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A practice in the Cornwall area

P-002864 · Statement · Decision date: 19 August 2024
Choice and Consent Tests Access Access Duty of Candour implementation
Complaint (AI summary)
Miss V complained a smear test for an STI was performed without her informed consent, results were withheld, an appointment was cancelled last minute, and the practice failed to contact her.
Outcome (AI summary)
The ombudsman closed the complaint; some matters are subject to potential legal action, and other concerns about appointment cancellation and contact were deemed not proportionate for investigation.

Full decision details

The Complaint

4. Miss V complains about the care and treatment she received from the Practice. She says:

• on 25 October 2023, the Practice conducted a smear test to test for an STI (sexually transmitted infection) and did not gain her informed consent for this procedure and the Practice did not provide her with the results of her smear test • on 5 October 2023, the Practice cancelled an appointment 14 minutes before she was due to attend • the Practice did not contact her after her grandmother raised concerns on her behalf to the Practice.

5. Miss V said the Practice not providing the results of her smear test caused panic and was distressing for her. She said the Practice not gaining her informed consent for the smear test has caused stress and impacted her mental health. Miss V said the Practice cancelling her appointment at short notice was frustrating, stressful and caused her lose to money as she had taken time off work for the appointment. Miss V said she feels let down by the actions of the Practice and for not contacting her even when her grandmother requested this.

6. By bringing this complaint to us Miss V would like financial reimbursement of loss of earnings. Miss V would also like financial remedy for the emotional impact these events have had on her.

Findings

Smear test

9. The law says we cannot investigate a complaint where a person has the option to take legal action, unless we consider this is unreasonable in the circumstances. We have discussed this with Miss V to understand her circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

10. We have considered the issues Miss V is raising (set out in paragraph four), and the impact she says these have had (as set out in paragraph five). It appears Miss V could have a legal claim of clinical negligence available for parts of her complaint.

11. Miss V complains the Practice did not gain her informed consent for the smear test it conducted or provide her with the results of this test. Considering this, we think Miss V could have a legal claim of clinical negligence. This is because she says the treatment provided by the Practice caused her mental health to deteriorate and caused her panic and distress.

12. Miss V has told us she is seeking financial remedy and reimbursement of loss of earnings. This could potentially be achieved via a clinical negligence claim. It is also something we could potentially achieve if we were to uphold the complaint.

13. We have next considered whether there are any factors which would mean it is not reasonable for Miss V to explore legal action. We asked Miss V if there were any practical barriers which would prevent her from seeking legal advice or pursuing legal action. Miss V advised that she would not be able to afford legal fees.

14. Whilst we appreciate Miss V has said there may be financial constraints that may act as a barrier, there are no win no fee solicitors that she could approach to take on her complaint. On 16 July Miss V informed us she had contacted a no win no fee solicitor regarding her complaint.

15. We are satisfied an alternative legal remedy may be available to Miss V, which may achieve the outcomes she is seeking, and she is taking steps to pursue this. Once any legal action has been concluded, Miss V is able to ask us to look again at her complaint in respect of any outcomes that could not been achieved through legal action, such as an apology or service improvements. We have told Miss V about our time limit for looking at complaints and advised her to return to us promptly.

16. We understand that Miss V has been through an incredibly difficult and distressing time. We were sorry to hear of the impact Miss V’s complaint has had on her. We apologise if our decision causes any further distress.

Appointment cancellation and not returning a telephone call

17. Miss V said she was due to attend the Practice at 5pm on 5 October 2023 to have a 24hour blood pressure machine fitted. Miss V complains the Practice cancelled this appointment at 4.46pm, 14 minutes before she was due to attend. Miss V said the Practice cancelling her appointment at short notice was frustrating, stressful, and caused her to lose money as she had taken time off work for the appointment.

18. Miss V also complains that her grandmother contacted the Practice as she was concerned about Miss V’s mental health and the Practice did not contact her following this. Miss V said this impacted her mental health and she feels let down.

19. We have limited resources, and we cannot investigate every complaint we receive. We need to use our resources to investigate the most serious cases, alongside cases that will have the biggest impact on improving public services for everyone.

20. To address this, we have decided to focus on the more serious complaints that people bring to us, where they may have faced a big impact. For example, these may be about a potentially avoidable death or where someone has suffered prolonged pain. These types of complaints are where we can often make the biggest difference. This will allow us to provide the right level of service to those people, as quickly as possible.

21. This means we are not looking into complaints where we can see there has been a smaller impact. We are not currently considering complaints which fall into levels one or two of our severity of injustice scale. Level two on our severity of injustice scale says it is for cases where the impact is distress, worry, annoyance or a similar injustice that a person would be expected to deal with on a regular basis. It says the impact should not affect the person’s day to day functioning or ability to live a normal life for up to six months.

22. Whilst we appreciate the impact Miss V has told us this had, if we were to consider these parts of the complaint, it is likely we would find it had a low impact (level one or two on our severity of injustice scale). We do not think we would be able to link Miss V’s claimed impact to a timeframe longer than six months. We are currently not considering cases that fall on level one or two of our severity of injustice scale. In line with our current demand management, we would not look at these components.

23. We understand our decision may be upsetting for Miss V. We apologise for any upset this may cause as it is certainly not our intention. We do not want our decision to diminish the seriousness of the issues Miss V has brought to us and the impact this had to her.

Our Decision

1. We have carefully considered Miss V’s complaint about a practice in the Cornwall area (the Practice). We are very sorry to hear of the circumstances that led Miss V to approach us. We recognise the impact Miss V’s complaint has had on her and we do not wish to diminish this impact with our decision.

2. We understand Miss V is currently exploring legal action in relation to some of the matters she has brought to us. Because of this, we are unable to consider Miss V’s complaint about the care and treatment she received from the Practice at present.

3. It does not appear proportionate for us to look at Miss V’s concerns about the Practice cancelling an appointment at short notice, and not returning a call made by her grandmother. This is because in line with our current demand management we are not looking at complaints which would fall on level one or two of our severity of injustice scale. We understand Miss V may be upset by our decision and we would like to sincerely apologise for any distress this may cause.

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