First appointment was not out of area
14. Mr N complains that the appointments agreed at the local resolution meeting (LRM) were not conducted out of area. Mr N tells us it was important to him that these were out of area as he did not want the outcome to be influenced by his previous appointments.
15. The Trust has said due to the lockdown restrictions at the time it was no longer able to facilitate face to face appointments for some services. As it was aware Mr N had expressed a strong preference not to be seen by any consultant who had reviewed his needs previously, it ensured he had a face to face appointment with a new consultant who had recently joined the Trust.
16. In a previous complaint the Trust apologised it had not given Mr N correct information regarding the need for a GP referral for an Individual Funding Request (IFR) for an out of area appointment. The Trust decided to offer an appointment with the new consultant as they could offer an impartial and independent medical opinion on Mr N’s needs without requiring the IFR.
17. Our Complaint Standards state that organisations should actively listen and demonstrate a clear understanding of the main issues for the complainant and the outcomes sought. The standards also state that organisations should look for ways to resolve complaints at the earliest opportunity.
18. We consider the Trust’s offer of an appointment with a new consultant to be in line with these standards. It has worked within the limitations at the time to best address Mr N’s concerns about a biased view of his care without causing further distress or delays at this time.
19. We have not seen an indication of a failing in the decision to offer this appointment.
Second appointment not offered
20. Mr N complains the psychologist appointment agreed at the LRM was not offered as promised.
21. The Trust has said psychological therapy services were unable to offer face to face appointments due to the lockdown restrictions but were offering telephone appointments. As Mr N is not reachable by telephone it was unable to offer an appointment.
22. The Trust has also said that it would have facilitated an appointment if the psychiatric consultant recommended it. Following the psychiatric appointment psychological therapy was not recommended as a treatment option so an appointment was not offered.
23. The records show that the psychiatric consultant felt it was difficult to see how further psychological therapy would be of benefit to Mr N. They noted Mr N had been offered therapy previously and this had not been shown to have a positive impact on Mr N’s symptoms.
24. The consultant was also of the opinion Mr N would not be willing to engage in any form of intervention that has the objective of changing or reducing his beliefs and behaviour.
25. We can see in the records the consultant provided a clear rationale for why they did not feel Mr N should be offered an appointment with a psychologist. However, there is no record of the consultant discussing the option of psychological therapy with Mr N. There is no record of Mr N’s opinion on whether psychological therapy could be helpful as part of his ongoing treatment.
26. GMC guidance says clinicians must listen to patients and take account of their views. It also says patients must be given the information they want or need in a way they understand. Clinicians must work in partnership with patients, sharing information they need to make decisions about their care.
27. The NHS constitution says patients have the right to receive care and treatment that is appropriate to them, meets their needs and reflects their preferences.
28. We have not seen evidence that Mr N’s point of view about his treatment options was taken into consideration. This is not in line with the GMC. While we cannot say for certain that Mr N would have accepted the offer of an appointment, it is likely this is the case as he had previously agreed to the appointment at the LRM. We also cannot say whether the appointment would have changed the outcome for Mr N.
29. The Trust’s decision not to offer the psychology appointment following Mr N’s medical assessment was not made in line with guidance. We consider that this is an indication of a failing.
30. We have asked the Trust to write to Mr N to acknowledge this failing and apologise for it and the impact it had on Mr N. The Trust has agreed to do so. We consider this is a sufficient remedy for not offering Mr N the second appointment. Our NHS Complaint Standards say an organisation should recognise the impact what happened had on a complainant and look to provide a remedy to address that impact.
31. We understand the Mr Bardney has found this experience very distressing. We consider that an apology and an acknowledgement of what went wrong from the Trust, is sufficient to remedy this issue and in line with our NHS Complaint Standards.
Complaint handling
32. Mr N complains that the Trust did not send the response directly to him, but to his advocate. As a result, he did not receive the letter until 23 December 2020. Mr N complains that he was isolated over the Christmas period and receiving the response at this time added to his distress.
33. The Trust has declined to respond to Mr N’s complaint further. In the response dated 3 December 2020 it has said it will not engage or acknowledge any further correspondence regarding this matter.
34. We understand that Mr N felt distressed at receiving the complaint response just before Christmas when he was not able to discuss it with his advocate.
35. Our NHS Complaint Standards state that a complainant should be told the outcome of the complaint in an appropriate manner, in an appropriate place by an appropriate person.
36. Mr N was entitled to receive the letter directly to his home if that was his preference, and the Trust should have taken that into consideration when issuing his response.
37. The Trust has agreed to write to Mr N and acknowledge that it should have sent the letter directly to him. Our NHS Complaint Standards say that when something has gone wrong organisations should look to provide a remedy. The Complaint Standards say this might include a meaningful apology and an acceptance of responsibility. The Trust has agreed to provide both these things to Mr N. We consider this is sufficient to address how they provided Mr N with its response to his complaint.
38. The Trust has agreed to issue a response to Mr N acknowledging the failings identified in this report. We consider this is sufficient to remedy this issue, in line with our NHS Complaint Standards.