Treatment
12. Mrs N complains the Practice failed to provide a failed to provide a good standard of care to her son, O between October, and November 2022 despite multiple visits to the GP. She also says during this time her concerns were disregarded by the Practice.
13. Mrs N told us after each visit to the Practice, she had to take O to her local walk-in centre or the emergency department (ED) on and on two occasions O was admitted into hospital with a diagnosis of bronchiolitis.
14. We have seen evidence in the medical records, O was seen at the Practice on several occasions throughout October and November.
15. GMC good medical practice guidance says a doctor should provide a good standard of practice and care. If a doctor assesses, diagnoses, or treats patients, they must adequately assess the patient’s conditions, taking account of their history, their views and values and where necessary, examine the patient. A doctor should also promptly provide or arrange suitable advice, investigations, or treatment where necessary refer a patient to another practitioner when this serves the patient’s needs.
16. Our clinical adviser explained that most of O’s consultations at the Practice were with symptoms consistent with reflux including vomiting and discomfort. They go on to say, during these consultations a full history was taken, and O was examined. We consider this to be in line with the GMC guidelines above. However, on 8 November, when O was seen with symptoms of a cough, no examination is documented. Although it was noted O had no fever and was well in himself, our clinical adviser explained if an examination had taken place in line with GMC guidelines, O may have been diagnosed with bronchiolitis on this date.
17. We have considered the impact of this on O, which Mrs N told us resulted in two visits to the ED the following day and O being given a diagnosis of bronchiolitis. We understand having to take her son to ED must have caused the stress and anxiety Mrs N has told us about and we were sorry to hear about her experience.
18. Our clinical adviser has explained when O was seen and diagnosed with bronchiolitis in the ED on 9 November, no treatment was given as there is no treatment as such for bronchiolitis. The recommendation is for a child to be given plenty of fluids until the symptoms resolve themselves.
19. We have seen evidence, Mrs N returned to the Practice twice after the ED admission on 9 November and on both occasions the Practice safety netted O with advice about what to do if the symptoms became worse. On the second consultation the GP spoke to an on-call paediatric doctor who agreed to see O which is when he was admitted into hospital on 14 November 2022 due to worsening symptoms. We therefore consider the Practice acted in line with the GMC guidelines above on both occasions which reduced any further impact on O.
20. We recognise Mrs N’s concerns about the Practices’ delay in diagnosing O with bronchiolitis on 8 November 2022. This was obviously a difficult period for O, with several consultations at the Practice and attendances at hospital which we understand must have caused her a great deal of anxiety and stress. However, we want to reassure her, we do not consider a delay of one day in O being diagnosed bronchiolitis caused the impact she has told us about which resulted in O being admitted into hospital. On the balance of probability, he would still have been admitted into hospital as his condition worsened.
21. We understand how difficult it must have been for Mrs N to have her young child admitted into hospital, however, in its final response, the Practice has acknowledged how distressing this experience was for her and has apologised for this and if it made her feel her concerns were not taken seriously. It said what happened had been fed back to the staff involved to ensure learning.
22. Our Principles say that to put things right organisations should provide an apology, explanation, and an acknowledgement of responsibility, as well as remedial action.
23. We are satisfied that the actions of the Practice in providing an apology to Mrs N and in providing feedback to the individual to ensure good practice in the future, are in line with our Principles.
24. As Mrs N also said she wanted compensation we have also reviewed our severity of injustice scale to consider if a financial remedy is proportionate. In this instance we have determined the distressing and anxious impact Mrs N has told us about would not lead to us recommending a financial remedy. We usually consider an apology to be an appropriate remedy for these cases.
25. We will therefore not take further action on this complaint. We hope we have been able to clearly explain our decision not to consider her complaint further and hope she will get some reassurance from the actions taken by the Practice.
Communication
26. Mrs N says she was spoken to inappropriately during consultations. She says during October and November 2022, she had concerns over her son’s O’s health and attended the Practice on several occasions. She says during these consultations, the GP she saw made comments about her son’s appearance which she found uncomfortable. She has told us this happened on a few occasions.
27. NICE guidance says patients should be treated with respect, kindness, dignity, compassion, understanding, courtesy, and honesty.
28. We sympathise with the experiences Mrs N has told us about, and how it made her feel at the time. Mrs N has told us about the stress and anxiety of attending the Practice on several occasions with her son and how she felt this was exasperated by the way she was spoken to. We were sorry to hear about her experience.
29. The Practice recognised Mrs N’s experience and the impact this had on her in its complaint response. It also provided evidence in its responses to demonstrate the actions it has taken in response to this, and it has also apologised.
30. We are satisfied that the actions of the Practice in providing an apology to Mrs N and in providing feedback to the individual to ensure good practice, are in line with our Principles. As we have explained above where the impact is distress and anxiety for a short period, we usually consider an apology to be an appropriate remedy for these cases and therefore would not recommend a financial remedy.
31. We will therefore not take further action on this complaint. We were sorry to hear how these interactions made Mrs N feel and we hope she will get some reassurance from the actions taken by the Practice.
32. It is understandable from what Mrs N has told us that she felt let down by the Practice in relation to O’s care. This has clearly been a very difficult for Mrs N and her son and we are sorry for their experience.
33. We hope that our explanations and our adviser’s expertise have given her reassurance that the Practice followed the relevant guidelines and did not do anything seriously wrong in relation to her son’s care. We are also satisfied the Practice acknowledging and apologising for her experience as well as reflecting on its practice are enough to put right any injustice.