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Barking, Havering and Redbridge University Hospitals NHS Trust

P-002956 · Statement · Decision date: 3 September 2024 · View Barking, Havering and Redbridge University Hospitals NHS Trust scorecard
Diagnosis Diagnosis Diagnosis Diagnosis Clinical negligence harms learning
Complaint (AI summary)
Mr E complained about a misdiagnosis of Complex Regional Pain Syndrome and incorrect treatment from multiple organisations between 2013-2022, causing irreversible damage and significant impact.
Outcome (AI summary)
The complaint was closed. The ombudsman decided not to consider the complaint due to it being considerably outside of the time limit.

Full decision details

The Complaint

4. Mr E complains about a misdiagnosis of Complex Regional Pain Syndrome (CRPS) and the subsequent incorrect treatment he was given between 2013 and 2022, by the following organisations:

• Barts Health NHS Trust (2013-2017) • Barking, Havering and Redbridge University Hospitals NHS Trust (2016) • Spire London East Hospital (2018-2021) • Royal National Orthopaedic Hospital NHS Trust (2017-2018)

5. Mr E explains that due to the misdiagnosis, he has not received the correct treatment and has now lost the opportunity to do so due to irreversible damage. He tells us he has been suffering for the last ten years with his symptoms, and this has affected him physically, mentally, and financially. Mr E tells us he has been unable to work in construction due to his condition and has therefore lost out on past and future earnings. Mr E also tells us this has impacted him socially, as he is unable to partake in activities with his children.

6. As an outcome to his complaint, Mr E is seeking an apology from the organisations involved in his care, as well as a financial remedy which reflects the impact these failings have had on him.

Background

7. Mr E was involved in a road traffic accident (RTA) on 5 November 2013 which caused a fracture in his foot. He tells us this is where his problems stemmed from. Mr E experienced ongoing pain and unfortunately suffered a broken shoulder in August 2014.

8. Mr E was seen at pain clinics, underwent spinal injections, and engaged with physiotherapy, but his pain persisted. Mr E also underwent various scans and nerve conduction studies. He was diagnosed with Chronic Regional Pain Syndrome (CRPS) and dystonic reaction in late 2016.

9. Unhappy with his treatment and lack of progress, Mr E sought a second opinion whilst in Portugal in February 2021. He tells us that the investigations he underwent discovered he has nerve damage in his foot, shoulder, and index finger. Mr E says these ongoing conditions have been causing him mobility issues for several years, and upon learning of his diagnoses, he raised his concerns with the organisations involved in his care back in the United Kingdom (the UK).

Findings

12. The Local Authority Social Services and National Health Service Complaints (England) Regulations say a complaint must be made within a year of the date which the events occurred, or the date on which a person became aware of their reason to complain. The NHS cannot investigate complaints brought to it after one year, unless there is a good reason to do so.

13. The Health Service Commissioners Act 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.

14. We have discussed this with Mr E to understand the reasons why he could not do so. We have also considered the time the organisation has taken to respond to Mr E. We will explain our considerations below for each organisation and conclude this statement with the reasons for our decision.

• Barking, Havering, and Redbridge University Hospitals NHS Trust

15. Based on the information available to us, we have concluded that Mr E was seen by this Trust in February, March, and September 2016. This is what we consider to be the ‘date of events’, i.e., the date which the events complained about occurred.

16. Mr E tells us that his ‘date of knowledge’, i.e., the date which he became aware of his reason to complain, was in February 2021 when he underwent a series of MRI scans, a 3-D CT reconstruction scan, and an EMG study carried out in Portugal.

17. Whilst there is evidence Mr E was frustrated with his lack of progress from the care and treatment he had been given prior to seeking the second opinion in February 2021, we accept that it was not until then that he became fully aware of his reason to complain.

18. As Mr E became aware of his reason to complain in February 2021, we would expect him to raise his complaint by February 2022, and once he had received a response from the Trust, to approach our Office in a prompt manner.

19. Mr E complained to the Trust in November 2021 and received a response in December 2021. If Mr E had approached our Office promptly after receiving his response from the Trust, it is likely we would have been able to look at the concerns he raises.

20. However, Mr E did not approach our Office with these concerns until 4 January 2023, which is a period of one year and one month after receiving his final response. This is a significant period of delay.

• Barts Health NHS Trust

21. Based on the information available to us, we have concluded that Mr E was seen by this Trust in November 2013, January 2014, January and February 2015, November 2015, February 2016, October 2016, and throughout 2017. This is what we consider to be the ‘date of events’. As stated above, we accept that it was not until February 2021 that he became fully aware of his reason to complain.

