10. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.
11. Mr R complains G4S did not chase up on the second part of a bilateral hernia surgery. He states he should have had the surgery as soon as the first operation had healed, but this was not followed up by G4S, despite G4S assuring him all was in hand.
12. G4S said the consultant surgeon stated that once Mr R and healed from his surgery, he would list him on the day unit waiting list for the other hernia repair. It said there is reference to the instructions for no follow-up after the initial operation, but recognises this refers to post-surgical requirements for the right-sided operation and is unrelated to the left side.
13. G4S also highlighted the medical records do not show that Mr R raised this in any appointment between 2017 and November 2022. When Mr R did raise this in November 2022, a referral was promptly made to the Trust for his surgery.
14. GMC Good Medical Practice states, ‘promptly provide (or arrange) suitable advice, investigation or treatment where necessary’.
15. In order to consider this matter, we sought independent GP clinical advice, to explore what the GPs responsibilities were in this matter and whether more action should have been taken to expedite Mr R’s second surgery.
16. Our adviser said G4S was not requested to re-refer him once he had healed. The letter from the consultant surgeon to G4S states that when Mr Drummond has healed, the surgeon will list him on the day unit waiting list. G4S therefore did not have any responsibilities in relation to this.
17. We note Mr R told us that he raised this with G4S. Despite detailed records of his medical appointments, we have not seen any evidence this was raised prior to 16 November. On 16 November Mr R attended the clinic and he explained he was awaiting left side hernia repair. The records state G4S advised they will chase the Trust regarding a referral.
18. We have not identified G4S had any responsibility to refer Mr R for hernia surgery following his first surgery in 2017. We can see that when this was raised, Mr R was promptly referred to the Trust. We have not identified any indications of failings in relation to this point.
Complaint handling
19. Mr R complains the complaint handling was appalling, unhelpful, impersonal, and lacking any compassion or care. He states this has had an ongoing negative impact on his mental health.
20. We can see Mr R first complained to the first complaint handling organisation on 5 December 2022. This complaint was passed to G4S, which is the responsible organisation, on 18 July 2023. We can see this took seven months to provide its response to the complaint and then to transfer the complaint to G4S Healthcare. G4S confirmed it is the appropriate organisation to respond to his complaint.
21. G4S were notified of the complaint on 18 July 2023 and it issued a final response on 23 February 2024. This is a period of seven months. Whilst we recognise there was an overall delay of 14 months for him to receive a final response, G4S responded to the complaint in seven months.
22. G4S states unfortunately there was a delay in the complaint being brought to the attention of G4S and states there has been an error between G4S and the other organisation who initially responded to the complaint.
23. G4S also acknowledged the complaint has been managed in a ‘far from satisfactory manner’ and it recognises the additional frustration and inconvenience this has caused.
24. The ‘NHS Complaint Standards’ guidelines, 2022, state ‘an effective complaint handling system gives an open and honest answer as quickly as possible, considering the complexity of the issues.’
25. NHS England Complaints Policy (2024) states ‘Unless we have agreed a longer timescale with the person raising the complaint within the first 6 months, we will inform them if we cannot conclude the investigation and issue a final response within 6 months.’
26. We recognise the process has been very difficult for Mr R, and he has had to pursue this complaint across two organisations. We also recognise the six-month expected timescale has not been met. We understand this would have caused him distress during an already difficult time.
27. Whilst we understand this will have been difficult, we consider this falls under level one of our severity of injustice scale. Level one states ‘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. This would typically arise 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.’
28. Whilst we understand the final response has not provided a direct apology, we have seen G4S recognised it handled the complaint in a poor manner and accepts the additional frustration and inconvenience this has caused. As G4S no longer provides healthcare services, it is not proportionate to recommend further action is taken. We therefore propose to take no further action on this element of Mr R’s complaint.
29. We thank Mr R for bringing this complaint to us. We understand he has had a difficult experience, and we do not wish to minimise what he has been through. We hope our report provides reassurance that his healthcare was managed appropriately.