Waiting times
13. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the event complained about had a negative effect which the organisation has not put right. Having done so we have found the Trust has already done enough to put right the impact of these events.
14. Ms W complains she injured her finger in January 2024 and did not see a consultant until August 2024.
15. Ms W explained in January 2024 she caught the tip of her finger whilst making her bed. She says she noticed her finger was not straightening and treated herself with a splint and gentle exercises.
16. Ms W says her finger became infected and she visited her GP who prescribed antibiotics and referred her for physiotherapy.
17. Following her physiotherapy appointment, the physiotherapist referred her to the Trust.
18. Ms W had an appointment with the Consultant Orthopaedic Surgeon on 27 August 2024.
19. The Trust response dated 8 January 2025 says the Trust received the referral from the Musculoskeletal Partnership on 16 February 2024.
20. The Trust response acknowledges Ms W did not have an appointment with the Consultant Orthopaedic Surgeon until 27 August 2024.
21. The Trust response explains there are long waiting lists for some trauma and orthopaedic specialities and apologised to Ms W for the waiting time being longer than expected.
22. The Trust response further explained Ms W’s recovery may have been easier if her GP had referred her to the hand service to see the hand therapy team. The Trust response says the Trust runs an acute hand injury service every week with open access for all types of injuries via Emergency Departments and GP’s.
23. It is unknown why Ms W’s GP did not refer her to the hand therapy team. This is not included within her complaint to the Parliamentary and Health Service Ombudsman (PHSO).
24. The NHS Constitution Handbook (October 2023) says ‘You have the right to start your consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions’.
25. The Musculoskeletal referred Ms W to the Trust on 16 February 2024. This means she waited 27 weeks from referral to her appointment on 27 August 2024. This is nine weeks longer than the NHS Constitution states.
26. It is clear Ms W waited longer than the target weeks set in the NHS Constitution which is an indication of a service failing.
27. If Ms W’s appointment had taken place within the NHS Constitution target of 18 weeks her appointment would have taken place by mid-June 2024.
28. We have looked at the impact on Ms W during the period of mid-June 2014, when her appointment should have taken place until the 27 August 2024 when her appointment did take place. This is a period of nine weeks.
29. Ms W says a result of the delayed appointment she suffers from pain in her left middle finger, and she struggles with gardening, cooking, and cleaning. Ms W says the pain is mild most of the time.
30. We are not made aware if Ms W was chasing the wait times or presented in A&E or at her own GP during this period to have the pain and discomfort addressed.
31. In her complaint to the Trust following her appointment Ms W said her finger was nice and straight but it feels stiff and tight, and it can ‘throb and swell’ if she types for too long.
32. Ms W’s desired outcome is an apology.
33. We can see the Trust have acknowledged the delay in Ms W’s appointment taking place and have apologised for this. We have reviewed the apology dated 8 January 2025.
34. When we identify a failing and impact flowing from it, we consider the range of injustices and impacts and use our severity of injustice scale to do so. This is a transparent scale the Ombudsman uses to ensure fairness in our decision making. The scale has six bandings ranging from lower-level injustices of worry or distress or inconvenience up to level six injustices where profound loss of life or permanent disability may occur.
35. Further to this we conduct precedent checks on all complaints we investigate to look at similar failings and remedy and lastly, we use a typology of injustice to establish if our remedies are consistent with others to ensure fairness.
36. In conducting our work, though we recognise what a complainant is seeking for remedy, it is for the Ombudsman to decide what remedy is fair, reasonable, and proportionate to a complaint.
37. Level one on the Severity of Injustice scale says ‘a case will generally be level one if we consider the person affected has experienced a low impact injustice such as annoyance, frustration, worry or inconvenience, typically arising from a single (one-off) incidence of maladministration or service failure, where the effect on the person complaining is of short duration, and where there are no other adverse effects or ongoing wider impact. We will usually consider an apology to be an appropriate remedy for these cases.’ We also note level one matters tend to be of a short duration up to two weeks.
38. We consider the Trust did not meet the waiting time target set by the NHS Constitution. And the impact on Ms W is at level two of the Severity of Injustice scale.
39. In Ms W’s case we consider Level two is appropriate. Level two on the Severity of Injustice scale accounts for minor pain of a longer duration.
40. Ms W explained to us the pain she experiences is mild most of the time. Although she does struggle with gardening, cooking, and cleaning she is able to carry out the tasks for short periods of time.
41. We consider an acknowledgement of the delay in Ms W’s and an apology is an appropriate response. We also note Ms W is not seeking financial redress.
42. We are reassured through precedent checking this does not indicate a matter indicative of a wider systemic issue thus the apology is in line with the principles of how we remedy a complaint – fair, proportionate, and reasonable in relation to the complaint handling. Thus, Ms W’s complaint can be closed as the Trust have apologised to Ms W.
43. We can see Ms W has had a troubling experience and would like to thank her for giving us the opportunity to look into her concerns. Complaints give us valuable insight into the organisations we investigate, and we recognise this has been an emotionally challenging process for Ms W. We would like to thank her for sharing her experience with us.