9. The law (The Health Service Commissioners Act, 1993 (section 9)) 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.
10. We usually consider a person had notice to complain when they first had reasonable grounds to be aware something was wrong. We have discussed this with Mrs U to understand when this was, and the reasons why she could not bring the complaint to us sooner.
11. To help understand when this was, it is useful to first set out a timeline of events.
12. Mrs U says she had a very difficult time in 2017, which included being diagnosed with cancer. She says as a result she had a mental health crisis and was sectioned for 28 days in June 2017. During her stay the Trust started her on olanzapine medication.
13. She says the Trust asked her GP to continue to prescribe the medication after she was discharged from its care, and she took this medication until 2023.
14. Mrs U explained her personality significantly changed on this medication, meaning she was not motivated and stopped socialising and leaving the house as much. She said this caused a profound change in her life. We understand Mrs U feels that she has lost out on a significant portion of her life and know how upsetting this must be.
15. Mrs U says around two years after starting the medication, a close friend told her that she was no longer her usual self. Mrs U’s friend suggested her medication could be the cause and to speak with her doctor. However Mrs U explained she felt that the doctors knew best and wanted to continue with their treatment plan.
16. Mrs U says around a year later (likely around 2019 or 2020) a friend she had not seen in many years told her they were concerned that she was not walking and talking in her usual way. The friend said they were concerned she said she was always tired all the time and suggested speaking with her doctor about her medication. Mrs U says she did not want to go to the doctors and again did not pursue this further.
17. During the first year of the pandemic, Mrs U says she was hospitalised with sepsis. She says her friend made enquiries with the hospital staff caring for her about her olanzapine medication and how they were concerned this was affecting Mrs U. Despite speaking with her friend about this, Mrs U says she did not make further enquiries into coming off the medication.
18. Mrs U has explained to us she has a regular yearly medication review with her GP, as she is on several medications. In her March 2023 review, she asked her GP if she could stop taking the olanzapine and did so a few weeks later.
19. Mrs U says within a few weeks she felt completely different, and this made her realise she should not have been on the medication all these years.
Date of awareness
20. Mrs U has been on olanzapine since 2017 and says this made a huge difference to her personality. She says that the effect the drug has had on meant she was not aware there was a problem. It was only after stopping the medication in 2023, that she realised she should complain about how it had affected her.
21. Mrs U has told us that on three occasions, between roughly 2018 and 2021, people who knew her raised concerns about her medication and the potential impact it was having on her. Mrs U says she never followed up on this advice from her friends, as she thought the doctors knew best and wanted to go along with their treatment plan.
22. We can understand that Mrs U may not have initially been aware if the impact the drug was having on her. However, we think it is significant that she was told by a friend that her personality had changed, and they specifically suggested her medication could be a cause. We think at this point, Mrs U had reasonable cause to know there might be a problem with her medication.
23. She also would have known at this point that she had not had a medication review with the Trust, especially considering she was having these regularly with her GP practice at this time.
24. This was then repeated on two occasions after, giving strength to the idea Mrs U should have known she should complain.
25. Mrs U also explained that at the time she wanted to go along with the doctor’s treatment plan and continue with the medication. This tells us Mrs U made a conscious decision that she did not want to make a complaint.
26. In summary, we think Mrs U’s date of awareness was when she was first told by a friend her medication might be causing a problem which is roughly in 2018 to 2019. Considering this in line with our one-year time limit, Mr U should have brought her complaint to us by the end of 2020 at the latest. We therefore consider Mrs U’s complaint is several years out of time.
Reasons for delay
27. We asked Mrs U for the reasons she did not complain sooner. Given we consider the complaint to be several years outside of our time limit, we would need strong reasons to put it to one side.
28. Mrs U says the medication affected her so badly she was unable to complain. She says for many years she was unable to work, and her life mainly consisted of dropping her children at school before returning home and was always in bed early. She says she was always fatigued and unmotivated and was not able to raise the issue of her medication.
29. We understand the significant impact the medication had on Mrs U and know it was a difficult period of her life.
30. Mrs U told us she decided to continue with the medication as she thought the doctor knew best, when her friend raised this with her. This does suggest she made a choice not to complain.
31. We must also consider Mrs U told us that, for the past several years, she and her GP go through a medication review on an annual basis. She explained they discuss her medications to ensure they are working well and at the correct levels etc.
32. Given Mrs U has regularly attended her annual medication review, it is unclear to us why she would have been unable to raise the olanzapine issue sooner.
33. We appreciate Mrs U was fatigued, but she was ultimately able to raise these issues in March 2023, as she realised she did not want to continue with it any further. Mrs U has not told us any reason her circumstances had changed that allowed her to question the medication at this point and not in previous years. We therefore do not think there is a strong reason she could not have queried her medication sooner.
34. We also know Mrs U was in contact with friends during the period in question. It seems likely she could have sought some help or advice in raising her complaint.
35. Having considered Mrs U’s reasons for delay, we do not think they explain why she did not question her olanzapine medication, or raise a complaint, over the course of several years.
Conclusion
36. Having considered everything carefully, we think that Mrs U had notice to complain several years before she did. We have considered her reasons for not bringing the complaint to us sooner, but do not think they adequately account for such a long period of time. We therefore think the complaint is out of time and we are unable to consider it further.
37. While we are unable to take further action, we do not wish to diminish Mrs U’s experience and know this has had a big impact on her life. We would like to wish her well in the future.