16. The Ombudsman’s powers are set out in the Health Service Commissioner’s Act (HSCA) 1993. Section 9 (4) of this legislation 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 see there is a good reason to do so.
17. Mrs N’s complaint is about events that took place from July 2020. Mrs N says she became aware of her reasons to complain about the Trust in July 2020 and Practice A in October 2020.
18. For her complaint about Practice B, we consider Mrs N knew about her reasons to complain in March 2021 when she met with it to discuss her concerns.
19. For her complaint to have been in time, Mrs N needed to bring her complaint to us within 12 months of her date of knowledge for each organisation, by July 2021 for the Trust, October 2021 for Practice A, and March 2022 for Practice B. Our records show we received Mrs N’s complaint in January 2024.
20. This makes Mrs N’s complaint significantly out of time. We asked Mrs N about the delay to understand the reasons why she could not bring her complaint to us sooner. We also considered the time the organisations took to respond.
21. Records show Mrs N raised her complaint to the Trust promptly on 29 October 2020, just three months after her date of knowledge. The Trust sent its first response two months later, 23 December 2020. Mrs N wrote back to it with further concerns and the Trust responded in January 2021. On 2 February 2021 Mrs N wrote to the Trust again and it sent its final response in March 2021.
22. Mrs N wrote to NHS England to raise her complaint about Practice A in October 2020. NHS England sent its final response, one month later, on 24 November 2020.
23. Mrs N told us she made her complaint to Practice B in June 2021. Practice B provided a response in July 2021.
24. NHS Complaint Regulations 2009 say the organisation investigating a complaint should respond within six months. We do not consider the time taken by the organisations unreasonable, considering the Regulations.
25. We can see Mrs N approached us in November 2020 However, her complaint was not yet ready for us because she had yet to complete local complaints processes. Mrs N returned to us in March 2021 as she had received a final response from the Trust and Practice A. There is no evidence is her correspondence or conversations with this Office that she raised a complaint about Practice B at this stage.
26. We discussed Mrs N’s complaint with her over the phone on 19 January 2022. Mrs N explained she had raised two other linked complaints about her son’s care and treatment. We understood these organisations to be a third GP Practice (different from those in this decision) and a Local Authority. Mrs N told us these complaints were still ongoing, she said she wanted us to look at her concerns all together so we could understand the full picture and impact. We asked whether Mrs N required an advocate to help support her through this process. Mrs N told us she did not require an advocate as she had the support of her husband.
27. We spoke to Mrs N on the phone again on 25 January 2022 and explained we would close her complaint to allow the third GP Practice and Local Authority to complete responses.
28. On 26 January 2022 we wrote to Mrs N to explain that we make final decisions on complaints UK government departments and NHS in England has not resolved. So, before we look at a complaint, we usually expect the person to have complained in full to the organisation they are complaining about and received a final response from it. We also acknowledged Mrs N’s request for her complaints to be dealt with as one.
29. We explained we could see she had received a response from the Trust and NHS England but required final responses from the third GP practice and the Local Authority. We named the organisations we understood Mrs N to be complaining about, this included the Trust, two GP Practices (one being Practice A, and the other the third practice) and the Local Authority.
30. We gave Mrs N information on what to do after she received responses and explained our time limit law and how we would need to consider reasons for delay if she fell out of the 12-month period.
31. We received Mrs N’s premature complaints in March 2021 and made our decision they were not yet ready for us in January 2022. The time taken to reach this decision was 10 months. We have not disadvantaged Mrs N for the time we took to reach this decision. We have identified periods where we think Mrs N could have pursued her complaint more quickly. We discuss these in more detail below.
32. Mrs N contacted us again in May 2022 to send us the response she had received from the Local Authority. We can see she accepted the outcome and investigation findings.
33. On 20 November 2023 Mrs N contacted and asked for an update. We wrote back the same day and advised we were still waiting for her to send one more response relating to the third GP Practice. We referred to our letter dated 26 January 2022 and the information we needed to proceed.
34. On 18 December 2023 Mrs N wrote back to us to clarify the GP Practice she was complaining about. She explained she was confused about this and there appeared to be a misunderstanding about which Practice she was complaining about.
