3. Mr M complains his GP failed to refer him for a hip replacement during his consultation in November 2022.
4. He says he has suffered daily with hip and groin pain for much longer than he needed to. He says he and his wife have suffered financial hardship by having to pay for his hip replacement privately. He says he was in so much pain he felt suicidal at times.
5. Mr M is seeking a financial remedy by bringing his complaint to us.
7. In November 2022. Mr M says he attended the Practice with hip and groin pain. He says the doctor examined him and he found movement painful. Mr M says the doctor told him a referral for a hip replacement had a lengthy waiting time unless he was able to go privately.
8. Mr M says he was not able to go privately due to the cost and told the doctor he would wait his turn on the NHS waiting list.
9. In March 2024, Mr M contacted his new doctor (the previous doctor had left the Practice) to enquire about the referral. Mr M says he was devastated to learn he had not been referred in November 2022 like he thought.
10. Mr M complained to the Practice in September 2024. He also sent his complaint to the Complaints and Patient Advice and Liaison Service (PALS) Officer at NHS Gloucestershire Integrated Care Board (ICB). PALS contacted the Practice on 13 November 2024 and the Practice responded on 18 November 2024. PALS told the Practice it would send an explanation to Mr M.
11. In December 2024, Mr M had a hip replacement through private care which he says he and his wife struggled to afford.
12. To decide if we should conduct a detailed investigation, we first consider if there are reasons not to. These include if an investigation might not be practical or come to a satisfactory conclusion. We have considered this case and think we should not investigate it. On balance, there is not sufficient evidence available to reach a robust view of the care provided.
13. Mr M visited the Practice on 17 November 2022. He gave us his account of what happened during the GP consultation. He told us he had pain in his hip and his groin.
14. The records from the consultation do not indicate he discussed hip or groin pain with the GP. The records state Mr M had pain in his knees and this was the reason for the consultation. We consider both sources could be plausible accounts of what happened.
15. We are very sorry to hear Mr M feels let down by the Practice following this incident. We recognise how frustrating this must be.
16. Sadly, there are no other medical records, or any other sources of evidence available, to help us determine on balance, whether the consultation was about Mr M’s hip pain and whether there was a discussion where the doctor agreed to refer him for a hip replacement. We are left with two different accounts from Mr M and the GP’s record about what they discussed in the consultation, which we are unable to reconcile.
17. It is important to explain our role is to make independent final decisions about NHS complaints in England. We make decisions by weighing up and considering all the available evidence. We then consider the likelihood that something has gone wrong with the service provided. As we are impartial, we must make robust decisions based on facts and evidence.
18. We recognise Mr M believes his medical records are not factual. We are not able to prove or disprove this.
19. Without further evidence we are not able to reach a robust view on what happened. This means we cannot reach a view on whether something went wrong at his appointment. For this reason, we consider a formal investigation would not be practical for this complaint, and we have decided not to consider it further.
20. We recognise this may cause Mr M further frustration. We are sorry we have not been able to investigate his complaint further or provide him with closure for his concerns. We would like to thank him for his time and effort in bringing this complaint to our attention.
1. We have carefully considered Mr M’s complaint about the Practice. We are very sorry to hear Mr M has suffered with daily hip and groin pain and was not referred for a hip replacement in November 2022.
2. Having carefully considered his complaint, we cannot reach a view on whether his consultation in November 2022 was for a hip replacement. This is because we cannot conclude he had a consultation about hip and groin pain. We do not have sufficient evidence available to us to determine what most likely happened or what was discussed during the appointment. For this reason, we have decided not to consider this complaint further.