Referrals
13. 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 do so. We have discussed this with Mrs O to understand the reasons why she could not do so.
14. Parts of Mrs O’s complaint (referrals) falls outside of this time limit. The concerns she has raised about referrals happened on 14 December 2021, 21 December and 14 January 2022. For the complaint to be in time she would need to complain to us by December 2022/January 2023. For the referral on 4 August 2023, she would need to complain to us by August 2024. Therefore, her complaint is between 14 months and two years outside our time limit.
15. On 11 March 2024, Mrs O complained about two males carrying out her transvaginal ultrasound scan without obtaining appropriate consent. At this point, there is no evidence to suggest Mrs O raised concerns about the specific referrals outlined in her complaint.
16. The complaint file shows the Trust responded on 5 November, 10 months later. We consider this delay of 10 months an unavoidable delay.
17. On 8 November, Mrs O responded to the Trust. It was at this point Mrs O raised her concerns about the referrals outlined in paragraph 14. This is between 14 months and two years later. We consider this 14 month to two years to be an avoidable delay.
18. On 6 and 15 April 2025, the Trust responded to the concerns Mrs O raised on 8 November, four months later. We consider this four-month delay and unavoidable delay.
19. Mrs O contacted us on 6 May 2025, three weeks after receiving her final response from the Trust.
20. In line with the law, we have considered whether it is reasonable for us to set aside our time limit. We have considered the time the Trust has taken to respond to Mrs O.
21. We asked Mrs O why it took her until 8 November 2024 to raise the complaints about the referrals. Mrs O said she was approached by the Deputy CEO on 28 October 2022, who gave her the impression she would not need to complain as the Deputy CEO was looking at getting her a different gastroenterology consultant. Mrs O says she genuinely believed she was being helped by the Deputy CEO until she unexpectedly left the Trust. Mrs O says her last contact with the Deputy CEO was 7 December 2023. She tells us she made several contacts with her but got no response. She then complained to the Trust on 3 January 2024.
22. We do not underestimate what a difficult time this was for Mrs O, and we completely understand she felt she was being helped by the Deputy CEO and did not need to complain.
23. Having carefully considered Mrs O’s response for the delay and the time taken for the Trust to complete its complaints process, we have not seen strong enough reasons to set aside our time limit for this complaint. The reason for this is the approach from the Deputy CEO happened about 10 months after three of the referrals were rejected. Mrs O could have made a complaint to the Trust about these three referrals prior to the Deputy CEO contact. Also, it would not explain why it took Mrs O until 8 November 2024, nearly 11 months after the Deputy CEO had left the Trust to raise her complaint about all the referrals mentioned in her complaint. We therefore consider this part of the complaint is out of time.
Consent
24. Mrs O complains the Trust did not obtain appropriate verbal or written consent for two male sonographers to carry out a transvaginal ultrasound scan.
25. NHS guidance on consent to treatment means a person must give permission before they receive any type of medical treatment, test or examination. This must be done on the basis of an explanation by a clinician.
26. For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision. The meaning of these terms are:
• verbally – for example, a person saying they're happy to have an X-ray • in writing – for example, signing a consent form for surgery 27. The clinical record says, ‘the patient is happy to be scanned by a male sonographer in the presence of a male chaperone’. We understand Mrs O disputes this and that appropriate consent was not obtained. She says the sonographer did not speak to her and only used hand signals to communicate. She says the only conversation she had was with the other male who asked her if her husband was able to help her undress and redress.
28. We understand how important it is to obtain appropriate consent and for a patient to feel comfortable undergoing a procedure. We recognise the clinical record conflicts with Mrs O’s own account. As there are two conflicting accounts of what happened and no independent evidence, we are unable to reach a view here.
Complaint handling
29. Mrs O complains the Trust failed to acknowledge receipt of emails and failed to provide deadlines. Mrs O says the Trust only responded after she consistently reminded and chased them.
30. Our Principles of Good Complaint Handling says ‘acknowledge the complaint and tell the complainant how long they can expect to wait to receive a reply. Public bodies should keep the complainant regularly informed about progress and the reasons for any delays’.
31. On 11 January 2024, the complaint file shows Mrs O wanted to raise a formal complaint with the Trust. The Trust acknowledged her email and responded on the same day saying she can send her specific concerns and questions to the complaints team and provided her with an email address.
32. On 11 March 2024, Mrs O raised additional questions about her gastroenterology care and treatment, and this included the appropriateness of two male sonographers carrying out a transvaginal ultrasound scan.
33. On 5 November, the Trust responded to the concerns Mrs O raised in her complaint of 11 March.
34. On 8 November, Mrs O responds to the Trust letter dated 5 November. In this letter she raised several questions, and this included the dates of her specific referrals. The Trust responded to these concerns on 7 March 2025.
35. We understand how important it is to acknowledge complaints and to know how long a complaint is likely to take. There is no evidence to suggest the Trust acknowledged either of Mrs O’s complaint of 11 March or 8 November 2024 or gave her a time frame on when it would respond. In line with our principles, we consider this to be an indication of failing. We have seen no evidence to suggest the Trust only responded to Mrs O complaint because she consistently reminded and chased them.
36. When we identify failings, we need to consider the impact this has caused. Mrs O says the Trust’s handling of her complaint caused her distress. We then need to consider if it is proportionate for us to consider this part of her complaint in isolation any further.
37. Our SMG says we need to ensure that we maintain a balance between supporting those who complain to us to get a remedy for the injustice they have experienced, while ensuring we use our resources to achieve the most impact.
38. It goes on not say this means that in some circumstances we will only consider cases at the higher end of our severity of injustice scale (3 and above) or where we can see our involvement will have a wider public impact.
39. Our severity of injustice scale level one says, ‘These will usually be injustices 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 individual is of short duration, and where there are no other adverse effects or ongoing wider impact.’ Having reviewed this, we would place the impact at level one.
40. For this reason, we have decided not to consider the complaint handling element any further in line with our SMG.
41. We would like to assure Mrs O we do not think in any way this diminishes the effect the issues in her complaint have had on her. We will take no further action on this complaint.
42. We thank Mrs O for bringing her complaint for our consideration.