35. We wrote back to Mrs N on 19 December 2023 explaining we had drafted a summary at that time based on discussions we had with her. This summary included the named organisations she was complaining about. We asked Mrs N to confirm her complaints and the issues she was bringing to our Office.
36. On 3 January 2024 Mrs N confirmed her complaint to us in writing and the organisations involved. Mrs N provided the outstanding final response from Practice B. She told us this was the GP surgery she had raised a complaint about, not the third named practice.
37. Mrs N chose to continue her complaints and did not return to us with the outstanding final response until two years later, in January 2024. We considered what happened during this significant period of delay.
38. We asked Mrs N why she did not provide Practice B’s response to us when she had received this in July 2021. Mrs N was not able to provide a reason.
39. When we asked Mrs N why she did not return to us sooner to clarify the organisations she was complaining about, Mrs N told us she did not recall receiving the letter we had sent on 26 January 2022, she explained some emails did not come to them.
40. Mrs N did not provide a reason why she did not contact us again after May 2022, but explained during the period from November 2023 to January 2024 she was trying to get her son the support he needed to have independence. She explained this took 12 months in total to resolve. Mrs N also told us about her own health difficulties and how she cared for her mother who was in hospital during this time. Mrs N told us she did not get enough help from our Office to understand the process and get information to us in a timely manner.
41. We have carefully thought about the reasons Mrs N has shared with us and do not think these sufficient to set our time limit aside. Mrs N was not able to provide us with a reason she did not send the Practice B response to us sooner, when she received this in July 2021.
42. We are very sorry to hear of how difficult things have been for Mrs N her son, Mr A and their family. We recognise this must have been a very difficult time.
43. We previously spoke to Mrs N about using advocacy service and can see NHS England provided details of a local service and its role in helping people with their complaint. It would have been open for Mrs N to seek the support of the service given her difficult personal circumstances and the distressing nature of Mr A’s complaint.
44. We understand Mrs N waited to receive further responses from both the Practice and the Local Authority, and this took some time. We can see Mrs N came to us promptly after receiving the response from the Local Authority in May 2022. It remains that we cannot see why she did not provide us with the outstanding response from Practice B which she had in July 2021.
45. In summary, Mrs N’s complaint was ready for us in May 2022 when she received the response from the Local Authority. By this time, she had received a written response from both organisations she wanted to complain about.
46. We accept correspondence can sometimes be lost or overlooked. However, we are assured Mrs N was aware of the decision we made in January 2022. We discussed this over the phone with her, shortly before we confirmed this in writing. We closed the complaint on the basis Mrs A wanted to consider us her concerns as a whole and she had not yet completed local complaints processes for two organisations.
47. As Mrs N knew to contact us in May 2022 with the final response from the Local Authority. We are assured she understood our process and what she needed to do, for us to be able to consider her complaint about Practice B.
48. We understand Mrs N chose to pursue matters about other organisations and wanted to return to us once these complaints had been responded to. It remains we cannot see any barriers which would have prevented her from coming back to us sooner. Instead, Mrs N waited to contact us nearly 1 year and 6 months later, after she sent the Local Authority response to us in May 2022.
49. This means her complaints about all organisations fell significantly outside of our time limit when she provided us with the final response from Practice B in January 2024. We think it would have been reasonable for her to have returned to us before November 2023, when she asked for an update on her complaint and the misunderstanding became apparent.
50. In our letter sent in January 2022 we told Mrs N that once she had received a written response from the linked organisations, she should come back to us promptly, and we advised of our 12-month time limit. We can see we also sent Mrs N information about our time limit when we sent her a copy of our complaint form in November 2020.
51. It remains Mrs N’s complaint has come to us significantly out of time. Whilst we acknowledge the local resolution and our processes took a portion of that time, we have identified Mrs N had the opportunity to pursue her complaint significantly earlier. We think it reasonable she could have provided the outstanding response from Practice B in July 2021 and come to us sooner than November 2023 to clarify her complaint.
52. We are very grateful to Mrs N for being so open and honest about what happened to her son and how these events continue to affect him. It is clear how much distress and emotional upheaval he has experienced and will continue to experience in future. We are very sorry to hear about this.