A practice in the Oldham area

4. Ms A complains about the care and treatment she got from the Practice from February to June 2021.

5. She complains that:

• the Practice incorrectly told her to go to A&E for follow up care • the Practice incorrectly told her to contact the ‘7 Day Access Service’ (a service offering extra appointments at other local practices) • she received a zero-tolerance letter from the Practice about a phone call she had with it • she received a letter from the Practice saying it had removed her and her children from its Practice list.

6. Ms A believes the Practice has incorrectly used its zero-tolerance policy to remove her without any ‘clear or sufficient evidence’ to explain the decision. She says the situation has made her feel ‘less trusting than before’. Ms A also says the situation has affected her health as the stress of having to register at a new GP practice at short notice caused her to have migraines.

7. She explains she had to ask advice from chemists for her child’s skin conditions. She explains her children were upset at having to change GP practices and were affected by seeing her stressed.

8. Ms A wants the Practice to acknowledge that errors were made in applying the zero-tolerance policy. She also wants service improvements to stop this happening again and to make sure all staff are correctly trained.

9. On 26 February 2021 Ms A contacted the Practice as she had numbness, tingling with pins and needles and poor circulation in her arm after an operation on it the day before. The Practice told Ms A to go to A&E if her symptoms did not improve or got worse.

10. On 19 March Ms A contacted the Practice as she was still having issues with her arm. The Practice told her there were no appointments available so she needed to contact the ‘7 Day Access Service’.

11. Ms A contacted the Service on the same day but was on hold for two hours trying to get through. As her arm was cold and painful she ended the call and contacted the Practice again. The Practice repeated what it had told Ms A earlier then told her to go to A&E and ended the call.

12. Later the same day Ms A contacted the Practice again and spoke to the office manager. An appointment was made for 4.30pm that day. The office manager said the receptionist Ms A had spoken with during her last call thought that she was rude to her.

13. Ms A attended the appointment expecting to be seen by one of the Practice GPs but was seen by an Advanced Nurse Practitioner (ANP).

14. On 22 March Ms A received a zero-tolerance letter from the Practice about the phone on 19 March.

15. On 10 June Ms A went to the Practice to complete data sharing opt-out forms (which stop your data being shared outside of the Practice).

16. On 15 June Ms A received a letter from the Practice saying it had removed her and her children from the Practice list due to offensive comments she was heard saying about the Practice manager on 10 June.

19. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to.

20. Ms A knew there was a problem from as early as 26 February 2021. To be within the time limit for raising a complaint with our service she needed to come to us by 26 February 2022.

21. We can see Ms A raised her complaint directly with NHS England on 20 October 2021.

22. The evidence available shows Ms A had appointed an advocate to help her with the complaint in 2021. The earliest contact we have seen between Ms A and her advocate is 24 August 2021. This evidence also shows the advocate chased NHS England for a response to the complaint on 24 March, 24 May and 31 August 2022.

23. NHS England responded to the advocate on 2 September 2022 explaining there had been delays in receiving a detailed reply from the Practice, which it received on 11 August 2022. NHS England issued its complaint response on 7 October 2022, which Ms A has confirmed she received on 20 October.

24. Ms A contacted our service on 20 October 2022 as she was unhappy with NHS England’s response. We emailed a blank complaint form to Ms A on the same day asking her to complete it and return it to us.

25. We received Ms A’s completed complaint form on 18 April 2023.

26. Ms A’s complaint was outside the 12 month time limit when she approached us on20 October 2022.

27. When Ms A returned to us on 18 April 2023, the complaint was even further outside the 12 month time limit. We needed to find out what happened between 20 October 2022 and 18 April 2023 to consider putting the time limit to one side.

28. We emailed the advocate to ask why it took Ms A almost six months to provide her completed complaint form.

29. The advocate responded saying that Ms A was ‘struggling with her health’ and had a ‘real scare regarding her thyroid’. The advocate also explained Ms A is a busy full time working mum with two young children to look after and that she wanted to make sure her complaint form was correct before submitting it.

30. We emailed the advocate again explaining that for us to consider setting the time limit to one side we need to understand the impact the matters complained about had on Ms A’s ability to complete day to day tasks such as going to work. We asked her to clarify if Ms A needed any medical treatment or hospital stays during this time.

31. The advocate replied with more information and explained that during this time Ms A was very lethargic (tired) because of her thyroid issue. She says Ms A suffers with chronic migraines and has an occupational therapy report to confirm this.

32. The advocate explained Ms A was struggling with work and using the computer and so worked under flexi time arrangements. She said at the end of her busy days, Ms A was ‘too tired to sit down and work on the complaint form’.

33. We are sorry to learn Ms A had a difficult time with her health. We thank her for her honesty and for the level of information she provided to explain the reason for the delay in coming back to us.

34. While we acknowledge the reasons provided by Ms A for the delay in coming back to us, we have not seen good reasons to set our time limit to one side.

35. We consider that although Ms A was a having a difficult time in her life, she could have come back to us sooner than 18 April 2023. We also consider that she had an advocate available to her, who was previously helping her with the complaint. Ms A was aware that advocacy was an option for her if she was struggling to complete her complaint form.

36. We also consider Ms A would have been aware of our time limits as it is included on the complaint form which we sent her by email. It seems reasonable to have expected her to come back to us earlier than 18 April 2023.

37. We thank Ms A for giving us the opportunity to look at her concerns about the Practice.

1. We have carefully considered Ms A’s complaint about the care and treatment she received from a practice in the Oldham area (the Practice). We are sorry to learn of the events that led to Ms A making a complaint.

2. We have decided Ms A’s complaint is outside our 12-month time limit and we have not seen good reason to put this to one side.

3. We recognise that this is not the decision Ms A had hoped for and do not wish to lessen the impact the events have had on her and her children. We explain our decision below.