5. Mr O says the Practice did not respond when he made complaints between December 2022 and November 2023.
6. Mr O says the Practice not responding caused a delay in the surgery for his hernia. He explains it also caused stress, anxiety and low mood that negatively affected his mental health.
7. Mr O wants the Practice to pay him £2,950.
8. In 2022 Mr O had an inguinal hernia (hernia in muscle wall of groin) affecting his ability to do his job. His employer offered him private treatment so he could return to work.
9. Mr O first complained to the Practice on 8 December 2022. He complained again on 14 March 2023. The Practice gave a response when we contacted it on 10 November 2023.
12. When we try and decide if there was a failing in the care complained about, we first consider what should have happened in line with relevant policies, guidelines, standards and good clinical practice. We then use all available evidence to see if what should have happened, did happen. If it did not, we then consider if what did happen fell so short of the expected standards that it amounts to a failing.
13. If we find there has been a failing in the care and treatment provided, we then consider the impact of this. If the failing has had a negative impact, we consider what actions the organisation has already taken to put things right. If we think it has not done enough to put things right, we may make recommendations for further action.
Complaint handling
14. Mr O says the Practice did not respond to the complaints he made in December 2022 and 14 March 2023 which delayed his hernia surgery and he had avoidable pain for longer than needed. He says explains how he had to chase up the Practice and he felt ignored when he had pain and was waiting for surgery. When recovering from surgery he experienced stress, anxiety and low mood that negatively impacted his mental health.
15. Mr O made a complaint about his referral for an ultrasound (scan of inside the body) of his hernia, and about no response to e-consult (online NHS consultation service patients can use) requests on 8 December. The complaint he made on 14 March 2023 was about a response to the occupational health adviser (OHA – for work related health).
16. The evidence we have seen shows Mr O asked the Practice for a response on 17 and 24 May 2023. He complained to us on 19 June and on 13 July we e asked the Practice to send Mr O a response. The Practice did not do this, so we sent it another letter to it on 31 July. The Practice said it would respond on 7 August, but it did not. On 10 November, the Practice responded.
17. The NHS Complaints Regulations 2009 Act says the responsible body to which a complaint is made, must investigate the complaint appropriately to resolve it quickly and efficiently. It states that this should be within six months of the complaint being received. Although it can take a longer, the complainant must be kept up to date when there is a delay.
18. The Practice’s complaints page says it will acknowledge a complaint within three working days and contact the complainant to agree how best to deal with it and give a reasonable timescale for this.
19. Based on when Mr O complained, we would expect responses in June and September 2023. The Practice also should have acknowledged Mr O’s complaints within three working days of receipt. The Practice did not meet these expectations. It has admitted it did not acknowledge or respond to Mr O’s complaints in December 2022 and there was a delay in responding to the complaint made in March.
20. We have found failings in the Practice’s complaint handling because of these issues. We will now look at what impact this failing had on Mr O. The complaint responses were expected by June and September 2023. Mr O’s surgery was done on 5 May.
21. Mr O was first assessed and referred for NHS treatment between November 2022 and January 2023 but after an offer from his employer, the OHA contacted the Practice on 10 February asking for information to get this treatment. The Practice emailed the approval of treatment to the OHA on 14 March and on the same day, Mr O made the complaint about the delay in responding to the OHA. The information requested by Mr O’s employer is not work we would expect the NHS to do. So, the delay in responding to the OHA is not what we are investigating. Mr O did not ask us to look at this and it is not something that we have powers to investigate.
22. Complaint responses would not have been needed until after Mr O’s treatment so the delays in complaint handling did not lead to a delay in treatment.
23. We appreciate that the Practice did not respond to Mr O’s complaints and he says he had to contact it many times. We understand this caused Mr O anxiety and stress. We also appreciate that the Practice’s poor communication meant he did not know about its response to the OHA.
1. After careful consideration we have decided to partly uphold Mr O’s complaint.
2. We have found a GP practice in the London area (the Practice) did not respond to Mr O’s complaints. This did not cause delays in treatment or have a medical effect but we understand it caused Mr O distress.
3. We have recommended that the Practice pays Mr O £150.
4. We are sorry to learn of the distress, anxiety and frustration Mr O experienced because of these events.
24. We looked at our ‘Principles for Remedy’ (our Principles). These state that where poor service or maladministration (fault) has led to injustice or hardship, the organisation responsible should take steps to put things right.
25. Our Principles say that public organisations should put things right and, if possible return the person affected to the position they would have been in had the poor service not happened. If that is not possible, they should compensate them appropriately.
26. We found failings with the complaint handling that led to anxiety and distress. We looked at whether the Practice has done anything to put this right.
27. The Practice apologised for the distress Mr O experienced in its of November 2023 response. The Practice said it has changed its process for how it receives, acknowledges and handles complaints and staff have had training to improve complaint handling. The practice manager who was responsible at the time when Mr O made his has now left the Practice.
28. Mr O also wants a payment to put right things right for him. The Practice did not make a payment and said it would not consider this.
29. Mr O told us he wanted between £500 and £29,50. The failings in complaint handling did not lead to a delay in treatment and we saw that the complaint responses would not have been expected until after his private surgery was done.
30. We understand Mr O was worried that the offer from his employer to pay for the surgery would be withdrawn.
31. Mr O waited 11 months in total for a response to his complaint and his distress and frustration increased during this time, especially in regards to the response to the OHA.
32. We note the request from the OHA was received on 10 February 2023. Mr O was assessed at the hospital in March and had his surgery in May 2023. this means the concern about delays to, or cancellation o, treatment would not have been for more than a month.
33. We understand that after his surgery, Mr O left the Practice due to his experience.
34. Our guidance on financial payments explains that for a level three impact (this starts at payments of £500) we would expect to see very poor complaint handling with delays of over a year or with delays of over six months combined with other failures like incorrect or incomplete responses. Mr O was not affected in this way so we would not recommend a payment in this range.
35. A level two impact would include poor complaint handling where there is a delay of more than a few weeks, up to around one year. The emotional impact would be distress, worry, annoyance but not affecting a person’s daily life or ability to live a normal life.
36. We think this is more in line with Mr O’s experience. A payment at this level would be between £100 to £450.
37. We have recommended for the Practice to pay Mr O £150 for the emotional impact.
38. We have been sorry to learn of Mr O’s distressing experience. We thank him for bringing his concerns to our attention.