The Trust did not tell Mrs O about the CT scan image and did not treat her
10. Before we decide if we should do a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found that the Trust did anything wrong.
11. Mrs O says nobody from the urology department told her about her enlarged left kidney and kinked ureter. She says the Trust should have given her an appointment, explained it to her and given her treatment. She says it is the reason for her pain and her urinary problems.
12. The GMC is responsible for regulating and setting professional standards for doctors in the UK. The GMC guidance says a doctor must provide or arrange suitable advice, investigations or treatment where necessary.
13. We asked our adviser about the CT scan image that Mrs O saw. Our adviser agreed with the Trust that it showed Mrs O has an extrarenal pelvis (where the renal pelvis extends outside the kidney). They explained a large amount of the population have this difference in their anatomy and it is not linked with any symptoms. Our adviser said there was no need for the Trust to tell a patient about the extrarenal pelvis because it is not a concern that needs to be treated.
14. We understand how upset Mrs O is with how she found out about this. When we weigh up the evidence, it seems there was no reason for the Trust’s urologists to tell Mrs O about the issue and it did not need to give treatment in line with the GMC guidance. The finding on the scan does not cause symptoms, so we cannot say it is the cause of her pain or urinary issues. We do understand why she thought there could be a link. We do not see anything wrong in the Trust’s actions.
The Trust refused to treat Mrs O in the future because of the complaint
15. The NHS Complaint Standards say organisations should make sure a patient’s care is not compromised if they make a complaint. So it would be wrong if the Trust had said it would not treat Mrs O in future because she had complained.
16. We can see that Mrs O did not go for a flexible cystoscopy (an examination to look inside the bladder) on two occasions, so the urology department discharged her back to her GP. Discharging a patient from a service is not the same as ending a professional relationship with a patient and refusing to see them again.
17. The Trust says it will treat Mrs O in the future. There is nothing stopping Mrs O’s GP from referring her to the Trust again. We hope this reassures Mrs O that making a complaint has not affected her ability to be treated by the Trust.
18. The Trust did not refuse to treat Mrs O in the future because she made a complaint. It discharged her back to her GP for a different reason. The Trust did not act outside the NHS Complaint Standards. We can see it did not do anything wrong.
The Trust only sent the second full response after we asked for it
19. After the Trust replied to her original complaint, she handed in another complaint letter on 14 September 2021. and The Trust acknowledged receipt the next day. It noted the details of the complaint on 14 October 2021. We asked the Trust for the status of the complaint on 21 April 2022 and it was waiting to sign off the response letter. The Trust sent the final response letter on 28 April 2022.
20. Our NHS Complaints Standards says organisations should resolve complaints at the earliest opportunity and keep complainants updated. The Trust did not keep Mrs O updated during this time. There is no indication of why it took over six months to respond to her second complaint that was a follow up. The Trust could have communicated better. We appreciate having to wait and ask us to chase the Trust for a response must have been frustrating for Mrs O. We thought about whether we should look into this further.
21. Mrs O wants a financial payment. We do not think the Trust’s delay in sending the final response merits a payment because the impact of waiting was relatively minor and her main concerns are about what the scan showed. We have decided not to look at this part of the complaint further.
22. Mrs O has had a difficult experience and we understand why she was worried. We hope our decision and knowing she can return to the Trust if she needs treatment in the future reassures her.