Removal from titration list
15. We first looked at Mr A’s complaint about Psychiatry UK’s decision to remove him from its waitlist for ADHD medication titration. He says he was unaware he had not sent all necessary information in time.
16. An ADHD specialist and independent prescriber contacted Mr A via email on 31 January 2024. They asked Mr A to complete a pre-titration checklist and provide an image of his photo ID as well as his current blood pressure, pulse, height and weight measurements. Both the email and letter clearly state Mr A needed to provide all necessary information by 13 February or Psychiatry UK would discharge him back to his GP.
17. On 15 February Psychiatry UK contacted Mr A to advise it was removing him from the waitlist.
18. Psychiatry UK told us its removal of Mr A was made in line with its ‘Titration not started process guide’. However, this guide did not detail what happens in situations like Mr A’s, where he engaged but did not send all necessary information by a deadline.
19. In lieu of specific standards or guidance, we refer to our Principles of Good Administration. These say organisations should communicate effectively, using clear language that people can understand and that is appropriate to them and their circumstances. Organisations should aim to ensure that customers are clear about their entitlements. Both in terms of what they can and cannot expect from the organisation and about their own responsibilities.
20. Both the email and the welcome letter show Psychiatry UK told Mr A what information it needed from him by 13 February. It is clear Mr A understood this as he told us he was aware of what he needed to send but did not realise he had missed a document.
21. The NHS constitution states people can make a significant contribution to their own good health and wellbeing and should take personal responsibility for this. It asks people to provide accurate information about their health, condition and status and talk to their clinician if they have difficulties.
22. Mr A had access to an online portal where he could directly upload the necessary information and was able to check what he had already provided. He acknowledged he did not send all the necessary information in time. Mr A says he found the online portal confusing and was unaware he had missed anything. We are sorry to hear he had difficulties accessing the online portal and recognise how frustrating this was.
23. We can see the email and welcome letter contain contact details for the prescriber. We consider Mr A could have contacted his prescriber if he was experiencing issues with the online portal before the deadline. Had he done so, Psychiatry UK could have supported him with providing the necessary information in time.
24. Our Principles of Good Administration state that organisations should communicate what customers can expect from the organisation as well as their own responsibilities. Having reviewed Psychiatry UK’s communication with Mr A, it clearly set out what he needed to send and when. We are satisfied that it properly explained what would happen if he did not provide this by the deadline.
25. As per the NHS constitution Mr A had a responsibility to provide Psychiatry UK with the information it needed by 13 February. He did not do this, and it reasonably removed him from its titration list. For this reason, we have seen no indication that anything went wrong in this aspect of the complaint.
Communication
26. Mr A also complains Psychiatry UK said it had removed him for not engaging with the titration process. He says he did engage with the process, rather that he missed some documents.
27. Psychiatry UK told Mr A it had removed him for not engaging. The evidence suggests this was not the case. As we explain above, Psychiatry UK removed Mr A from its list as he did not provide all necessary information by 13 February.
28. Mr A found Psychiatry UK’s communication around the removal confusing. He says this caused him distress as he could not understand why it was removing him for not engaging when he had engaged with the process. We have informed Psychiatry UK that its ‘Titration not started process guide’ does not appear to apply to Mr A’s situation and therefore that its explanation for his removal did not appear to be accurate.
29. Mr A said the most important outcome for him was for Psychiatry UK to improve its services to prevent others from having a similar experience.
30. Psychiatry UK said it had reflected on Mr A’s complaint and made service improvements. It said if a patient engages but has not provided all necessary by a deadline, it now contacts them and offers an additional seven days to provide missing information. It explained it is currently amending its policy to cover situations like Mr A’s.
31. We asked if Psychiatry UK was willing to write to Mr A to acknowledge the reason it gave for removal was incorrect and apologise for the impact this had. As well as confirm the service improvements it has made. Psychiatry UK confirmed it is willing to do so.
32. Our Principles for Remedy say where poor service results in injustice, organisations should take action to put the complainant back in the position they would have been in had the poor service not occurred.
33. We consider the outcome Psychiatry UK is willing to provide is appropriate for the impact Mr A has experienced and are satisfied this is in line with our Principles for Remedy. For this reason we are not taking any further action. We recognise this has been a stressful time for Mr A and are pleased to hear he has since begun titration with positive effect. We thank him for bringing his complaint to the Ombudsman.