3. Mr Y complains the Trust confirmed it would not investigate his complaint about his diagnosis.
4. Mr Y says he is frustrated his complaint has not been answered and a failure to diagnose a balance disorder affects his daily life. Mr Y says this has made his existing conditions worse and his left eyesight has been affected. He says he had to have private consultations to diagnose his balance disorder.
5. Mr Y wants a financial payment and apology from the Trust.
8. The Trust said Mr Y’s complaint had been investigated before. It said it had issued its decision in 2020 and Mr Y could complain to us if he was still unhappy.
9. Mr Y said his private neurologist did a vestibular function test (a series of tests to check the function of the inner ear balance organs) on 16 December 2022. He says the findings were abnormal. Mr Y contacted the Trust on 16 January 2023 to tell it this. Mr Y requested a reinvestigation of his neurological care between 2015 and 2020.
10. To consider if the Trust’s decision not to investigate Mr Y’s complaint is reasonable we have considered the events of previous complaints.
11. We note Mr Y has made several complaints to the Trust about several issues. The Trust provided a number of responses. We have focused specifically on the Trust’s responses to the issue of neurological care.
12. We have not noted all previous complaint correspondence between Mr Y and the Trust about his neurological care between 2019 and 2023. We have considered the significant correspondence that details the Trust’s actions and explanations for not doing another investigation.
13. We have seen the first complaint Mr Y made was by phone at 3.30pm on 25 June 2019. Mr Y complained the Trust had missed a diagnosis of cervical dystonia (a painful condition where your neck muscles contract involuntarily causing your head to twist or turn to one side) over the last three years. The phone call included a complaint about his ankle.
14. The Trust responded to Mr Y on 25 June and 20 August. The Trust did not directly address his complaint about neurology as it dealt with other parts of the complaint.
15. On 25 September Mr Y wrote directly to the Trust’s head of neurology to complain.
16. On 30 September the Trust acknowledged Mr Y’s complaint and explained it would be reviewed by a senior member of staff.
17. NHS website information on ‘How to complain’ says:
‘What to expect You should expect an acknowledgement and the offer of a discussion about the handling of your complaint within 3 working days of receiving your complaint.’
18. In line with this the Trust responded within three working days. A weekend fell between Mr Y’s complaint and the Trust’s response.
19. On 23 October a multi-disciplinary team (MDT is when staff from different areas of specialty meet to discuss an issue) meeting took place to discuss Mr Y’s neurological care. It is noted Mr Y did not have an identifiable neurological disease. The MDT looked back through all of Mr Y’s neurology records. It decided the assessments and tests done were unremarkable (did not find anything).
20. We have considered the NHS Complaint Standards that explain how all organisations who provide NHS services should approach complaint handling. Under being through and fair these say:
‘Organisations make sure all staff have the appropriate level of training, skills and authority to look into complaints thoroughly.’
21. An MDT meeting was appropriate so the relevant clinicians could discuss Mr Y’s complaint. This is in line with NHS Complaint Standards.
22. On 5 November 2019 the Trust responded to Mr Y’s complaint about his neurological care. It did not uphold his complaint and found no failings in his care and treatment.
23. On 9 and 13 January 2020 Mr Y contacted the Trust. He told it he wished to make a new complaint about neurology. He explained he had the opinion of a private neurological consultant. He said based on what they said he had concerns over his care and treatment from the neurological department between 2015 and 2019.
24. On 16 January the Trust wrote to Mr Y. It said if Mr Y had new information, he could share and it would consider the evidence. On 27 January Mr Y explained he would only share the private consultants report if the Trust agreed to cover the costs of the consultation and its process.
25. On 31 January 2020 the Trust wrote to Mr Y. It explained it would be happy to look at the private consultant’s report and consider its previous response. It said if appropriate it would get another opinion from a consultant neurologist outside of its organisation. It explained without the report it would be unable to consider the matter further.
26. We would not expect a trust to pay to receive a report that a patient has from a private healthcare provider.
27. The NHS Complaint Standards say under being through and fair:
‘Staff give everyone involved in a complaint the opportunity to give their views and respond to emerging information, where appropriate. They take everyone’s comments into account and act openly and transparently and with empathy when discussing this information.’
