9. The law 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. We have communicated this with Mrs O to understand the reasons why she could not do so. We have also considered the time the organisation has taken to respond to Mrs O.
10. Mr H complained of lower limb leg ulcers (a break in the skin) for many years, since 2020.
11. Mrs O was concerned about her son’s ulcers and arranged to see a private doctor in January 2022. Mrs O was told by the private doctor that treatment for the ulcers was available on the NHS. Mrs O told the GP about this during a consultation with her and Mr H on 26 January 2022. The GP made a referral to a ‘vascular team’ on 8 February 2022. The GP surgery requested ankle brachial pressure index readings and when these were available commenced compression dressings in May 2022.
12. Vascular refers to the blood vessel system, including veins and arteries. Ankle brachial pressure index readings is a comparison of a blood pressure reading taken at the ankle to that found at the wrist. Compression dressings is bandaging that encourages better blood flow, whilst supporting the wound.
13. A letter from the private varicose vein (swollen veins) specialist dated 27 April 2022 suggested Mr H could consider treatment of foam sclerotherapy via the NHS. Mr H and Mrs O had already decided to pursue this treatment privately. Foam sclerotherapy is a procedure where a diluted drug is injected directly into varicose veins.
14. Mrs O complained to the GP surgery on 24 May 2023. She said this was following appointments in March 2023, when she found out that guidance suggested her son should have been referred for vascular treatment earlier than he was. Mrs O also said that her concerns about reasonable adjustments took place throughout Mr H’s care at the GP surgery, since 2020.
15. The GP surgery responded to the complaint in letters dated 1 July 2023, 8 November 2023 and 27 February 2024. Mrs O also contacted NHS England and it advised her in an email 26 January 2024 she should contact us. Mrs O sent a complaint to us on 2 February 2024.
16. It is our view that Mrs O’s date of knowledge was the time she was aware there was a problem and she contacted a private doctor in January 2022. She was also told at this time that treatment was available via the NHS. The complaint is therefore one year out of time.
17. Mrs O told us her son is autistic and unable to advocate for himself or question the services provided to him. Mrs O thought he was receiving good care from his GP surgery and she thought they had to wait for the ulcers to heal.
18. She said she was not aware that treatment was available until they went to see a private vascular consultant in January 2022. They had booked Mr H in for private treatment but he was involved in a serious housefire in June 2022. Mr H was in hospital from June to December 2022. Mrs O was especially busy supporting him during his stay and his return to independent living. Their lives were dominated by Mr H treatment and life following the housefire in June 2022.
19. Once he started to receive treatment for his ulcers in February 2023, Mrs O found out national guidance outlines that wounds that are open for more than two weeks should be referred for vascular service. This led to her to want to make a complaint to the GP surgery.
20. We appreciate Mr H has suffered with leg ulcers for a number of years and this must have been very upsetting and painful for him. We were also saddened to read about the horrific event that took place when Mr H was in a housefire and suffered from upper body burns. This must have been an extrmeley distressing time for him and Mrs O. We do not underestimate how extremely distressing this must have been for them both.
21. We appreciate Mrs O says that she did not know about the guidance until 2023. The medical records we have seen suggest she was aware that there was a concern about the care being provided in January 2022. This led her to arranging a consultation with a private doctor who told her that treatment could be carried out via the NHS. It is our view, that this is Mrs O’s date of knowledge. We are of the view that Mrs O could have raised her concerns to the GP surgery at this time. She did not complain to the GP surgery until 24 May 2023.
22. We understand the events of the housefire and Mr H’s health were more important and took priority from June 2022 until the beginning of 2023. We accept there may have been delays during that period of time. It is our view, that Mrs O could have raised her concerns with the GP surgery earlier, from January 2022 and into the beginning of 2023 when Mr H was discharged from hospital. She did not complain until 24 May 2023. This delay, led to the delay in raising her concerns with us.
23. Our decision is not made without recognition of the impact caused by the delay in referral, pain and discomfort which Mr H has felt.
24. We have decided not to consider this complaint further at detailed investigation because it is out of time. Our decision is not made without recognition of the distressing events.
25. We are sorry to hear about the events that led to Mrs O’s complaint. We understand this has been an upsetting time. We have noted the GP surgery has made changes on the back of Mrs O’s complaint. This includes contacting Mr H’s support worker about his booked appointments an if any changes are made to them. The GP surgery also sends a text message to Mr H of his prebooked appointments. We do hope this is helping with attending the appointments.
26. We log all the complaints we receive. This means, if we receive a similar complaint about the same organisation or see a pattern from a number of complaints, we may raise this with the organisation in future. We will log this complaint, so we have a record of it if we do receive any similar complaints. We hope this reassures Mrs O that she did the right thing by bringing her complaint to us.