call centre, but the case was allocated to them as a priority in March 2022. The advocate also said Mrs C could not complain to us sooner due to her ill health. We have not seen this explains the initial delay in raising a complaint.
23. The advocate said it was difficult to contact Mrs C at times as she would be at work. The advocate asked us to get a medical report to confirm how ill Mrs C was that she was not able to attend to paperwork. We looked at Mrs C’s medical records from the period May 2020 to November 2021 to assist in our decision.
24. We can see Mrs C’s daughter contacted the Practice on 11 May 2020 and said her mother had treatment at Hospital B and it was due to discharge her that day. We could see Hospital B’s cardiology department sent a discharge summary to the Practice on the same date. Mrs C then contacted the Practice on 14 May 2020 as she wanted to discuss a few symptoms following her treatment.
25. Following this, Mrs C contacted the Practice on 26 May 2020 where she asked about returning to work. The Practice told Mrs C she did not qualify for shielding (the government advised patients most at risk of becoming seriously ill from covid to shield during the pandemic). It advised Mrs C, as she recently had treatment for her heart attack, it would be reasonable for her to have some time off.
26. Mrs C contacted the Practice on 7 May 2021 and confirmed she was having breathlessness, headaches, dysphasia, reflux, and other symptoms since she had the heart attack. The Practice then referred Mrs C to physiotherapy.
27. On 3 November 2021 the Practice returned a call from Mrs C where she referred to the telephone consultation on 7 May 2020. It recorded, ‘She is upset that she remembers mentioning L (left) arm pain and her concerns that presentation may be related to her heart.’
28. We recognise Mrs C had a difficult time with her symptoms, physically and emotionally, after suffering from a heart attack. We recognise it would have been a more distressing time which may have affected her mental health as it was when the UK was in a national lockdown due to the pandemic. She needed time to recover from her heart attack, as advised by the Practice.
29. Mrs C brought a complaint to the Practice 17 months after she had reason to complain and five months out of time for us. We do not think the reasons Mrs C gave us indicates there was a significant barrier which prevented her from complaining to the Practice and then to us sooner.
30. Mrs C instructed an advocate after contacting us in December 2021. We consider Mrs C could have contacted an advocate sooner if she was struggling, to assist in bringing her complaint to the Practice and then to us. We consider as Mrs C was able to work again in May 2021, it is our view she could have complained to the Practice around then before bringing her complaint to us.
31. There is also clear information on our website about our time limits. We do not think the reasons Mrs C provided are sufficient for us to set aside the time limit and we think she could have made a complaint sooner to the Practice and then to us.
32. Therefore, we cannot consider the complaint further. We appreciate this decision will be upsetting for Mrs C. We hope we have been able to explain the thorough consideration we have given to her complaint. We wish her well for the future.
1. We have carefully considered Mrs C’s complaint about a medical practice in the London Borough of Bromley (the Practice). The complaint falls outside of our time limit, and we have decided there is no sufficient reason for us to put this to one side and consider her complaint further.
2. We recognise this decision may be disappointing for Mrs C. We acknowledge it has been a very difficult and distressing time for Mrs C when she had her heart attack, especially during the pandemic. Our decision is in no way intended to detract from her experience.