A practice in the Suffolk area

3. Mr I complains the Practice prescribed him simvastatin (medication to reduce cholesterol) at a dose of 40mg with amlodipine (medication to treat high blood pressure), when the maximum recommended dose was 20mg. He complains this continued for around a decade between 2012 and September 2022 and the Practice did not pick this up during any of his annual medication reviews.

4. Mr I is concerned that he is at risk of long-term complications from taking simvastatin at a dose above the maximum recommended amount.

5. Mr I wants an explanation and apology from the Practice, as well as service improvements to make sure this is not happening to other patients.

6. Mr I was taking this medication after a triple heart bypass.

7. In September 2022 Mr I had an annual medication review with a pharmacist from the Practice. They advised a dose of 40mg was higher than the maximum recommended dose.

8. The maximum recommended dose was changed according to a Medication and Healthcare products Regulatory Agency (MHRA) drug safety update in 2012. That advised that the maximum recommended dose to be taken with amlodipine should be 20mg.

11. To decide if we should do a detailed investigation into a complaint, we look at what outcome is wanted to resolve the complaint. Our guidance says we can resolve a complaint without doing a detailed investigation if we can deliver the outcomes wanted at an earlier stage in our process.

12. Mr I told us the main outcomes he wants are an apology and explanation of how and why the mistake happened. He said he also wants an explanation of the improvements the Practice has made to make sure a similar issue does not happen to him or other patients in the future.

13. Mr I also wants confirmation that he is not at risk of long-term complications.

14. In its response to Mr I’s complaint, the Practice apologised it did not pick up the prescribing of the higher dose of simvastatin with amlodipine. It seemed to accept a failing. The Practice explained the risk of this medication could be muscle pain and this would be reversible. It said as Mr I had not reported muscle pain, he had not suffered any side effects.

15. Mr I told us he would be open to resolving the complaint through communication with the Practice, particularly if it could explain the reasons the issue was missed and any improvements it had made.

16. We looked into the possibility of a resolution meeting with the Practice. The Practice agreed to meet with Mr I to explain what happened with the prescribing and any service improvements it had made.

17. We got advice from our adviser who reviewed the Practice’s response and confirmed it had given the correct information about the potential complications of taking this medication.

18. They also confirmed that despite the Practice prescribing above the maximum recommended dosage, Mr I was not at increased risk of long-term complications. They said this was because his medication had already been changed from simvastatin to atorvastatin (used to treat high cholesterol) and any potential side effects stop within weeks.

19. We gave this information to Mr I, who confirmed he understood it. He also confirmed he was still open to resolving the other parts of the complaint by meeting with the Practice. The Practice invited Mr I to discuss his concerns with a GP partner on 9 November 2023.

20. Mr I has been given the reassurance he needed about possible long-term complications and has been able to meet with the Practice to discuss the other issues. Mr I told us the meeting had been useful and he now considers the complaint closed.

21. Based on this, Mr I’s outcomes have been achieved and we do not need to take any further action.

22. We recognise that Mr I has experienced distress and we hope the actions taken by the Practice go some way to putting this right.

1. We have carefully considered Mr I’s complaint about a GP practice in the Suffolk area (the Practice). We recognise the worry Mr I experienced because of the situation with his cholesterol and blood pressure medication. We are sorry to hear of the distress this caused.

2. We have decided not to consider Mr I’s complaint further because after investigation, we have achieved the actions Mr I was looking for. We consider the agreed actions have resolved Mr I’s complaint.