2. Mrs O complains the Trust’s gynaecology department discharged her from its service after offering a cancellation appointment that she was unable to take.
3. Mrs O says this has caused her to start the referral process again with her GP, she is in pain and discomfort every day, it is affecting her quality of life.
4. As an outcome she wants to be issued a surgery date or information as to when she can expect the surgery.
5. In October 2020, Mrs O’s GP sent a referral to the Trust for a consultation with a gynaecologist for management advice.
6. In June 2021 Mrs O was seen and was added to inpatient waiting list.
7. On 12 November 2021 Mrs O was offered a cancellation appointment for surgery but was unable to take as it was inconvenient time.
8. Mrs O was then removed from the waiting list and the Trust say no further contact was made.
9. In August 2022 Mrs O chased up appointment, and found out she was removed from waiting list.
10. In August 2022 Mrs O went back to her GP to make another referral.
11. On 16 June 2024 Mrs O raised a formal complaint raised with Trust.
12. On 3 September 2024 Trust gave its final response.
15. The law says people need to make their complaint to us within a year of becoming aware of the problem. We cannot consider complaints brought to us after one year, unless we consider there is a good reason to do so. We have discussed this with Mrs O to understand why she did not complain to us sooner.
16. Based on the information provided by Mrs O and the Trust, we have established Mrs O knew of her reason to complain in August 2022. This is when she was made aware she had been taken off the waiting list for surgery.
17. When considering complaints bought to us outside of our time limit we turn to look at the complaint timeline to identify and understand the reasons for any delays. We consider the reason for any delays, including and delays by the Trust during its complaints process.
18. If we identify delays which are justified, we may consider setting the time limit aside for that period.
19. Mrs O knew about the events complained in August 2022. She complained to the Trust in June 2024. In line with our time limit we would expect Mrs O to bring her complaint to us by August 2023. She bought her complaint on 16 September 2024. We consider this means the complaint is over 13 months outside our time limit.
20. In conducting our work, where a delay has occurred we consider what prevented a complaint being raised promptly to reach the Ombudsman and if those reasons for delay are reasonable and clearly justify the delay.
21. There is no exhaustive list of reasons which we refer to and in conducting our work, consider each complaint and delay on a case by case basis. It is for the Ombudsman to decide whether we can put our time limit aside and something we must consider by law.
22. When a complaint comes to us outside of the 12 month time limit, we must consider whether to put the time limit to one side. In doing so we should consider the complainant’s reason for the delay and the time it has taken them to pursue the organisation’s complaints process. We can only set the time limit aside if we see exceptionally good reasons for doing so.
Complaints process
23. Mrs O complained to the Trust on 16 June 2024 and the Trust responded on 3 September 2024.
24. The Trust took three months to respond to Mrs O’s initial complaint which is in line with National Health Service Complaints (England) Regulations 2009. This says complaints should be answered within six months. We do not consider the time the Trust took to handle the complaint caused any unnecessary delay.
Complainant’s explanation for the delay
25. We discussed Mrs O’s reason for delay in raising a complaint with her. She says when she was put back on the waiting list she thought she would just be given or offered a new date. She says she did not expect to be put back on a waiting list and have to wait an extra 14 months on top of what she had already waited.
26. Mrs O also says she feels the complaint response is confusing, as it says the Trust was waiting for her to get back in touch when it was convenient. She says this meant she thought she would get a date sooner than the Trust offered and it did not make it clear, or she did not realise she would be back in a queue. She also did not realise her quality of life would remain affected for so long.
27. We asked why Mrs O did not raise the complaint in August 2022 when she first found out she had been taken off the waiting list. Mrs O said when she was taken off the list she started to look into private care to see if she could fund the surgery privately to get it done quicker.
28. She contacted a private health provider, and says she spoke with the same secretary at the Trust who she had previously when under the Trust. The secretary told her not to pay any further and they would attempt to try and get her back on the Trust’s list. Mrs O says she just thought it would get sorted one way or another.
