Manchester University NHS Foundation Trust

3. Mrs U complains about the Trust’s care and treatment when she attended the emergency department (ED) on 13 February 2022. She complains the Trust:

• did not do appropriate tests in a timely way • did not prescribe antibiotics as recommended in her Christie protocol card • said she did not have neutropenic sepsis (a life-threatening condition that happens when an infection overwhelms a weakened immune system) but her notes state ‘neutrophils appear toxic and left shifted’.

4. Mrs U says shortly after attending the Trust she was admitted to the Christie Hospital (a separate Trust that is not part of this investigation) for over three weeks with neutropenic sepsis, mucositis (a condition characterised by pain and inflammation of the body's mucous membrane), peripheral neuropathy (a disease affecting peripheral nerves that causes weakness, numbness and pain in feet and hands), high temperature, COVID-19 and severe fatigue. Mrs U says the delay in care at the Trust made these symptoms worse.

5. Mrs U said she had to take 15 months off work because she struggled to walk without a walking stick. She said she has changed her job role so she can sit. Mrs U said she believes if the Trust had acted quicker, she may not have experienced peripheral neuropathy and difficulty walking.

6. Mrs U would like the Trust to make service improvements. She would also like financial compensation.

7. Mrs U went to the ED in the early hours of 13 February 2022 because she had a high temperature, COVID-19 and back pain. She said she wanted to go to the Christie Hospital where she was having treatment for breast cancer, but it advised her to go to the Trust as it did not have a bed for her.

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 in the circumstances. We discussed this with Mrs U to understand her circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look into.

10. Mrs U thinks the Trust was negligent. Mrs U could make a clinical negligence claim.

11. We contacted Mrs U to confirm her complaint and the outcomes she wants. In this telephone call, Mrs U said service improvements were the most important outcome for her and compensation was secondary. We sent Mrs U our guide to financial compensation (severity of injustice scale) so she could see the types of recommendations we make depending on how a person has been affected. Mrs U thought her complaint falls into level four on the scale.

12. We asked Mrs U if there were any barriers to her taking legal action and if she would be willing to do this.

13. Mrs U asked how a legal case would stop the same things from happening to somebody else. We explained that although clinical negligence claims are solely for compensation, service improvements could happen as a by-product of taking the legal route. For example, if the courts found negligence, the Trust would be obligated to make sure it did not happen again.

14. We consider the legal route is more appropriate for Mrs U to explore at this stage, given that she could achieve all the outcomes she is looking for.

15. Mrs U mentioned she felt taking legal action may be too stressful for her. We explained a solicitor would be representing her and would be able to help with any stress she felt about the situation. Mrs U said she would like some time to discuss the legal route with her sister and if compensation is really an outcome she is hoping to achieve. Mrs U decided to get some legal advice. We appreciate Mrs U wants to do this and to make a decision about what to do after.

16. Because Mrs U confirmed she is getting legal advice, we are satisfied she is willing and able to explore legal action and there does not seem to be anything stopping her from taking this step. There is a clear legal route for Mrs U to take so we cannot continue to investigate at this time.

17. If Mrs U explored legal action but is advised she is unable to make a clinical negligence claim, or she feels that her outcomes have not been achieved, she can bring her complaint back to us. We advise her to do this quickly. This is because, by law, we expect people to complain to us within a year of becoming aware they have reason to complain. But we can put this time limit aside if we think it is reasonable to.

18. We recognise this has been a distressing experience for Mrs U. We thank Mrs U for bringing her complaint to us.

1. The Parliamentary and Health Service Ombudsman has carefully considered Mrs U’s complaint about Manchester University NHS Foundation Trust (the Trust). We consider Mrs U could take legal action on the matter she has brought to us.

2. We are sorry to learn about the circumstances of Mrs U’s complaint and the impact this had on her. We appreciate this must have been a distressing time for Mrs U and her family and we appreciate her bringing this complaint to us.