Manchester University NHS Foundation Trust

3. Mr H complains Manchester University NHS Foundation Trust (the Trust); • did not categorise his referral from NHS dentist correctly in April 2024 resulting in an appointment not being arranged until 18 December 2024 • did not take the symptoms he reported to the Trust’s helpline between April and July 2024 seriously enough.

4. Mr H explains, had the referral been categorised correctly in April 2024 his referral would have been sooner than 18 December 2024. Mr H believes if his telephone calls to the Trust have been dealt with correctly his treatment would have been expedited. As a result, he was in pain for longer than he should have been, so visited a private dentist at considerable cost.

5. As an outcome to his complaint, Mr H wants a financial remedy to reimburse the £17,000 he paid for private dental care. He also wants significant compensation in line with level 6 of our Severity of Injustice scale. He would like the Trust to change its process to categorise all ORN patient referrals as urgent.

6. Mr H told us he had tonsil cancer several years ago. As a result of the radiotherapy administered during his treatment he was diagnosed with Osteoradionecrosis (ORN). ORN can occur after radiotherapy, particularly to the jaw area. It is characterised by the death of bone tissue due to decreased blood supply. As a result of this diagnosis, Mr H explained it was likely he would lose his teeth.

7. In April 2024 Mr H was in need of a tooth extraction and visited a local NHS dentist who referred him to the Trust.

8. Mr H believes the NHS dentist explained the issues he was experiencing fairly in their referral but believes when the Trust triaged his case they miscategorised the referral, downgrading the severity unreasonably. This resulted in an appointment being made for him for 18 December 2024.

9. Mr H explained he telephoned the Trust on several occasions between April and July 2024 as the pain he experienced worsened. During his final call on 22 July 2024, he described how his symptoms had progressed. He explained he was in extreme pain as a result of an exposed root.

10. Mr H said the Trust’s helpline service was poor. He says the Trust maintained its stance that he needed to wait for his appointment in December 2024. He says it did not offer any support to manage his developing issues.

11. While awaiting his appointment Mr H sought the help of NHS dentists who were unable to support with an extraction due to the ORN diagnosis. Mr H also visited private dentists to request the required extraction. Despite several requests, both the NHS and private dentists explained the secondary care at the Trust was the only option available.

12. Mr H went to a private dentist who had agreed to complete the extractions, and they also performed a procedure to input implants for the missing teeth at a cost of £17,000.

15. 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) unreasonable in the circumstances. We have discussed this with Mr H to understand his circumstances and the outcomes he wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

16. Mr H raised concerns about the clinical care and treatment provided by the Trust. He believes these failings meant he had nowhere else to turn other than the private dental practice who ultimately completed the treatment.

17. As an outcome to his complaint, Mr H has told us he is seeking a financial remedy. When we explored this further, Mr H told us she is seeking reimbursement of private dental treatment of £17,000 as well as compensation of over £12,500 for the pain and worry this matter has and continues to cause.

18. Given Mr H’s complaint, it appears he may have a claim for clinical negligence. This is because he believes the Trust’s failure to carry out the treatment in a timely manner has resulted harm for which he seeks a financial remedy. We have gone on to consider whether it looks like legal action could achieve the outcomes Mr H is seeking.

19. Mr H also wants service improvements in the form of better care should he need to return for similar treatment in the future which he says is likely given his ORN diagnosis. Mr H told us his primary outcome is a financial remedy.

20. Whilst we can ask the Trust to consider service improvements, we cannot tell it what care it should provide. The Trust may consider altering its approach in the future if Mr H’s legal case is successful.

21. Mr H stated the only barrier to him pursuing legal action was him ‘not knowing where to start’. We have provided Mr H with information on organisations who can support him.

22. As Mr H has a legal route available to him and it is reasonable for him to pursue, we will not be taking any further action on his case.

23. Mr H can return to us if he finds he is unable to pursue legal action. He can also return to us if following legal action, he has outstanding outcomes which the court was unable to order, or if the court was unable to consider parts of his complaint.

24. We were sorry to hear of Mr H’s experience and the ongoing impact that this has had on them and thank him for bringing his concerns to our attention.

1. We have carefully considered Mr H’s complaint about Manchester University NHS Foundation Trust (the Trust). We were saddened to hear of the events Mr H complains about, how he continues to deal with these issues and how the worry of these issues being repeated continues to impact his life.

2. We believe Mr H may have a legal remedy available to him. Having discussed this with Mr H we consider it is reasonable for him to pursue this. We are therefore unable to consider his complaint at this time.