Cambridge University Hospitals NHS Foundation Trust

Miss V complains about the care provided to her son, U, by the Trust in April 2018. She explains that:

• the Trust staff did not put a proper safeguarding process in place when U was unwell and admitted into care • the Trust staff did not share U’s scans with her promptly • on 13 April 2018, the Trust staff did not successfully take a cerebrospinal fluid sample (way of looking for conditions that affect your brain and spine) from U • on 22 April 2018, there was a communication breakdown between the safeguarding team and Ward staff about U’s parents attending the ward • on 27 April 2018, the Trust staff did not get parental verbal consent to give U a lumbar puncture • there was a lack of transparency, openness and inclusion about updates on U’s care and treatment • the Trust staff did not provide appropriate accommodation to allow Miss V to breastfeed while under supervised contact.

4. Miss V says she has ‘lost faith’ in the NHS and she has experienced frustration and significant distress. Miss V says she was left feeling ‘unfairly treated’ as she was excluded from U’s treatment.

5. Miss V would like an apology and acknowledgement of failings. She is also seeking service improvements.

6. We have considered the following information when coming to our decision on this complaint:

• Miss V’s complaint form and the information she provided by phone • the Trust’s complaint correspondence.

7. We use relevant law, policy, guidance and standards to inform our thinking. This allows us to consider what should have happened. In this case, we have referred to section 9(4) of the Health Service Commissioners Act 1993 (the law).

8. The law says a person needs to make their complaint to us within one 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.

9. Miss V confirmed she knew of her reasons to complain during U’s admission in April 2018. To be within our time limit, she needed to come to us by April 2019. Miss V brought her complaint to us on 18 November 2021. Her complaint is two years and six months outside of our time limit. We have discussed this with Miss V to understand her reasons for the delay. We also considered the time the Trust took to respond to this complaint.

10. Miss V told us she did not approach the Trust with her initial complaint until January 2020 because it had been a very traumatic time for her family, so this complaint was ‘not her priority’. She told us that her children were in foster care until April 2019, and she had to attend a court case for custody of her children which was very distressing and ‘emotionally challenging’. She also explained U was undergoing chemotherapy treatment while in foster care, and this caused her additional worry and distress.

11. Miss V also explained she was affected by the COVID-19 pandemic. Her partner was working away from home, and she had home schooling responsibilities for her children. Miss V explained that on receipt of the Trust’s initial response, she had to take a long time to look through U’s records because her complaint was very complex. This caused additional delays during the complaints process.

12. We can only imagine how worrying U’s ongoing ill health must have been for Miss V. This, coupled with the pressures of her ongoing custody case and the subsequent COVID-19 pandemic, was clearly a difficult and distressing time for her and her family. We are sorry to hear how upsetting this was.

13. We first considered the delay until April 2019. As outlined above, it appears Miss V had the ability to engage independently with ongoing legal proceedings during this period. It is difficult for us to say she was not able to approach the Trust earlier to raise her initial complaint.

14. Miss V then submitted her formal complaint to the Trust in January 2020. This is approximately eight months after her legal proceedings and U’s chemotherapy treatment had ended. In her complaint form, Miss V said the Trust ‘were happy to accept her complaint’ because of the distress and difficulties she had experienced during the legal proceedings and with U’s health. That said, there is no clear explanation about why Miss V took a further eight months after the legal proceedings finished to submit her complaint. Without this delay, it is difficult to say she could not have approached the Trust earlier.

15. We recognise the COVID-19 pandemic caused more pressures for Miss V. We are sorry to hear home schooling and her partner working away from home caused further disruptions and demands on her family life.

16. As explained above, Miss V first raised her complaint with the Trust in January 2020. The first national lockdown was put in place on 26 March 2020, and schools reopened on 1 June 2020. We cannot say the lockdown delayed her initial complaint to the Trust.

17. We have also reviewed Miss V’s initial complaint letter to the Trust. We can see Miss V wrote and signed the letter, which was accompanied by a statement from a family friend. We have seen no signs Miss V was not able to bring the complaint to the Trust herself, or that her partner had to act as her representative. We consider her partner working away from home was not a significant barrier to her raising this complaint sooner.

18. Finally, we considered the delays during the Trust’s investigation of this complaint. The Trust sent its first response to Miss V in September 2020. Miss V then sent a follow-up complaint in May 2021. Miss V explained it took her eight months to answer the Trust’s initial response because her complaint was complex and she had to review U’s records.

19. Having reviewed the second complaint letter, we can see Miss V did go into extensive detail in respect to U’s records. This is clearly a complex case, as the Trust took ten months initially to investigate the issues raised. It is reasonable to expect Miss V would also need time to process and review all the information before she could raise further questions about U’s treatment. We note Miss V also had to go through two national lockdowns, which would have placed more demands on her time and caring for her children. Taking all this into account, we consider the eight-month delay during the complaints process to be reasonable.

20. In summary, we found there was a significant delay of one year and nine months before Miss V approached the Trust with her complaint. We consider she could have reasonably approached the Trust much sooner with her concerns. We have decided not to consider this complaint further because it falls outside our one-year time limit. In making this decision, we do not wish to diminish in any way how distressing it must have been for Miss V to witness her son being unwell during his hospital admission. We would like to take this opportunity to wish her and her family the very best for their future.

1. We have carefully considered Miss V’s complaint about Cambridge University Hospitals NHS Foundation Trust (the Trust). We are very sorry to hear Miss V felt the Trust staff did not include her in decisions about her son’s treatment in April 2018. We recognise this caused her significant distress and she felt ‘let down’ and has lost faith in the NHS. We also appreciate she has taken significant time and effort to raise her complaint with us. We are grateful for the time she has taken to speak to us.

2. Unfortunately, Miss V’s complaint falls outside our one-year time limit. We have not seen a strong reason to set aside our time limit, so we have decided not to consider this complaint further. We explain our decision in more detail below.