A Medical Centre in the London Borough of Waltham Forest

3. Mrs Y complains in August 2019, the Practice did not diagnose her chronic kidney disease (CKD) in a timely manner. She says it did not give her a treatment plan or any advice about how to manage her CKD. Finally, she says since 2010, the Practice failed to inform her that her blood tests were showing a decrease in her kidney function.

4. Mrs Y says had she known about her CKD earlier, she could have educated herself and managed her condition. She says her CKD has deteriorated which means she is in more pain. Mrs Y says she is now frightened to get her blood test results and is concerned she will need dialysis. She says this has caused her significant distress and she feels hurt by her GP.

5. Mrs Y wants the Practice to admit, acknowledge, and apologise for failing to diagnose, and provide appropriate treatment for her CKD. She is also seeking financial compensation.

6. On 30 July 2019, Mrs Y attended an appointment with a locum GP. She was diagnosed with stage three CKD. CKD is a condition where the kidneys are damaged and cannot filter blood the way they should. The disease is called chronic because the damage to the kidneys happens slowly over a long period of time.

7. Mrs Y submitted her initial complaint to the Practice on 2 August 2019. She said it had not given her timely advice and treatment for her CKD. She also said it failed to inform her that her blood tests were showing a decrease in kidney function since 2010.

8. On 17 October 2019, the Practice responded to the complaint. It addressed all the concerns raised and signposted her to the Parliamentary and Health Service Ombudsman. The Practice also said it would make service improvements to make sure it communicated and shared test results with patients in a timely manner.

9. Mrs Y submitted a second complaint on 5 December 2019 about the same issues. The Practice sent a second response on 28 April 2020. It repeated its original responses to her complaint set out in the letter of 17 October and signposted her to us.

10. Mrs Y sent a further complaint letter on 15 September 2020. She said she was unhappy with the Practice’s response and the service improvements did not go far enough to put her complaint right.

11. The Practice sent a further response on 29 March 2021. It said it was “satisfied that a thorough investigation has been carried out” and Mrs Y had “been provided with explanations and information that appear to be reasonable and appropriate.

12. Mrs Y brought her complaint to us on 19 September 2021.

15. 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 Y to understand the reasons why she could not bring her complaint to us sooner. We have also considered the time the Practice has taken to respond to Mrs Y’s complaint.

16. Mrs Y first became aware of her CKD diagnosis and the issues with her treatment during her appointment of 30 July 2019. For her complaint to be in time she would have needed to approach us no later than 30 July 2020. Mrs Y sent us her complaint form on 19 September 2021, so her complaint is one year and two months out of time.

17. We asked Mrs Y to tell us about the reasons for the delay. She explained the Practice took a long time to respond to her complaint. Additionally, she had to attend several appointments for her CKD. She said she suffered adverse side effects, including swelling in her body and poor eyesight, as well as was adapting to new medication. She also said her CKD deteriorated and she had low kidney function. Finally, Mrs Y explains she was taking care of her young children and suffered a bereavement.

18. We are very sorry to hear Mrs Y was unwell and suffered adverse side effects from her treatment. It must have also been very distressing to suffer a bereavement during this period of ill health and we acknowledge this was a challenging time for her.

19. The records show Mrs Y first raised her complaint on 2 August 2019. The Practice agreed to investigate it and sent its first response on 17 October 2019. In this letter, the Practice signposted Mrs Y to our office should she remain unhappy with the outcome of the complaint. Mrs Y decided to submit a further complaint to the Practice on 5 December. It responded on 28 April 2020 and signposted her to our office again. Mrs Y sent a final complaint letter on 15 September 2020. It sent its response on 29 March 2021 and said it had addressed all the issues raised.

20. In total, the Practice’s complaints process took one year and seven months. This is a significant amount of time. That said, we have identified two opportunities where Mrs Y could have escalated her complaint to us sooner.

21. Mrs Y was signposted to our office in October 2019 and April 2020. Mrs Y did not bring her complaints to us on these occasions. Instead, she decided to write further complaint letters to the Practice.

22. We have considered whether this was a reasonable action to take. On both occasions, Mrs Y complained about the same issues which she raised in her original complaint. The Practice’s response letters fully address all the concerns she raised. Given the Practice provided a full and complete response on both occasions and signposted her to our office, these appear to be fair and reasonable opportunities where Mrs Y could have approached us earlier. Taking this into account, we do not consider this to be a good reason to set our time limit to one side.

23. After Mrs Y received her final response letter of 29 March 2021, she did not approach us until September 2021 (six months later). We next carefully considered her reasons for this delay including her poor health, bereavement, and childcare needs.

24. To better understand her circumstances, we asked her to tell us what changed in September 2021, which meant she was then able to approach us with her complaint. Mrs Y said she ‘did not get better’ and very sadly ‘her health continued to deteriorate’. She explained her decline in health ‘triggered her’ to submit her complaint to us in September, as she was concerned about getting worse.

25. It must have been extremely worrying for Mrs Y when her health continued to deteriorate. We are very sorry to hear she has experienced significant pain and poor health for a prolonged time.

26. It is important to note, Mrs Y submitted her complaint to us independently in September 2021. That said, it is difficult for us to say she could not have approached us sooner when her health was worse at this time. In addition, we can see her circumstances did not change. Mrs Y still had childcare needs and very sadly she had suffered a bereavement. With this in mind, we consider she could have approached us much sooner on receipt of her response in March 2021.

27. In summary, for the reasons stated we have decided not to put our time limit to one side. In making this decision, we do not wish to diminish the pain and distress Mrs Y has experienced because of her poor health. We recognise it has taken a great amount of effort to speak to us about her complaint. We are grateful for the time she has taken to bring these concerns to our attention.

1. We have carefully considered Mrs Y’s complaint about a Medical Centre in the London Borough of Waltham Forest (the Practice). We are sorry to hear Mrs Y feels she did not get a timely diagnosis or appropriate treatment plan for her chronic kidney disease (CKD). Mrs Y told us this has left her feeling frightened of getting future blood tests, that she may need dialysis, and her deteriorating health has caused significant pain and distress. We do not wish to underestimate how difficult and worrying these events have been for her.

2. This complaint falls outside of our twelve month time limit. We have carefully considered the circumstances, including Mrs Y’s reasons for the delay and the time it took for the Practice to investigate this complaint. We have not seen a good reason to put our time limit to one side, so we have decided not to consider this complaint further. We will explain our decision in more detail below.