A practice in the City of Southampton area

4. Mr R complains the Surgery withdrew mental health support for him in February 2023 and failed to communicate this decision with him or provide alternative support. He says the lack of support has caused him emotional distress and has resulted in his mental health deteriorating. He says he has also lost faith in the Surgery. He wants an acknowledgement of failings, an apology and service improvements.

5. Mr R has been under the care of the mental health nursing team at the Surgery since November 2022. In February 2023, he was discharged from this service and received a text message informing him of this on 31 March.

8. Mr R complains the Surgery withdrew mental health support for him in February 2023 and failed to communicate this decision with him or provide alternative support. Mr R told us he had been under the care of the mental health nursing team at the Surgery since November 2022, but he was discharged in February 2023 without any warning which left him without any mental health support.

9. Mr R was supported by a mental health practitioner (MHP) at the Surgery from 2022. MHP’s provide GPs and other primary care staff with timely support on the best ways to help people with complex mental health needs, helping to relieve pressure on workloads and building stronger relationships with mental health services. Mr R had weekly then two weekly telephone call appointments with the MHP.

10. The NMC code says a nurse should work in partnership with people to make sure care is delivered effectively and encourage and empower people to share in decisions about their treatment and care.

11. On 25 January 2023, the Surgery spoke to Mr R and noted in his records that he advised he was attending the gym and having sessions with a private therapist. Following this call, the Surgery noted it would not book any further follow up telephone appointments as Mr R said he wanted to move his life forward. We have not seen any evidence that this was explained to Mr R during this call.

12. In the following months, Mr R attempted to access ongoing support through the Surgery. On 31 March, it sent him a short text to advise him the MHP would no longer engage with him, and he should access any additional support he needed through his GP.

13. Based on the evidence we have seen it does not appear the Surgery acted in line with the NMC code as it did not discuss the discharge with Mr R on 25 January and did not fully explain why when he tried to access support from the MHP why he could no longer do this. Mr R was also not given an opportunity to be involved in decisions about his treatment and care in line with the NMC guidance.

14. In its final response to the complaint the Surgery did explain a patient has one pathway of care and as Mr R was seeing a private therapist, no further input from it was needed at that time. But this was not explained at the time.

15. Mr R told us the lack of support caused him emotional distress and has resulted in his mental health deteriorating. He says he has lost faith in the Surgery.

16. We have seen that at the time of discharge from the MHP, Mr R was given advice on getting additional support through e-consult. This is a software which allows a patient to quickly and safely get help and advice from their own GPs if needed. We have seen evidence that Mr R knew how and did contact the Surgery using e-consult when he needed support. We have therefore not seen any significant gaps in him being offered support.

17. We recognise how upsetting and difficult it was for Mr R when he reached out for mental health support and was sent a brief text from the MHP. He has told us he was able to access support through other means, but we can clearly see from what he said this did cause him distress at an already stressful time.

18. In its final response, the Surgery acknowledged how upsetting this experience was for Mr R and apologised for the abruptness of the text. The MHP also reflected on their own practice to ensure learning from the complaint.

19. Our Principles say that to put things right organisations should provide an apology, explanation, and an acknowledgement of responsibility, as well as remedial action.

20. We are satisfied that the actions of the Surgery in acknowledging it did not communicate with Mr R enough, providing an apology and giving feedback from the individual to ensure good practice, are in line with our Principles for putting things right. This also appears to have achieved the outcomes Mr R told us he wanted.

21. We will therefore not take further action on this complaint. We hope we have been able to clearly explain our decision not to consider his complaint further and hope he will get some reassurance from the actions taken by the Surgery. It is understandable from what Mr R has told us that he felt let down by the Surgery in relation to his mental health support. This has clearly been a very difficult for Mr R and we are sorry for his experience.

1. We have carefully considered Mr R’s complaint about the Surgery. We were sorry to hear of Mr R’s experience and the impact that this had on him. It is clear that this has been a very difficult time for Mr R, and we were sorry to hear he felt unsupported by the Surgery.

2. We have looked at the evidence provided to us by Mr R and the Surgery, and it appears the Surgery did not fully follow guidance in its communication with Mr R in relation to his ongoing mental health support. We have seen the Surgery has already acknowledged and apologised for the lack of communication. Based on this, we consider the steps the Surgery has already taken to acknowledge, apologise, and reflect on future practice, has addressed what went wrong and there is nothing further for us to add.

3. We are sorry for any additional upset this may cause and hope our explanations below explain how we have fully considered this.