29. We also asked why she did not complain at all during 2023 as she was still waiting. Mrs O told us she did not really have the time. She says she is running the household by herself; she has four children one who is disabled, and she has lots of appointments for him, and her own health takes a backseat.
30. Mrs O says she has no support; her husband mainly lives in the middle east for work, and they are going through a divorce. She said she cannot be chasing up appointments and complaints about her health and feels the Trust know there is a problem that requires an operation and just keep putting it off.
31. We appreciate the above caused strain and added pressure for Mrs O and can take up a lot of her time. We also acknowledge that her husband works away, and this adds pressure trying to run family and a home on her own.
32. We have to consider the situation with Mrs O’s family and home life has been this way for a long time. We understand these circumstances were the same in August 2022 when she found she wanted to complain as they were in June 2024 when she complained to the Trust and in September 2024 when she brought the complaint to us.
33. We therefore do not feel these were exceptional circumstances for her.
34. We think Mrs O was reasonably aware she had reason to complain when she went back to her GP in August 2022. We are not persuaded that these are exceptional circumstances that could have prevented her in raising a complaint after August 2022 or throughout the whole of 2023 and into the first half of 2024.
35. It is the complainant’s responsibility to ensure they get their complaint to us within a year of when they first became aware they needed to complain.
36. We asked if Mrs O had any support around for her during this time to help her raise the complaint or if she approached any advocacy services. Mrs O said no, and explained her husband moved away three years ago; she does not really have anyone she does not have a social life so no friends to call on. She told us she is a full time carer for her son, he is out of education now which is more difficult as there is no one to step in and help. Her parents work full time, and her grandmother passed away in December 2023 and she felt this is when everything peaked.
37. We recognise Mrs O has been through a difficult time with losing a loved one, and having full time caring responsibilities of her son and other children alongside her own ongoing health issues.
38. We need to consider that by December 2023, when she was dealing with a bereavement, her complaint was already four months outside of our time limit.
39. Mrs O said she does not or was not aware of getting an advocate for herself. She says she has an advocate that helps her son but was unsure how to get help from an advocate to make her own complaint. We have listened to what she has told us about being unaware she could get an advocate. We note when she brought her complaint to us, she did so herself without the support of an advocate.
40. We asked Mrs O what was different in June 2024 when she felt able to make the complaint to how things had been in the previous 22 months. She told us the pain got so severe it was impacting on how she was able to look after her children. Mrs O said she had to attend A&E and there was a significant rise in her attending GP and hospital appointments.
41. Mrs O said she felt from January 2024 is when everything peaked, and she was unable to look after anyone which is why she went to outside agencies to try and get help with her son as she was struggling. She says she is only just starting to get the help now. We appreciate and understand Mrs O has been suffering with her symptoms alongside looking after her family during a challenging time.
42. We must consider 22 months is a considerable amount of time to wait before making a complaint. We have considered everything Mrs O has told us. We are not persuaded during the 22 month period she could not make time to raise a complaint We consider her circumstances, while challenging, were largely the same, but with worsening symptoms in June 2024 when she did first complain to the Trust as in August 2022.
43. We consider there likely were opportunities for Mrs O to complain earlier once she found out in August 2022 she was taken off the Trust’s waiting list for surgery.
44. We consider the 22 months wait to raise any concerns with the Trust was not a justifiable delay.
45. We have carefully considered Mrs O’s health issues and the caring responsibilities of her son and other children. We are not persuaded these justify a 22 month period of inactivity in totality.
46. It is our view Mrs O could have brought her complaint to us sooner and the reasoning she has provided is not sufficient or persuasive for the Ombudsman to overlook this extensive time-period. Therefore, we will take no further action.
47. We thank Mrs O for bringing her complaint to us. We are pleased to hear Mrs O has now seen a consultant in December 2024 and is now on a waiting list for surgery. We wish her well with this.
1. We have carefully considered Mrs O’s complaint about The Royal Wolverhampton NHS Trust (the Trust). We are sorry to hear about the difficulties Mrs O faced during this time. We have decided the complaint falls outside of our time limit. We have not seen sufficient reason for us to put our time limit aside to consider it further.