University Hospitals Birmingham NHS Foundation Trust

3. Mrs L complains that following surgery on her right hip in April 2016, the Trust failed to identify her right leg was now shorter than her left leg. Mrs L says she has limb length discrepancy (LLD) because of the surgery the Trust performed on her right hip. LLD is a disabling condition where legs are different lengths.

4. Mrs L says since having the right hip surgery her mobility has been affected and she has fallen several times. She now requires an aid to walk. She can no longer do gardening, cooking, or cleaning. She says she can no longer go shopping, go on public transport or go on holidays.

5. Mrs L says she feels she can no longer live an independent life and relies heavily on day-to-day support. She says she experiences swelling, and redness and pain in her right leg. She says she remains very much home bound.

6. Mrs L would like the Trust to make service improvements and provide a financial remedy.

7. The Trust performed surgery on Mrs L’s left hip in May 2014. The Trust performed surgery on Mrs L's right hip in April 2016.

8. Later in 2016, Mrs L was experiencing problems with her balance and started falling. She visited her GP and was told not to worry. She was told that the muscles in her leg just needed to strengthen.

9. Mrs L was admitted to the Trust on 25 February 2023 due to a fall. Investigations by the Trust showed she had a hip fracture.

10. On around 11 March, a physiotherapist at the Trust measured Mrs L’s legs and identified her right leg was shorter than her left leg. Mrs L says she was diagnosed with LLD and was discharged from the Trust on 25 March.

11. Mrs L complained to the Trust on 20 October about failing to identify she had LLD following the right hip surgery. The Trust provided its response to the complaint on 16 January 2024. Mrs L brought her complaint to us on 18 April.

13. The Health Service Commissioners Act 1993, which governs how we do our work, says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances.

14. We have reviewed and considered what Mrs L has told us in her complaint from, and during our calls with her, to understand her circumstances and the outcome she wants. We do not consider whether legal action would succeed, but whether it would be a reasonable option to look into.

15. An alternative legal remedy exists when there is both a proper legal cause of action and the remedy the complainant seeks is achievable through that action. This means that the court can consider the matter and has the power to give the outcome wanted. We have first considered whether it looks like a legal remedy might exist.

16. Generally, an individual may pursue a clinical negligence claim where they become injured as a result of the treatment they receive, or where an organisation fails to provide appropriate treatment. The courts can independently review a complaint, decide whether there has been clinical negligence, and then award financial damages if they feel it is correct to do so.

17. Mrs L complains the Trust failed to identify her right leg was shorter than her left leg following surgery on her right hip. We understand Mrs L feels failings by the Trust left her in pain and affected her mobility, which means she can no longer live an independent life.

18. It appears there may be a legal remedy available to Mrs L through the courts. This is because she believes the Trust’s failure to identify LLD led to years of pain and mobility issues, which she could have received treatment for sooner.

19. We also have considered the outcomes sought and whether legal action could potentially achieve these, or whether we are better placed to do so. Mrs L is seeking a substantial amount of financial compensation from the Trust for the overall impact the claimed failings have had on her. This is something the courts could consider as part of a clinical negligence claim. We recognise that we can also recommend financial remedy, although not in the same way the courts can.

20. Mrs L is also seeking service improvements. This is something we could also achieve. Although the courts cannot order the Trust to implement service improvements, this could be achieved indirectly as a result of legal action. The Trust is likely to make service improvements if the courts uphold Mrs L’s claim.

21. It appears Mrs L may have a claim of clinical negligence and that the courts may be more likely to achieve the outcome Mrs L is seeking than we are. We have gone on to consider whether there appears to be any barriers, or any reasons why it would not be reasonable for Mrs L to explore this.

22. We discussed this with Mrs L and she has told us there would be no barriers or reasons which would prevent her from pursuing a legal action. She told us that if we decided it was reasonable for her to explore the legal route, she would consider this. It therefore appears there are no barriers to Mrs L pursuing legal action at this time.

23. Having considered the evidence Mrs L gave us, we have decided not to consider her complaint further. It appears a legal remedy may be available which may be able to resolve the complaint, and it appears reasonable for Mrs L to explore this.

24. We appreciate it has been difficult for Mrs L to bring her complaint to us and we thank her for giving us the opportunity to consider her concerns.

25. The time limits for pursuing legal action are strict. It is our view that Mrs L should explore whether this option may result in the best outcome for her while she still has this window of opportunity.

26. Should Mrs L need to contact us again, for example due to establishing there is not a viable legal claim for her to pursue. Then we would need to consider the time limit set for us by law.

27. The Health Service Commissioners Act 1993 says complaints must be brought to us within a year of the person complaining becoming aware of the issue being complained about. We can set this aside, but only if there is good reason to do. It is important that Mrs L avoid any unnecessary delay if she does need to contact us again later.

1. We have carefully considered Mrs L’s complaint about the care and treatment she received from University Hospitals Birmingham NHS Foundation Trust (the Trust). We are very sorry to hear about Mrs L’s limb length discrepancy diagnosis and about the impact this had on her.

2. We have looked at what Mrs L has told us about her concerns and the outcome she is seeking. We consider she could take legal action on the matters she has brought to us. On this basis, we have decided not to consider the complaint further.