A practice in the Norfolk area

4. Mrs U complains the Practice did not refer her to the fertility clinic despite telling her it would, in May 2022. It became apparent in February 2023 the Practice had not made the referral.

5. Mrs U said her traumatic experience with the Practice means she feels unable to pursue fertility treatment. She described an extreme sense of hurt, mistrust and hopelessness which means she feels unable to engage with the Practice going forwards. Mrs U is further concerned the delay has statistically reduced her chances of successful fertility treatment.

6. She is looking for service improvements and a financial remedy.

7. On 28 April 2022, Mrs U had a blood test at the Practice in order to begin the process for fertility treatment.

8. On 20 May, the Practice told Mrs U it had referred her to the fertility clinic.

9. In February 2023, Mrs U asked the Practice for an update on her fertility referral. At this point, the Practice realised it had not made the referral for Mrs U. It then offered to initiate the referral and collect all the information it needed.

12. Mrs U had a GP appointment on 4 October 2021 to discuss her fertility concerns. The Practice planned to arrange blood tests, which it needed before it could refer her to the fertility clinic.

13. The Practice completed Mrs U’s blood tests on 28 April 2022. It received these results on 16 May.

14. The Practice sent a copy of Mrs U’s blood results to her on 20 May after she contacted it to ask for an update. The Practice confirmed it had actioned her referral to the fertility clinic. This was incorrect, as it had not done so at this point.

15. Our Principles of Good Administration say public bodies should give people information that is accurate. As the Practice provided Mrs U with inaccurate information at this point, this is a failing.

16. After it received the results, Mrs U should have had a follow up appointment to discuss the results. The Practice has acknowledged Mrs U did not know she had to make this appointment, as it had not made her aware she needed to do this. It explained at this point, after the follow up appointment, the Practice should have referred Mrs U to the fertility clinic.

17. The Practice’s Appointments policy says patients can book routine appointments up to six weeks in advance. We can therefore say that Mrs U should have had her follow up appointment by 1 July at the latest.

18. The Practice’s Referrals policy says clinicians should ensure they make referrals promptly following the decision to make one within a consultation. The Referrals policy also states all requests for e-referrals (electronic referrals) should be processed within 14 days.

19. Mrs U had a GP consultation at the Practice on 27 February 2023. At this time, Mrs U believed the Practice had actioned the referral and asked for an update. It was at this point the GP realised the Practice had not made the referral. They then actioned the referral.

20. Based on the above, the Practice delayed Mrs U’s fertility referral by approximately seven months.

21. We acknowledge Mrs U had a traumatic experience with the Practice while seeking fertility treatment. We further recognise that finding out she had been misinformed about her fertility referral being made caused her significant distress. We do not underestimate Mrs U’s experience and frustration.

22. Mrs U told us she was at the beginning of the fertility process, and she did not see a fertility expert. We therefore also have no clinical information about her fertility at a later time. Mrs U has told us about a statistical reduction in successful fertility treatment, but without information relating to her specific circumstances, we cannot make this link.

23. We can say there is a link between the failings and Mrs U feeling a sense of hurt and some significant distress.

24. In order to establish the level of mistrust we noted she is no longer a patient at the Practice. She registered with a new GP Practice in December 2023, ten months after she realised the Practice had not sent her referral. We hope she is happy with the care she is receiving at her new Practice. As she is no longer receiving care from the Practice, we cannot say her distrust in the Practice is an ongoing matter.

25. Our Principles for Remedy say where an organisation has failed to get things right, they should take steps to put things right.

26. They explain an appropriate range of remedies may include an apology, an explanation or remedial action to prevent the same thing happening again. Additionally, in some cases, financial compensation may be appropriate for financial loss, inconvenience, distress or a combination of these.

27. In line with our Principles for Remedy, the Practice has appropriately explained it made two errors with Mrs U’ care. It acknowledged it did not submit her fertility referral correctly after she had blood tests, and has agreed one of its reception staff incorrectly told Mrs U the Practice had actioned the referral. It apologised for this, and for the impact on Mrs U.

28. In light of this, the Practice explained it has made changes to the way it records the information it provides to patients. It said it was working with its reception staff and delivering both individual and team training for this issue.

29. The Practice explained it had discussed Mrs U’s complaint at a clinical governance meeting, as well as at its clinical team monthly meeting, to ensure it improves its practice. The Practice has also given training to its staff about the importance of correctly recording and delivering information to patients.

30. It has further offered her a face-to-face appointment to discuss her clinical situation and progress the fertility referral. Mrs U has declined to progress her fertility referral, which she is entitled to do.

31. We are satisfied these actions are in line with our Principles for Remedy. In this case, we consider the Practice should also pay Mrs U some financial redress in light of the distress she experienced.

1. Mrs U complains a GP practice in the Norfolk area (the Practice) delayed her referral for fertility treatment. We were sorry to hear about Mrs U’s experience and the significant distress and mistrust this has caused her.

2. We have decided to partly uphold this complaint. We have seen a failing in terms of a delay of approximately seven months in the Practice sending Mrs U’s fertility referral. We have not seen any evidence to say there was a link between this and the possible success of any treatment. We found the delay has caused her great distress. From what she has told us, it is clear how difficult this experience has been for Mrs U.

3. The Practice has apologised to Mrs U and has already made service improvements. We are reassured the Practice has done enough to ensure the same thing does not happen to other patients. We recommend the Practice provides Mrs U with financial compensation for the distress caused by the delayed referral.

32. In considering our recommendations, we have referred to our ‘Principles for Remedy’. 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 the poor service had not occurred. If that is not possible, they should compensate them appropriately.

33. To decide on a level of financial remedy, we review similar cases where the person has experienced similar injustice, along with our severity of injustice scale. Following this review, we recommend the Practice pays Mrs U £500 in recognition of the significant distress she felt, as a result of the actions of the Practice. We ask that it does this within six weeks of the date of our final report.

34. We acknowledge the difficult and distressing time Mrs U has experienced and do not underestimate the impact this has had on her. We understand how difficult it was for Mrs U to bring her complaint to us, and we thank her for doing so.