4. Ms G complains about the care and treatment provided by the Practice, between June 2021 and July 2023. Specifically, Ms G complains opportunities were missed to diagnose and treat her infections.
5. Ms G says she has been left suffering and in pain, and she is concerned that her infection may be passed to others.
6. Ms G is seeking our independent review and an acknowledgement of the failings in her care, with a view to potentially receiving further treatment.
7. Ms G was in contact with the Practice between June 2021 and July 2023, as she felt she had an ongoing infection, which may have various causes such as mould, cats, rats and parasites. She was very worried that this was also affecting her daughter and family, and her concerns have had a considerable impact on her daily life.
8. The Practice noted Ms G’s concerns with her itchy skin and arranged tests for this and provided medication and creams. The Practice also referred Ms G to dermatology to consider her symptoms further.
9. Ms G remains concerned that no cause for her symptoms has been diagnosed. She feels her symptoms have instead been dismissed as mental health concerns.
13. We have reviewed the care the Practice provided in line with the GMC guidance ‘Good medical practice’. This says doctors must provide a good standard of practice and care. To do this, the doctor must:
• ‘adequately assess the patient’s conditions, taking account of their history (including the symptoms and psychological, spiritual, social and cultural factors), their views and values; where necessary, examine the patient • promptly provide or arrange suitable advice, investigations or treatment where necessary • refer a patient to another practitioner when this serves the patient’s needs.’
14. Ms G attended the Practice on a number of occasions to report concerns about a facial skin rash and itchy eyes. We can see the GP appropriately considered these and prescribed medications to help treat any secondary infection from the facial rash, and eye drops to help the eye symptoms.
15. In addition, the GP also recommended Ms G seek further review from her optician and made referrals to dermatology to consider the skin rash. We consider these actions were appropriate in line with the GMC guidance, as the Practice referred Ms G to other appropriate practitioners to further consider her symptoms.
16. Ms G was seen by the dermatology clinic on 27 September 2021. The clinic letter to the Practice explained Ms G had a history of seborrhoeic dermatitis (a long-term skin disorder - symptoms include flaky, scaly, greasy, and occasionally itchy and inflamed skin) and had previously raised concerns about infections caused by parasites. It also noted Ms G’s current struggles with symptoms of itching and that she felt she had an infection in her skin.
17. The dermatologist assessed Ms G’s skin and arranged medication to treat a possible pruritus condition (the medical term used to describe the feeling of itchy skin) and also arranged blood tests to consider if there were any underlying factors to her generalised itching. We therefore consider the Practice will have had reassurance that Ms G’s symptoms were being fully considered by an appropriate specialist.
18. The initial dermatology tests did not show cause for concern. The dermatologist therefore referred Ms G to a different dermatology department, who were specialist in unexplained medical conditions. This team arranged further testing of some samples Ms G brought to the appointment. The specialist dermatology clinic recognised the considerable distress Ms G was experiencing but explained the test results did not show a cause for concern and there was no evidence to suggest a parasite or infection.
19. Ms G had further review with the dermatology team, and it was suggested that Ms G may benefit from mental health support. We can see the Practice made referrals to the appropriate teams to see what support could be offered to Ms G. Again, we consider the Practice’s actions here were in line with the GMC guidance.
20. In addition to the above, we can also see Ms G attended the sexual health clinic, to see if her symptoms were related to a sexually transmitted infection. The letter to the Practice explains the clinic completed blood tests and an examination, and the test results were all negative.
21. Ms G also told us she had seen a private consultant and had been diagnosed with giardiasis. This is an infection in the small intestine caused by a microscopic parasite called Giardia lamblia. We have reviewed Ms G’s records and can see a clinic letter from the private consultant on 31 August 2023. This notes Ms G had requested testing for worms and parasites, and a stool test had been completed. The private consultant notes the results of this were negative.
22. We have not seen any other evidence to suggest Ms G has been diagnosed with an infection caused by worms or parasites.
23. We recognise Ms G feels her symptoms have been dismissed as being related to mental health concerns. This is a difficult and distressing position for Ms G.
24. From our review, we can see the Practice has carefully considered Ms G’s symptoms, prescribed treatment, and made appropriate referrals to specialists where needed. We have not seen any indications to suggest that her symptoms were dismissed or ignored and have not seen indications to suggest an opportunity was missed to diagnose or treat an infection.
25. It was appropriate for the Practice to also consider any mental health support Ms G might need during this time in line with the GMC guidance, as it is clear her symptoms were causing her considerable distress and were affecting her daily life. We therefore do not see indications of failings in the mental health advice and referrals.
Conclusion
26. Whilst we have not seen indications of failings in the care provided by the Practice, we do not doubt the significant distress and concern these events have caused Ms G. We hope our report provides some reassurance that these events have been carefully considered.
1. We have carefully considered Ms G’s complaint about the Practice. We recognise Ms G’s considerable distress that she has an ongoing infection, and her concern that opportunities to diagnose and treat this have been missed.
2. We have carefully considered the records and have not seen indications of failings in the care provided by the Practice. We can see appropriate tests were arranged and Ms G was also referred onto appropriate specialists to consider her symptoms. It is for these reasons that we do not take further action on this complaint.
3. We recognise our findings may be difficult for Ms G, but we hope our report provides some reassurance as to the actions taken by the Practice.