28. We consider it appropriate for the Trust to offer to consider Mr Y’s evidence. We have not seen evidence of the Trust refusing to consider his evidence. This is in line with NHS Complaint Standards.
29. On 3 February Mr Y emailed the Trust. Again, he said he would only provide the Trust with a copy of the private report, if it paid the cost of the private fees. He said if the Trust did not meet the costs of his care, it will have to proceed with the complaint without the expert opinion of the private neurologist.
30. We do not think the Trust refused to reinvestigate Mr Y’s complaint. The Trust requested the new evidence and offered, on receipt of this evidence, to consider if it changed its view.
31. On 27 February the Trust wrote to Mr Y. It explained its investigation decided the care he received was reasonable and appropriate. It explained if he provided written confirmation from his private neurologist on his new diagnosis then it would be happy to review his care in line with this. It said it may ask a clinician from another trust to do this review. The Trust also directed Mr Y to us.
32. The NHS Complaint Standards also say under being through and fair:
‘Staff make sure they tell people about their right to complain to the Ombudsman if they are not satisfied with the written final response at the end of the organisation’s complaint process’
33. The Trust actions are in line with NHS Complaint Standards. The Trust explained it did not have anything further to add and Mr Y should come to us if he was still unhappy.
34. On 1 May Mr Y wrote to the Trust. Mr Y confirmed he had come to us about two other issues with the Trust. He had not come to us about his neurological concerns. He once again asked the Trust to reinvestigate his concerns.
35. On 29 May the Trust confirmed to Mr Y it was reviewing its previous investigation and response.
36. On 21 August the Trust wrote to Mr Y. It confirmed a review of the care he received from 2015 to 2019 while under the neurology department had been completed. The outcome of this investigation was shared with him on the 5 November 2019. It said that after his correspondence in May 2020 it requested a second review of his care by a consultant neurologist who had not been involved in his care. This review was shared with him in the letter dated 30 July 2020.
37. The NHS Complaint Standards say when giving a fair and account response that:
‘When a complaint does not suit early resolution and needs more detailed consideration and investigation, this is done fairly. Where possible, staff who have not been involved in the issues complained about should look at the complaint. If this is not possible, the person looking into the complaint should openly demonstrate they are acting fairly when they consider all the issues.
38. The actions of the Trust are in line with NHS Complaint Standards. In the response a member of staff who was not involved with his care reviewed his complaint. We consider that by 29 May 2020 the Trust had reviewed its response and was happy with the care it had provided.
39. On 26 May 2021 we issued our decision on Mr Y’s complaint. We took neurological advice and found no failings.
40. NHS England says:
‘Unhappy with the outcome of your complaint?
If you are not happy with the way your complaint has been dealt with and would like to take the matter further, you can contact the Parliamentary and Health Service Ombudsman (PHSO) which makes final decisions on unresolved complaints about the NHS in England. It is an independent service which is free for everyone to use.’
41. Mr Y had his complaint investigated by us and no failings were found.
42. On 16 January 2023 Mr Y contacted the Trust. Mr Y explained a private neurologist did a vestibular function test on 16 December 2022. He says the findings were abnormal. He again requested a reinvestigation of his neurological care between 2015 and 2020.
43. We have not seen evidence that Mr Y’s diagnosis received on 16 December 2022 was linked to the care he had two years before at the Trust.
44. On 7 February 2023 the Trust told Mr Y it would not reinvestigating his complaint. We acknowledge Mr Y is unhappy with his care and we understand he is concerned he has not had the correct treatment.
45. We have seen the Trust provided two responses to Mr Y’s complaint. The Trust was satisfied with the care and treatment it provided. In line with NHS Complaint Standards, the Trust informed him we could consider his complaint about his neurological care between 2015 and 2020. Mr Y did come to us and no failings were found. We see no sign of a failing in the Trust deciding not to reinvestigate his complaint and we would not expect a trust to pay to receive a private report a patient had decided to get.
1. We have carefully considered Mr Y’s complaint about Harrogate and District NHS foundation Trust (the Trust). We have seen its decision making was sound when declining to reinvestigate Mr Y’s complaint.
2. We understand how frustrating this period has been for Mr Y while he tried to get neurological treatment. We are sorry to hear about his experience.