Summary
Mr A had concerns about the care and treatment he received from his medical practice in diagnosing his kidney condition. An advice worker (Ms C) complained to the practice on his behalf in April 2013. When she had not received a response to her complaint, despite chasing a response and resubmitting her complaint, she complained to my office. Ms C noted that the only contact she had with the practice was a reply from them asking her to pay £50 to release Mr A's medical records, which was not what she had asked for. She was also concerned that the practice was operating outwith the NHS complaints procedure, as her complaint should have been acknowledged within three days and responded to within 20 working days. My complaint reviewer considered the evidence available, upheld Ms C's complaint and made recommendations to the practice, which were to issue a response to Ms C's original complaint, apologise to Mr A and review their complaints handling procedure. We published our decision on this case in March 2014.
There then followed several attempts from my office to ensure that the practice had complied with our recommendations. The correspondence we received from the doctor at the practice noted that the practice had no idea what their mistake was or what they were to apologise for. Eventually, after making several attempts to correspond with the practice, I wrote to the chief executive of the board to make them aware of the matter. The chief executive noted that many of the statements made by the practice to my office during our investigation were inaccurate. In particular, the chief executive confirmed that the mail system within the building in which the practice was located was not dysfunctional (the practice had said that the mail system had led to them not receiving Ms C's initial complaint).
I took independent advice from one of my clinical advisers who is a GP. He noted that whilst Ms C presented a credible history, the practice appeared to contradict themselves and were less credible with the explanations and information they had provided to us. My adviser commented that the practice did not appear to have correct and proper systems in place to ensure the safe running of the practice. In addition, he said the chaotic way in which the practice dealt with Ms C's complaint including treating it as a request for copies of medical records and requesting a payment for £50 was worrying. My adviser highlighted a number of sections of the General Medical Council (GMC)'s Good Medical Practice guidance, and noted where the practice appear to have failed to demonstrate their compliance with this guidance, including their failure to operate a credible complaints system.
The advice I have received, and accepted, is that the practice had deliberately complicated the issues around Mr A's complaint with the aim of not answering it, which was compounded by the poor systems they had in place for handling complaints. The practice's failure to engage with the board to allow mediation and assistance to improve their situation led to the injustice of Mr A not having his complaint answered.
Finally, my adviser commented that the actions, and lack of action, taken by the practice were serious enough to threaten the reputation of the medical profession because they had repeatedly failed in the duties expected of them by the GMC. The evidence available indicates that they failed to handle Ms C's complaint appropriately in line with the NHS 'Can I Help You?' guidance. In addition, I have extreme concerns about the practice's resistance to accept that they failed to handle the complaint properly. Their refusal to comply with my recommendations has resulted in my office having to issue this report when the complaint should have been finalised following the decision issued by my complaints reviewer over a year ago. In light of my serious concerns, I have not only made further recommendations to the practice, but also recommended that the board consider the contract held with the practice, and consider whether to refer the practice to the GMC.
Redress and recommendations
The Ombudsman recommends that the Practice:
- (i) acknowledge acceptance of Mr A's complaint and answer it appropriately within 20 working days;
- (ii) apologise to Mr A for failing to deal with his complaint appropriately in line with Can I help you?; and
- (iii) provide the SPSO with a copy of its complaint handling procedure to demonstrate compliance with Can I help you?.
The Ombudsman recommends that the Board:
- (i) consider referring the Practice to the GMC; and
- (ii) consider its position in relation to the contract held with the Practice.