10. Before we decide if we should do a detailed investigation of a complaint, we look at whether there are signs the event complained about had a negative effect on the person that the organisation has not put right. We have done this and think the Practice has already done enough to put right the impact of these events.
11. The Practice accepted the care Miss I received during her check-up fell below the expected standard. Miss I says when the GP could not get the blood pressure monitor to work they said to her, ‘I think you’re the problem. I think you should come back when you have lost weight’. The Practice apologised for these comments. It described the comments as ‘off the cuff’.
12. Miss I told us the GP questioned her about her baby’s skin colour after Miss I explained both she and her partner have mixed heritage. The Practice accepted the GP could have dealt with this better. But the Practice does not link what happened during the check-up with Miss I’s claimed impact of a decline in her mental health.
13. We are sorry to hear about Miss I’s experience and the effect it had on her. We appreciate Miss I went to her Practice at a time when she was feeling quite vulnerable, having just given birth to her second child in three years. Miss I told us she had been feeling quite low and she planned to speak to the GP about her mental health during the check-up.
14. The Practice asked another doctor to investigate Miss I’s complaint. This is in line with our ‘Principles of Good Complaint Handling’. The Practice sent its first complaint response to Miss I within 40 days of getting her complaint, in line with its own policy.
15. Our ‘Principles for Remedy’ say organisations should quickly identify and acknowledge when things have gone wrong and apologise if there has been poor service. An apology means:
• acknowledging the failure • taking responsibility for it • explaining clearly why it happened • expressing sincere regret for any injustice or hardship caused.
16. The Practice agreed with Miss I that the GP’s comments were not appropriate. It also agreed the GP did not address the question of ethnicity in an appropriate way, and it apologised on the GP’s behalf.
17. Our ‘Principles for Remedy’ also recommend:
• changing procedures to prevent the same thing happening again • training • supervising staff.
18. In its first response, the Practice suggested a different way to accurately identify the baby’s ethnicity could have been used. The Practice also said the GP who saw Miss I had spent time reflecting on Miss I’s experience and had ‘used the complaint as a learning experience’.
19. We consider these actions show the Practice has acted in line with our principles. These actions are typical of what we would expect an organisation to do when making improvements after a complaint has been made.
20. We appreciate how upsetting Miss I found the comments about her weight and ethnicity of her baby. We understand she felt unsupported but uncomfortable to speak to her GP because of what happened.
21. During the appointment the GP asked Miss I about her mental health and wellbeing. The GP completed a GAD-2 questionnaire (a screening technique used to monitor generalised anxiety disorder) and Miss I’s score (0/6) did not give any cause for concern.
22. We looked at Miss I’s medical records and notes made during appointments she had after the one on 10 March. At some of these appointments we can see she was asked about her health and wellbeing. Notes from a consultation on 30 March, three weeks after the appointment complained about, say Miss I ‘denies feeling depressed, sad, or anxious’.
23. Alongside the routine check-ups Miss I had, she also contacted the Practice many times in the six months after the events she is complaining about. As an asthma patient, Miss I regularly contacts the Practice for prescriptions, and in the first few months after the birth she experienced bad migraines. During this time the records show she had telephone conversations or face-to-face appointments with different Practice staff.
24. We appreciate Miss I’s reluctance to speak up on 10 March about how she was feeling. We can see she had many other opportunities to speak to different staff about this issue. We think she could have spoken to any of the staff about her mental health concerns.
25. Having considered all the information, we are persuaded the Practice has been open and honest when investigating this complaint. We have seen the Practice identified where things went wrong and took action to put it right. We consider the Practice’s actions to be enough to put right Miss I’s experience.
26. We have also seen Miss I was dealing with mental health concerns before the appointment she is complaining about. The Practice actively monitored her physical and mental wellbeing in the months that followed, giving her many opportunities to discuss any concerns she had.
27. We thank Miss I for bringing this complaint to us. For the reasons explained, we will not be investigating the complaint further.