Issue one – Telephone call with a consultant gastroenterologist
11. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the event(s) complained about had a negative effect the organisation has not put right. We have found the Trust has already done enough to put right the impact of these events.
12. We can see the Trust sent Mr A a final response dated 14 February 2022. In it the Trust explained its interim service manager for gastroenterology had investigated Mr A’s complaint about the telephone call on 7 December 2021.
13. The Trust’s response stated the consultant gastroenterologist Mr A spoke to on 7 December 2021 recalled the call was difficult because Mr A had people doing work in his home at the time. It said the consultant also found Mr A challenging. The Trust accepted the call did not go well and said this is not the aim of any of its staff. It apologised to Mr A for causing him distress.
14. The Trust added it did not have a recording of the call and offered to review its findings if Mr A decided to share his recording of the call with it.
15. We realise Mr A has lost trust in the Trust as a result. We also know he wants the Trust to confirm the consultant gastroenterologist disconnected the call.
16. We appreciate Mr A is unhappy with the explanation the Trust gave in its response. But an investigation would not be able to get the outcome Mr A wants.
17. We are sorry to hear the matter affected Mr A’s mental health to the point he needed hospital treatment. We do not wish to diminish the impact of the matter on Mr A and understand it is important to him. But an investigation would not be able to identify if this event alone was directly responsible for his decline in mental health or his hospitalisation.
18. We consider the Trust’s acceptance the call did not go well and the apology it gave in its final response are adequate to address the emotional impact of the matter. This is in line with our ‘Principles of Good Complaint Handling’. These say in many cases a prompt explanation and an apology will be a sufficient and appropriate response.
19. A prompt explanation and an apology are also in line with the remedies considered appropriate for level one injustices on our severity of injustice scale. The scale states level one injustices will usually be injustices such as annoyance, frustration, worry or inconvenience, typically arising from a single (one-off) incidence of maladministration or service failure, where the effect on the individual is of short duration and there are no other adverse effects or ongoing wider impact. We would generally consider an apology to be an appropriate remedy for a level one injustice.
20. With all the above in mind, we consider it would be disproportionate for us to investigate the matter further as this would not produce a different outcome from what the Trust has already done. So no further action is required on this complaint component as we consider there are no unremedied injustices outstanding.
Issue two – Missing emails between 30 March 2022 and 4 April 2022
21. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the event(s) complained about had a negative effect which the organisation has not put right. Having done so we cannot link the events complained about with the negative impact Mr A has claimed.
22. We can see Mr A emailed the Practice on 4 April 2022 at 10.52am stating it appears he has ‘been placed back in the don’t matter category’. He was dissatisfied with the prescription clerk and said he wanted to raise an official complaint.
23. The Practice replied on 4 April at 3.20pm to say because it was short-staffed over the previous couple of weeks it had only just picked up his emails from 1 April at 9.31am and his email from 10.52am that day.
24. The Practice added it did not receive an email from Mr A on 30 March and asked him to check his sent mailbox and forward the emails to the Practice. The Practice assured Mr A all its patients matter and no one had been placed in the ‘don’t matter category’. The Practice apologised for not responding to his 1 April email sooner but said it felt it had replied within a reasonable time frame.
25. The Practice’s reply also said its prescription clerk was extremely competent in their role and rarely received complaints. The Practice asked Mr A if he would like to continue with an official complaint now it had responded.
26. At 4.41pm on 4 April 2022 Mr A forwarded the Practice two emails he sent it on 30 March 2022, stating they were confirmed as sent.
27. The first email Mr A sent to the Practice on 30 March at 3.32pm is addressed to his doctor and asks questions about his repeat prescription. It also mentions his dissatisfaction with the prescription clerk.
28. The second email Mr A sent to the Practice states it previously had issues with the prescription clerk as it had to apologise for their behaviour in the past. Mr A mentions an occasion when he spoke with the same clerk on the telephone and did not appreciate their attitude during the call. He asks the Practice to raise a complaint and investigate the matter.
29. Mr A then emailed the Practice on 5 April to say he found emails ‘vanishing’ very suspicious.
30. Internal emails between the Practice inbox and the practice manager dated 6 April suggest the Practice spoke to Mr A at some point between 5 April and 6 April.
