London Ambulance Service NHS Trust

4. Mrs I complains on behalf of her father, Mr O, about the Trust. Mr O had stroke symptoms on 15 November 2022 and called for an ambulance immediately.

5. Mrs I complains it took three hours from their first call and a minimum of four phone calls for the ambulance to arrive. Mrs I complains that when her father reached hospital, it was too late for tissue plasminogen activator treatment to be used (tPA is a protein that breaks down blood clots). Mrs I complains the ambulance team said the time gap for stroke treatment is ten hours, but the hospital said it is four.

6. Mrs I says because of the delay her father has complete right-side paralysis (when you cannot move the right side of your body). Mrs I says her father: • is now incontinent • has from aphasia (difficulty with language and speech) and apraxia (a brain disorder making movements difficult) • has severely reduced memory • needs one to one care in a nursing home.

7. Mrs I says her father was very active for his age before having the stroke. Mrs I says the seriousness of her father’s symptoms are because of the delayed ambulance, which led to the hospital saying it was too late for tPA.

8. Mrs I also says the family has faced ongoing financial difficulty due to caring costs. She says this could have been avoided if Mr O had got the treatment he needed at the right time.

9. Mrs I would like the Trust to admit service failures and to make service improvements. Mrs I would also like a financial payment.

10. Mr O had stroke symptoms in the morning of 15 November 2022. His wife called for an ambulance at 10.16am. The emergency call handler triaged the call as category two priority (the target for this is an average response time of 18 minutes and for 90% of calls is responded to within 40 minutes).

11. Three more calls were made at 11.42am, 12.37pm, and 12.52pm. The Trust did not change the call category. An ambulance crew arrived at 12.59pm. After assessment, they took Mr O to the stroke unit of the hospital and his care was handed over at 1.47pm.

12. Mr O arrived on the stroke unit four hours and 47 minutes after his symptoms started.

14. The Health Service Commissioners Act 1993 says we cannot investigate a complaint where a person has the option to take legal action, unless we consider this is unreasonable in the circumstances. We have discussed this with Mrs I 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 in to.

15. Adding to how Mrs I told us Mr O and his family were affected by what happened, she says care costs have been estimated at £1,700 per week for a live-in carer and for other carers to come in up to four times a day.

16. Based on these factors Mrs I could make a claim of clinical negligence. Mrs I would be able to claim the Trust breached its duty of care towards her father.

17. Mrs I wants service improvements and a financial payment. We discussed with Ms I the maximum amount we would recommend in this situation if we were to investigate and uphold the complaint. Mrs I said when she originally brought the complaint to us the family were more focused on service improvements than financial outcomes. But because of the care costs, a financial payment was more important to them.

18. As the costs will be well into the thousands, this suggests a legal route would be better as it can achieve higher payments in line with what Mrs I wants.

19. Unlike us, service improvements are not outcomes a court can directly provide. As this is now a secondary focus, we should not prioritise getting these at the expense of losing any opportunity for the best financial outcome. For these reasons we think it is reasonable for Mrs I to explore her legal options.

20. We asked Mrs I if there are any barriers that may stop her from taking legal action. Mrs I said there are no barriers she is aware of and she would likely speak to ‘no win, no fee’ solicitors. Mrs I later confirmed by email that she and her family are now looking to take legal action.

21. Should Mrs I be unable to achieve all of her outcomes through court action, she can ask us to consider her complaint again. If she needs to do this, she should come back to us quickly because we still need to consider our time limit.

1. We have carefully considered Mrs I’s complaint about London Ambulance Service NHS Trust (the Trust).

2. We are sorry to hear about the events that led to Mrs I’s complaint. We understand it was distressing for her and her family and empathise with the situation they are now facing.

3. We have decided not to look at this complaint further at this stage because we think Mrs I could take legal action. We explain the reasons for this decision below.