Dartford and Gravesham NHS Trust

4. Mrs H (assisted by Mr M) complains that following an appointment on 28 January 2020, when the consultant said she should have hip replacement surgery as a priority, the Trust did not put her on the February surgical list as planned.

5. She says although she was later placed on the surgical list for April, this was cancelled due to the COVID-19 pandemic. She says this delay only happened due to the initial mistake. Subsequently, the Trust booked surgery for September 2020 but then cancelled this shortly before. She says it then did not provide a further date for surgery and despite requests, did not arrange transfer to another NHS or private hospital (NHS funded). She says the Trust repeatedly told her such a transfer was not possible.

6. Mrs H also complains the Trust ignored their and the GP’s request for assistance with pain relief or to prioritise the surgery, due to the levels of pain she was experiencing.

7. She says due to these events she was left in excruciating pain for several months, which had a significant impact on her quality of life. She says she was in continual severe pain, which affected her physical and mental health. She says she was left with no choice but to pay for hip surgery on 28 October, and surgery on the other hip in February 2021, at a cost of around £40,000.

8. In bringing this complaint she seeks an apology from the Trust and reimbursement of the costs of the private surgeries.

10. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so.

11. Mrs H was initially concerned on 1 March 2020, when she had not had surgery the previous month as she expected. These concerns grew over the next few months when surgical procedures planned for April and then September were cancelled.

12. This was an evolving picture but we can see the latest point at which Mrs H was aware of the overall issues in this complaint was 30 September 2020. This is the date Mrs M complained to the Trust on her behalf.

13. For the complaint to be within our time limit, we would have needed to receive it by 30 September 2021. Mr M brought the complaint to us on behalf of Mrs H on 14 December 2023. This was 26 months and 14 days outside our time limit.

14. We discussed this with Mrs H and Mr and Mrs M to understand the reasons why they could not bring the complaint to us sooner. We have also considered the time the Trust took to respond to the complaint.

15. The NHS complaint regulations say organisations should provide responses to complaints within six months.

16. We can see the Trust took two months to respond to each of the first two complaint letters. It took approximately three and a half months to respond to the third complaint and then two weeks to respond to a final issue.

17. Although the Trust took a total of eight months to respond to the complaint, there were a total of four complaint letters and follows ups. The Trust responded to each of those within the time set out in the NHS complaint regulations. Taking this into account, there is no indication of delay on the Trust’s part and it is not the reason the complaint has reached us significantly beyond our time limit.

18. We have identified two periods of delay where we think it is possible the family could have progressed the complaint sooner than they did.

11 February 2021 to July 2022

19. This was a period of 17 months from 11 February 2021, when they received Trust’s second complaint response, to July 2022, when they initially contacted us.

20. Mr and Mrs M told us Mrs H had her second hip operation in February 2021 and there were complications due to this. She was readmitted to hospital for three weeks, needing two heart operations.

21. We appreciate how stressful this must have been and that progressing the complaint would not have been on their minds at that time.

22. Mrs M told us her mother subsequently had a couple of falls and she had to take her to monthly appointments at another hospital trust. Mr M told us that since 2021 Mrs H has had significant neurological decline which has meant she required more care from them. He said that this takes substantial time on top of their other commitments, such as running their business. We understand Mrs H lives alone but near to Mr and Mrs M.

23. Mr M told us they were also trying to get clarification about the protocol for patients being referred to a different NHS trust or the private sector (although NHS funded). We acknowledge it was frustrating for them to receive different information from different organisations.

24. We can see that when the Trust provided its response in February 2021, it offered them opportunity to discuss the letter by telephone or at a meeting. It also said that if they remained unhappy with the Trust response, they should contact us. The family did not take either of those steps for 17 months until July 2022 when Mr M contacted us.

25. The family knew they were concerned about the delays and cancellations to Mrs H’s surgery and the costs they had incurred for private surgery. Our view is it was not necessary for them to have information about patient transfer to other hospitals in order to progress the complaint. The Trust had already outlined the next steps in its second response letter.

26. We do not doubt Mr and Mrs M had busy lives which included their business and caring for Mrs H. However, the gap in progressing the complaint is significant. Whilst they were undoubtedly going through a challenging period, we have not seen any indication that it was not possible for them to contact us sooner during this time. We do not see that the explanations provided justify such a large delay.

January 2023 to December 2023

27. After Mr M contacted us in July 2022, he went back to the Trust with some concerns he felt were outstanding. The final contact with the Trust was in December 2022. Mr M then contacted us in January 2023.

28. Our records show, at that time, Mr M explained the Trust had directed him to a GP practice in relation to some of the concerns about pain relief. He asked us for advice on progressing the complaint.

29. Mr M says we told him he could bring the complaint to us within 12 months of receiving responses to all of the issues they had raised, and/or responses that compounded the prior issues. He says that by bringing the complaint to us in December 2023, his complaint was in time.

30. We have explained in paragraphs 10 and 13 what the law says about our time limit and why the complaint is out of time. Our records of the call say we told Mr M that if he had not started his complaint with the GP, he should keep the organisations (the Trust and GP practice) separate. We told him as he had already received a final response from the Trust, it would be better not to delay further.

31. We have conflicting explanations of what was discussed on that call. We accept that being given incorrect information could potentially justify this part of the delay. However, it still does not account for or justify the prior 17 month delay.

32. In summary, the family complained to the Trust promptly when they were concerned about delays to Mrs H’s surgery and the lack of pain relief. They also sent a follow up complaint promptly. However, following this, they did not take any action to progress the complaint for 17 months. It was only at that stage that they contacted us.

33. Having considered the family’s explanations for this, we do not consider it justifies the extent of the delay.

34. Had this delay not happened the family would have brought the complaint to us sooner. Although it may still have been beyond our time limit, it would not have been so far out of time. Based on the information available, we cannot justify exercising our discretion to put the time limit to one side. This means we will not consider the complaint further.

35. We were sorry to hear about the pain Mrs H experienced while waiting for surgery and for the financial costs the family incurred. We know our decision will be disappointing for Mrs H and the family. We hope they appreciate it is important we act within the law when considering complaints brought to us.

1. We have carefully considered Mrs H’s complaint about delays to her hip replacement surgery and lack of pain relief during that time. We are sorry to hear about these difficult circumstances.

2. We have decided not to consider this complaint further. This is because Mrs H’s complaint falls outside of our time limit and we have decided there is no good reason for us to put our time limit aside.

3. We acknowledge this will be frustrating for Mrs H and her family. We explain the reasons for our decision below.