5. Mx U complains about the Trust’s service between 8 April 2019 and 12 February 2021. Mx U says the Trust did not put them on the waiting list for an ADHD assessment. They also say the Trust caused delays in their medication and did not prepare for monthly sessions.
6. Mx U says their mental health is worse than it would have been had they received a better service.
7. Mx U is seeking financial compensation and service improvements.
8. Mx U started seeing the Trust’s psychiatrist in April 2019 after Mrs M had raised concerns including trouble sleeping and low mood.
9. In November 2020 the Trust carried out an autism spectrum disorder (ASD) assessment before discharging Mx U to adult mental health services in February 2021.
10. Mrs M complained to the Trust on 13 February 2021 on Mx U’s behalf.
11. The Trust responded on 28 May 2021.
12. Mx U complained to us on 5 July 2021 represented by Mrs M.
ADHD assessment
15. ADHD is a behavioural disorder. Symptoms may include being impulsive and having trouble concentrating.
16. Mx U says each time they chased for an update the psychiatrist advised they were on a waiting list.
17. Mx U says they became aware they were not on the waiting list when the Trust discharged them to adult mental health services in February 2021. We recognise this would be a shock and concerning after waiting for a long time.
18. Mrs M complained to the Trust through its PALS (Patient Advice and Liaison) on 13 February 2021. The Trust responded on 28 May 2021.
19. In its response the Trust says there was a significant delay between the doctor deciding that an assessment was needed, and this being done.
20. The Trust apologised for the delay. It says the psychiatrist completed an assessment for ASD in November 2020 and did not feel an ADHD assessment was needed given the findings from this.
21. Mx U complained to us in July 2021. They say their mental health has been severely impacted as without a formal ADHD diagnosis they have not had access to the support they need.
22. We are sorry to hear Mx U say this has led to self-harming and an eating disorder. Mx U says they have had trouble with their social skills and coping at school. We realise this must have been a difficult time for Mx U and their family.
23. Mx U much of what has happened to her because of not having an assessment and diagnosis, cannot now be put right. They say this is the reason want financial compensation to pay for a support dog, accommodation which would allow a support dog, ongoing coaching and gender identity support.
24. Our guide to financial compensation says we look to put the person affected back into the position they would have been in, had there not been a negative impact on them.
This means we cannot consider financial compensation for ongoing care costs.
25. We do not wish to take away from the difficulties Mx U has struggled with. In this case we would not be able to achieve what she is looking for. For this reason, we are not able to take this part of the complaint forward.
Delayed medication, psychiatrist not preparing for meetings
26. 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. We have discussed this with Mx U to understand the reasons why they could not come to us sooner. We have also considered the time the Trust took to respond to Mx U’s complaint.
27. Mx U began appointments with the Trust’s psychiatrist in April 2019 after Mrs M raised concerns about trouble sleeping. The psychiatrist prescribed antidepressants and sleeping tablets. The psychiatrist carried out monthly reviews with Mx U and sometimes their parents were present.
28. Mx U says the Trust’s psychiatrist did not update the GP on their medication which caused delays with their prescriptions. Further, Mx U says the Trust’s psychiatrist failed to prepare for their monthly sessions. They say the psychiatrist did not check their medical records before appointments to update themselves on what had happened in previous sessions throughout the care episode. We appreciate this must have been frustrating and recognise Mx U’s concern that this could have led to bigger problems.
29. The Trust says from its investigation it found engagement with Mx U and their family to be extensive throughout, but there were areas which fell below its expected standard. It says there was no correspondence with Mx U’s GP about their medication, as would be expected. We appreciate this was a worry for Mx U.
30. We are pleased to see the Trust apologise in its response. It says since being made aware of concerns around documentation and communication it has introduced fortnightly meetings to correct and address the problem. The Trust says this is an ongoing process.
31. In the records provided by Mrs M we can see three times where she contacted the Trust to chase medication (14 June 2019, 15 August and 7 July 2020) before making a formal complaint on 13 February 2021.
32. We cannot see in the records any time where concerns were raised about how prepared the psychiatrist was until the formal complaint was made.
33. Mx U says this was an issue from when they first started to see the psychiatrist in 2019.
34. We consider it is reasonable to say they were aware of an issue with delayed medication by the second time Mrs M chased their prescription in August 2019.
35. It is understandable not to raise a complaint after this happening once. By the second time of chasing medication, Mx U had also had appointments with the Trust’s psychiatrist more than once. We consider it is reasonable to say they were also aware of a problem with the psychiatrist preparing for meetings.
36. This means they would have had to complain to us by August 2020.
37. The complaint is 11 months out of time as the complainant came to us in July 2021. We have considered the reasons given for the delay to see if we can set the time limit to one side.
38. Mx U says the significant delays in getting assessments and a diagnosis affected the time it took to make a complaint.
39. We appreciate how difficult it must be for Mx U and their family to have experience delays while also struggling with their mental health.
40. As the issue of diagnosis is separate to delayed prescriptions and the psychiatrist’s preparation for monthly sessions, we cannot consider this as a reason to set our time limit aside.
41. We also considered the time taken for the Trust to handle the complaint.
42. The Trust issued its final response on 28 May 2021. This is within the six-month time frame stated in the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009. We therefore do not consider it caused significant delay in Mx U complaining to us.
43. We do not consider the reasons given by Mx U are enough to put our time limit to one side. We are sorry to hear of the difficulties Mx U has had with their mental health. Mx U knew of their concerns about the psychiatrist and medication for quite some time before raising a formal complaint.
44. We are satisfied the Trust did not cause the delay in Mx U bringing their complaint to us. We are not persuaded Mx U could not have pursued these parts of their complaint earlier. We will therefore take no further action on their complaint.
1. We have carefully considered Mx U’s complaint about Oxford Health NHS Foundation Trust (the Trust).
2. We appreciate Mx U has suffered with their mental health over the years and has felt unsupported which must have been difficult for them and their family.
3. We have decided we cannot achieve the outcomes Mx U would like about their concerns about a lack of an attention deficit hyperactivity disorder (ADHD) assessment. We appreciate this will be disappointing for Mx U and their mother, Mrs M.
4. We are sorry to hear Mx U’s concerns about delayed medication and the psychiatrist not preparing for monthly sessions. We have reviewed the information they provided. Having done this, we have decided not to consider these parts of their complaint further. This is because of the time that has passed since the events they complain about.