Decision report 201201028

Summary

Mr C complained that his medical practice failed to provide appropriate care and treatment when he had an eye infection and unreasonably refused to allow him to see a GP.

Mr C developed an eye infection, and called his practice on a Friday to request an appointment. He was told that there were no appointments available and that he should call again on Monday. By Monday his eyes had not improved, and he contacted NHS 24 (a national phone helpline service for advice on health matters). They advised him to see his GP. His workplace occupational health team also advised him not to work, and to see his GP. When Mr C contacted the practice again, he was told that when he first called he should have been referred to the LENS service (a service set up by the regional NHS board, providing direct access to treatment for minor eye conditions). The receptionist he spoke to on this occasion apologised that he was not told this when he first called, and advised him to contact a local optician, a participant in the LENS scheme.

Mr C was treated with various eye drops but his condition was slow to resolve. He contacted the practice several times over the next two weeks asking to see a GP. Although he twice saw a nurse from the practice, he was never able to see a GP. As he was unable to see a GP, Mr C continued with the treatment provided by the LENS service and was discharged the next month with the infection resolved.

Our investigation, which included taking independent advice from a medical adviser, concluded that it was reasonable that Mr C should have been referred to and treated by the LENS service. We, therefore, did not uphold the complaint about his initial treatment. The adviser said that the care and treatment provided by the service was reasonable and appropriate, and would not have been different from the treatment provided by a GP. However, we did find that when his condition was slow to resolve, it was unreasonable that Mr C was not given the opportunity to discuss his condition with a GP and be reassured that the treatment being provided by the LENS service was appropriate. Because of this, we upheld his complaint that he was refused access to a GP during that time.

Recommendations

We recommended that the practice:

• apologise for the failings identified; and
• review their policy and procedures for the allocation of GP appointments where patients have been referred to another service, and ensure that staff are considerate of the possible need for the reassurance provided by discussion with a GP when a condition is not resolving within a reasonable time.