31. Mr A emailed the Practice on 14 April at 1.50pm. He addressed this email to his doctor and asked several questions about his medication. The Practice replied on the same day at 2.07pm to tell Mr A his email had been forwarded to the doctor. The Practice explained Mr A’s doctor would be on annual leave from 15 April, returning on 25 April. The Practice also explained NHS Digital (responsible for NHS information technology) was looking into whether it could retrieve his missing emails or find out if they had been deleted and, if so, who by. The Practice explained the practice manager would also be on annual leave from 15 April to 25 April but would email Mr A again on their return to keep him updated.
32. Mr A emailed the Practice on 27 April at 12.02pm to say he would be away from home from 29 April to 4 May. This email was to arrange a suitable time for a nurse to visit Mr A to take blood samples.
33. We can see the Practice replied on 27 April at 5.08pm to tell Mr A it had passed his earlier email to the district nurses. The Practice explained the home visit would probably be after 4 May 2022 and it had asked the district nurses to confirm this by text message before the visit.
34. In its 27 April email the Practice also updated Mr A on the investigation into his missing emails. The Practice said NHS Digital was able to recover all emails deleted from the Practice’s email box between 30 March and 5 April 2022. But Mr A’s emails were not among these. The Practice said it had asked if anything further could be done but NHS Digital had concluded although the emails showed as sent at Mr A’s end, the Practice did not receive them. The Practice told Mr A it was aware of similar incidents during the past couple of weeks and had reported this to NHS Digital.
35. Mr A emailed the Practice on 27 April at 5.43pm unhappy with the explanation it had given about his missing emails. He said he believed the prescription clerk had ‘attempted to avoid being held accountable’. Mr A also asked if this was the Practice’s final response on the matter.
36. Mr A emailed the Practice on 28 April at 9am stating his dissatisfaction. He said he would be requesting full details of the other alleged email errors, possibly through the police or his legal representative.
37. Mr A sent an email to the Practice on 3 May at 10.05am, addressed to his doctor and asking if they had looked at his previous emails and complaint. Mr A said he was dissatisfied with the situation and once he received the final response he would escalate the matter to both us and the police.
38. Mr A also emailed the Practice on 3 May at 11.31am to convey his dissatisfaction with the explanation the Practice gave on 27 April about the missing emails.
39. The Practice responded to Mr A on 3 May at 4.21am explaining it would email him its final response once the practice manager and his doctor had discussed the matter further. The Practice said Mr A should get in touch to arrange a consultation if he experienced ongoing or worsening anxiety and would like medical help.
40. We can see the Practice issued a final response to Mr A on 10 May. This reiterates the information it gave in its response on 27 April and the Practice attached a copy of the email it sent NHS Digital on 20 April. The Practice said it got a reply from NHS Digital on 25 April to say all recoverable emails had been restored, but the Practice was still unable to find Mr A’s missing emails.
41. The Practice added it did not dispute Mr A sent the emails, but they were not received in the Practice’s inbox or spam/junk folder.
42. The email attachment dated 20 April confirms the Practice contacted NHS Digital to ask if Mr A’s emails dated between 30 March and 4 April 2022 could be retrieved. The Practice gave NHS Digital Mr A’s email address to help with the search and confirmed it had seen evidence from Mr A of the emails being sent to the Practice’s correct email address.
43. Mr A replied to the Practice on 10 May at 4.14pm and 11 May at 9.18am to say he was unhappy with its response and it had failed to investigate his initial complaint.
44. The Practice replied to Mr A on 11 May at 1.37am stating it had no further comment to make and would not enter any further conversation on the matter. The Practice clarified it was satisfied with the prescription clerk’s conduct.
45. We appreciate the matter has caused Mr A to lose trust in the Practice. We also know he wants the Practice to admit it ‘intentionally deleted’ his emails.
46. We are sorry to hear the matter affected Mr A’s mental health to the point he needed hospital treatment. We understand this is important to Mr A and do not wish to diminish the impact on him. But an investigation would not be able to establish this matter alone was directly responsible for his decline in mental health or his hospitalisation.
47. We appreciate Mr A is unhappy the Practice has been unable to locate the emails he sent it between 30 March 2022 and 4 April 2022. But an investigation into the matter would not be able to produce the outcome Mr A wants.
48. With all the above in mind, we consider it would be disproportionate for us to investigate the matter further as this would not yield a different outcome to what the Practice has already done. So no further action is needed on this complaint component as we consider there are no unremedied injustices outstanding.
49. We appreciate the outcome of our primary investigation to unlikely to be what Mr A was hoping for. We recognise the upset and frustration Mr A experienced and would like to thank him for taking the time to tell us about his complaint.