Northern Lincolnshire and Goole NHS Foundation Trust

2. Mr U complains about the care and treatment his wife, Mrs U received from Northern Lincolnshire and Goole NHS Foundation Trust (the Trust). Specifically, he complains that:

• when attending the Emergency Department on 5 February 2024 with an asthma attack, Mrs U waited six hours to receive the first nebuliser treatment and a further three hours to receive the second treatment • a medical student inserted a cannula in Mrs U’s arm incorrectly, causing bleeding and bruising • the Trust did not conduct a swallow assessment on Mrs U • clinical staff in the Emergency Department provided treatment/conducted observations without appropriate personal protective equipment or hand hygiene • the Emergency Department’s level of hygiene and cleanliness was poor • Mrs U received multiple doses of steroids, causing her to receive an overdose

3. Mr U says as a result of the treatment Mrs U received from the Trust, and the lack of hygiene, Mrs U contracted a Pseudomonas infection (an infection caused by bacteria that are commonly found in the environment), and later experienced two Transient Ischemic Attacks (TIA, a ‘mini stroke’) on 9 and 11 February 2024. Mrs U’s mobility has deteriorated significantly since then.

4. By bringing his complaint to us, Mr U would like to achieve financial compensation of between £3,750 and £12,450, in accordance with around level five of our severity of injustice scale.

5. What follows is a summary of the complaint components. We have not included all the detail as both parties are aware of this.

6. Mrs U attended the emergency department on 5 February 2024 experiencing an asthma attack. She received her first nebuliser treatment after six hours and the second treatment after a further three hours.

7. Whilst in the Emergency Department, a medical student inserted a cannula into Mrs U’s arm but experienced some difficultly and this caused Mrs U’s arm to bleed and bruise significantly.

8. Mrs U received multiple doses of steroids to try and control her asthma attack whilst at the Emergency Department. Following this, Mrs U experienced two TIA’s on 9 and 11 February 2024, she was diagnosed with a prednisolone (a steroid) overdose.

11. The law (Health Service Commissioners Act) 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. We have discussed this with Mr U to understand his circumstances and the outcomes he wants to achieve. We do not consider whether legal action would succeed but whether it would be a reasonable option to look into.

12. Section 4(1)b of the Health Service Commissioners Act 1993 (the law) states the Ombudsman shall not investigate if there is a remedy by proceeding the complaint through any court of law. Further to this, the law states that the Ombudsman must be satisfied that in considering personal circumstances of a complaint, it is not reasonable to expect the complainant to resort to legal proceedings.

13. This translates into our own policy, referred to as a ‘two stage legal test’ that we must look at before any consideration of a complaint. The two stages being, is there a legal route and is it reasonable for the complainant to pursue?

Is there a legal route?

14. Through speaking with Mr U, we recognise the strength of feeling that he considers medical negligence has occurred regarding Mrs U’s care and this has caused Mrs U’s deteriorated mobility, and significant distress during her hospital admission in February 2024.

15. The primary redress to Mr U’s complaint is significant financial compensation to acknowledge the impact this has had (and continues to have) on Mrs U both mentally and physically.

16. To reach our view, we consider if a complainant has an alternative legal remedy in relation to their complaint, based on if the remedy they are seeking is one that a court could reach a determination on.

17. We note our own Severity of Injustice Scale, the scale which allows the Ombudsman to make fair and consistent recommendations, where injustices are not remedied. The scale ranges from £0 to around £12,000 at the top of the sixth banding in the scale. As a result of this, though we can make financial awards, we also acknowledge courts can too and can also determine significant financial redress.

18. In this consideration, we are minded that the claimed injustice is ongoing and there is a claim of a serious impact to Mrs U’s ability to live a relatively normal life.

Is it reasonable to pursue a legal claim?

19. After establishing there is a legal route, we have gone on to explore with Mr U if it is reasonable for him to pursue.

20. When considering reasonableness, the factors we consider are based on the individual circumstances of a complaint. Although not an exhaustive list, examples include if the costs are proportionate to the legal claim, if Mr U has financial means to pursue a claim, how long legal proceedings may take, the age and health circumstances of the complainant and, if there are any other circumstances which may impact on this.

21. We spoke with Mr U over the telephone on 12 December 2024 to understand the complaint, the injustices he says were faced as a result of their experiences, and whether legal action would be reasonable for him to pursue.

22. Mr U informed me that he had not contacted a solicitor to date, but he was happy to pursue this alongside this complaint to the Ombudsman if needed.

23. I explained the Health Service Commissioners Act 1993 to Mr U, how it governs our work and what we need to consider before we are able to make a decision. Within this discussion of reasonableness, Mr U did not inform us of any barriers that would prevent him from pursuing a legal remedy.

24. During our discussion with Mr U, we were not made aware of any other circumstances which leads us to consider it unreasonable to pursue a legal route, no barriers, or any concerns to prevent this.

25. We consider it is reasonable for Mr U to pursue a legal route as he has expressed that he hopes to achieve a significant financial remedy of between £3,750 and £12,450, and we have not been made aware of any other present factors that may cause us to doubt this reasonableness.

In summary

26. The law 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) reasonable in the circumstances. We have engaged with Mr U to understand his circumstances, the outcomes he hopes to achieve, and if it is reasonable to pursue a legal route.

27. With Mr U’s complaint it is clear that intent to pursue a legal route is available and from the conversation had with Mr U we recognise this potentially could be for a significantly increased amount of money. We have not been made aware of barriers that would stop this. We therefore consider there is potential for the Ombudsman to be prevented from investigating the complaint in line with the statutory bar (legal requirement) and therefore we would expect the complainant to have resorted or to resort to pursuing a legal route firstly.

1. We have carefully considered Mr U’s complaint about Northern Lincolnshire and Goole NHS Foundation Trust. We were sorry to hear of his concerns regarding the care his wife, Mrs U received and the impact this continues to have on her. In speaking with Mr U, we consider he should take legal action on the matter he has brought to us, and it is reasonable for him to do so.