The Princess Alexandra Hospital NHS Trust

3. Ms E complains about the Trust’s gynaecology department and its service between February 2018 and February 2019. She complains:

· after three referrals were made for irregular periods, the Trust failed to diagnose her with premature ovarian insufficiency (when the ovaries stop making normal levels of certain hormones) or perimenopause (the transitional time around menopause). She feels it should have considered perimenopause, and asked her about other symptoms, but instead it only asked about hot flushes.

· the Trust should have prescribed her hormone replacement therapy (HRT) for her symptoms.

4. As a result, Ms E says she has spent longer than necessary having symptoms of perimenopause. This is because she did not know she had premature ovarian insufficiency until she saw a private health provider in February 2021, who diagnosed her and prescribed her HRT. Ms E also feels her symptoms may not have been as severe if she had got a diagnosis and HRT sooner. Ms E told us her symptoms had a huge impact on her mental health and her ability to function as they worsened her ADHD (attention deficit hyperactivity disorder) symptoms. She says she was misdiagnosed with autism spectrum disorder because of her symptoms.

5. Ms E told us she would have felt reassured about what she was going through if she had had a diagnosis sooner, as she was questioning what was causing all her symptoms. She also developed mild osteopenia (a weakening of the bones due to lower bone density), which she feels may not have happened if she had received HRT sooner.

6. Ms E says she also had other private healthcare costs because of what happened, as she was getting private treatment for chronic fatigue syndrome (extreme long-term tiredness). She says her menopausal symptoms were mistaken for chronic fatigue syndrome, and she may have avoided these costs if the Trust had recognised the cause of these symptoms straight away. She feels she would also have avoided private migraine consultations and costs.

7. To resolve the complaint, Ms E would like the Trust to acknowledge the failings and apologise for what happened. She would also like the Trust to improve its service to prevent other people having the same experience. Ms E is seeking financial compensation for her private healthcare costs and to acknowledge the impact on her life, the emotional and cognitive impact on her and the pain she experienced.

9. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable. We have discussed this with Ms E to understand her circumstances and the outcomes she wants. We do not look at whether legal action would succeed but whether it would be a reasonable option to look into.

10. Based on what Ms E has told us, we think she could pursue the complaint via a clinical negligence claim.

11. Ms E told us she wants financial compensation for her private healthcare costs and to acknowledge the impact on her life, the emotional and cognitive impact on her, and the pain she experienced. She looked at our severity of injustice scale and she told us she felt her situation falls into level three to five on our scale.

12. Each level on our scale shows a range of the payment amounts we would usually recommend in those circumstances. The amounts for level three to five are between £500 and £9,950.

13. Ms E also gave us some information about her private healthcare costs, which she says she incurred because of what happened. Based on the information she gave us, we think these costs total £5,868. As this is a large amount, it might be better for her to seek the outcome she wants from legal action.

14. Ms E would also like the Trust to apologise for the failings, accept these and improve its service. Although a court cannot order remedies in the form of apologies, service improvements, or explanations, she may be able to get these outcomes by making a legal claim.

15. When we talked about legal action with Ms E, she told us she had already been to a solicitor. She said they told her they would not be able to take her case on. She said she did approach this solicitor before she was on hormone replacement therapy, so things may have changed. We asked Ms E if she could show us some evidence of the solicitor’s advice, and she said she could not, as she could not remember the name or the company and she could not find any email correspondence. She said it is possible her communication was by phone and letter.

16. We accept what Ms E has told us about her contact with a solicitor. However, this does not mean she has no other legal action available to her. We think Ms E may be able to make a clinical negligence claim and we have not seen any evidence to show Ms E has exhausted this option. As Ms E has only contacted one solicitor and we have not seen any evidence of this, we think she should look further into whether she can pursue this complaint via a legal route.

17. We cannot be sure at this stage that other firms would tell Ms E the same as the firm she spoke to. We therefore cannot say legal action is unreasonable in Ms E’s case.

18. We looked at whether there were any barriers that would make a legal process difficult for Ms E. As Ms E has already successfully contacted a solicitor, we think this shows she could pursue a legal route without any barriers. Ms E did tell us she has dyspraxia (problems with movement and co-ordination), which, she said, means she is slow at writing and she does not always find it easy to organise her thoughts on paper or put together project files. We think a solicitor could communicate with Ms E in the same way our organisation has been, and this would not make a legal route unreasonable.

Summary

19. Based on the information Ms E has given us, we cannot investigate the complaint. This is because we believe she could possibly get the outcome she wants by taking legal action and this is something she should look into further. For this reason, we will not take any further action.

20. We have given Ms E details of where she can find more information about the legal process. If she looks into this and finds there is no legal route available to her, she can bring her complaint back to us if she remains unhappy. If she were to come back to us in future, we would keep in mind we cannot take on issues which the courts have already looked at.

21. If Ms E brought her complaint back to us, we may also need to think about our time limit. The law says a person needs to make their complaint to us within 12 months of becoming aware of the problem. We can put this time limit to one side but only if it is reasonable to do so.

1. The Parliamentary and Health Service Ombudsman has carefully considered Ms E’s complaint about The Princess Alexandra Hospital NHS Trust (the Trust).

2. We think Ms E could take legal action on the matter she has brought to us. We are sorry to learn about the reasons for Ms E’s complaint, and for what she has been through.