United Lincolnshire Hospitals NHS Trust

3. Mrs N complains about the care and treatment she received from the Trust on 28 May 2022 after having an accident and injuring her index finger. She says the Trust: • gave her a hepatitis B injection incorrectly • gave her wrong information about the side effects of the injection.

4. Mrs N says because the injection was not given correctly she has experienced pain, swelling, and stiffness in her shoulder and neck. Mrs N says she was in pain immediately after the injection and the swelling came out a couple of weeks later. She says the swelling lasted a couple of days, and the pain and stiffness was at its worst for about six months.

5. Mrs N went to her GP practice and they gave her some exercises to do. She also had private physiotherapy treatment which she paid for. She continues to have occasional pain in her shoulder. She explains she has lost faith in the Trust and is frustrated she was not given enough information about the side effects of the injection.

6. Mrs N wants the Trust to make service improvements so staff give patients the correct information. She would like the nurse who gave her the injection to be retrained.

7. On 28 May 2022, Mrs N went to the Trust’s A&E department and saw a doctor who did a risk assessment and told her she was at low risk. A nurse took some bloods and gave her the hepatitis B injection.

8. Mrs N says she screamed when the nurse injected her. She says she had never felt pain like it before. She says the nurse checked her arm, said it was fine, and told her it will be sore for up to a couple of weeks.

9. Mrs N feels the injection was given into her bone or too high up and questions why she was given the injection if she was low risk.

11. Before we decide if we should investigate a complaint, we look at whether there are signs the events complained about had a negative effect on the person, which the organisation has not put right. We look at what the organisation has done to put things right, consider what the complainant is looking for and weigh up if anything more needs to be done to resolve the complaint.

12. Mrs N wants staff to give the correct information and for the nurse who gave her the injection to be retrained.

13. In the Trust’s complaint response, it explains one of the most common side effects of a hepatitis B injection is soreness and stiffness which can last a few days to a few weeks. It apologises for Mrs N’s great pain and discomfort when she was given the injection.

14. The Trust says there is no evidence in its medical records to suggest there were any difficulties in giving the injection, which is something it would expect to see if there were. It says it would also expect for any difficulties to have been discussed with Mrs N at the time.

15. The Trust says the nurse who gave the injection was fully qualified and all nursing staff within A&E regular have training on giving injections. The Trust says any concerns or need for further training are always escalated to the department lead so this can be arranged.

16. The Trust apologises if the possible side effects were not clearly explained to Mrs N at the time, and she was not made aware of shoulder pain being one of the more common side effects.

17. The Trust says her complaint will be shared at the next departmental meeting to remind staff of the importance of explaining the possible side effects of medications to patients and what they should do if they are concerned. It apologises for Mrs N’s ongoing problems with her shoulder.

18. The Trust has confirmed its staff have regular training in giving injections. This is one thing Mrs N wanted. It has apologised if its communication was not clear and for the pain Mrs N has experienced since having the injection.

19. To make sure the Trust has done what it said it has, we asked it to give us supporting evidence. We have seen evidence of all staff in A&E having the needed skills and training to work in the department. Any issues raised are escalated to the Lead so further training can be arranged, and all staff who give injections complete medicine management competencies (an internal staff development process).

20. The Trust confirmed it has raised these concerns with the relevant department managers and also explained the nurse who gave Mrs N the injection no longer works for the Trust. It said managers will make sure other staff are aware of Mrs N’s concerns. This is so they can take learning and get additional support for any extra medicine management training that is needed.

21. The Trust also confirmed it will check its records of meetings to see when the complaint was heard at the governance meeting. If it has not been heard, this will be scheduled for either April or May 2023 as the governance meetings are held monthly.

22. We are satisfied the outcomes Mrs N wanted have already been achieved and we do not need to ask the Trust to do anything more. We recognise this may not be the outcome Mrs N expected but hope this statement clearly explains what she has achieved by making her complaint and seeing it through.

1. The Parliamentary and Health Service Ombudsman has carefully considered Mrs N’s complaint about United Lincolnshire Hospitals NHS Trust (the Trust). We understand how Mrs N has been affected by her experience at the Trust and appreciate the time and effort she has taken to bring her complaint to us.

2. We have had detailed discussions with Mrs N about her complaint and have spoken with the Trust. Having done this, we have decided the Trust has already done enough to put right what happened and we are not taking any further action.