22. As Mr E became aware of his reason to complain in February 2021, we would expect him to raise his complaint by February 2022, and once he had received a response from the Trust, to approach our Office in a prompt manner.

23. Mr E complained to the Trust in August 2022, which is six months out of time when considering the Local Authority Social Services and National Health Service Complaints (England) Regulations, and the Health Service Commissioners Act.

24. Mr E received a response from the Trust on 8 September 2022, but did not approach our Office with these concerns until 4 January 2023, which is a period of four months after receiving his final response. In total this is a ten-month delay.

• Royal National Orthopaedic Hospital NHS Trust 25. Based on the information available to us, we have concluded that Mr E was seen by this Trust in 2017 and January 2018. As stated above, we accept that it was not February 2021 that he became fully aware of his reason to complain.

26. As Mr E became aware of his reason to complain in February 2021, we would expect him to raise his complaint by February 2022, and once he had received a response from the Trust, to approach our Office in a prompt manner.

27. Mr E complained to the Trust in August 2022, which is six months out of time when considering the Local Authority Social Services and National Health Service Complaints (England) Regulations and the Health Service Commissioners Act.

28. Mr E received a response from the Trust on 19 October 2022, but did not approach our Office with these concerns until 4 January 2023, which is a period of three months after receiving his final response. In total this is a nine-month delay.

• The Spire London East Hospital

29. Based on the information available to us, we have concluded that Mr E was seen by this Trust in December 2018, February 2019, February 2020, and 7 January 2021. These are what we consider to be the ‘date of events’. As stated above, we accept that it was not until February 2021 that he became fully aware of his reason to complain.

30. As Mr E became aware of his reason to complain in February 2021, we would expect him to raise his complaint by February 2022, and once he had received a response from the Trust, to approach our Office in a prompt manner.

31. Mr E complained to the Trust in November 2022 and received a response in January 2023. We consider Mr E’s complaint to the Trust is eight months outside of the time limit stated the Local Authority Social Services and National Health Service Complaints (England) Regulations, and the Health Service Commissioners Act.

32. Whilst Mr E approached our Office promptly after receiving a response from the Trust, this was 11 months outside of the 12-month period outlined in the Health Service Commissioners Act. This is a significant period of delay.

Conclusion

33. When any complaint comes to us outside of our time limit, we must consider the time taken by the person complaining and the time take by the organisations to respond.

34. Mr E explained to us that there were some delays in him being able to return to the UK, and when he did return, it proved difficult for him to get appointments for examinations due to the ongoing impact of the Covid-19 pandemic. He tells us he faced many appointment cancellations.

35. We acknowledge Mr E’s frustrations with appointment availability, and with what he has endured over the last ten years. It is evident he has had a challenging time.

36. We cannot see that his ongoing difficulties with obtaining appointments or returning to the UK were a barrier to him being able to pursue his concerns with the organisations listed above, as he could have raised concerns whilst waiting for these appointments. Additionally, Mr E has not told us that his physical health caused a barrier to him raising his concerns, nor has he expressed a lack of knowledge about the complaints process.

37. We can see from the clinic letters Mr E has provided us with that he was unhappy with his care and treatment as far back as 2018. He reported he had not received good care, and felt he had fractures which had not healed correctly. Mr E had sought several second opinions before undergoing examinations in Portugal in February 2021.

38. We have accepted February 2021 as his date of knowledge as this provided him with new information which, in his view, confirmed his concerns about the treatment he has received to date. We consider this is when Mr E should have contacted the organisations involved in his care to raise his concerns, especially as he had previous suspicions about this dating back to 2018.

39. We have concluded that there are considerable delays which occurred when the matter was left with Mr E to pursue, and we have not identified any exceptional circumstances which would convince us to put the time limit to one side.

40. We are very sorry to have learned how Mr E has been affected by the concerns he raises, and we understand how much this complaint means to him. It is important we consider and act within the law, and we regret any further upset this decision may cause. For the reasons explained in this statement, we do not see good reason to set aside our time limit. We hope this statement clearly explains the reasons why we will not be considering this complaint further.

Our Decision

1. We were very sorry to learn of Mr E’s concerns about the care and treatment he has received over the last ten years. We recognise this continues to be a source of frustration for him, and that he suffers with ongoing pain because of what has happened to him. We have carefully considered the information Mr E provided about his complaints.

2. We have decided not to consider Mr E’s complaints further because they have come to us considerably outside of our time limit. We thoroughly considered the reasons Mr E gave for this. We did not think there was sufficient reason to set out time limit aside.

3. We recognise and we are grateful for the time and effort that has gone into making this complaint. We are sorry for any disappointment caused by our decision.

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