A practice in the Harrow area

5. Miss A complains about the care she had from the Practice between December 2021 and June 2022, after an injury to her knee.

6. Miss A says: • the GP wrongly diagnosed her knee injury • a doctor refused to discuss her knee injury during a telephone consultation the phlebotomist (clinician who does the blood test) did not listen to her concerns when attempting to draw blood.

7. Miss A says wrongly diagnosing her knee injury caused her pain and delayed an MRI scan. She says she experienced a lack of sleep, had to take time off work and needed painkillers for the great pain. She said the blood test increased her fear of having a test and made her uneasy about having another one again.

8. Miss A would like the Practice to apologise and explain what went wrong. She would also like it to add an alert to her record about her preferences for this type of treatment.

Knee injury

9. Miss A fell and injured her knee in December 2021. Four days later she had a consultation at the Practice.

10. In March 2022 Miss A contacted the Practice about the knee pain because it was still causing her discomfort. During a telephone consultation the next month Miss A complained again to the Practice about her ongoing knee pain. On 6 April Miss A = had a face-to-face consultation at the Practice.

11. Miss A called the Practice in June 2022 to discuss a separate health issue but also wanted to discuss her ongoing knee symptoms. The doctor did not discuss her knee and booked her in with another doctor.

12. A week later, during a consultation at the Practice, Miss A said she suspected there was something structurally wrong with her knee and asked to see a specialist. The GP made a referral on 4 July.

13. At an orthopaedic appointment (a clinic that specialises in treatment for bones and muscles) in September, an MRI scan did not show conclusive information and Miss A was referred to a specialist.

14. Miss A was referred to an orthopaedic special interest GP on 18 October and had an appointment in January 2023. They did an MRI and confirmed she had a meniscal tear (knee cartilage damage).

Blood test

15. In June 2022, Miss A went to the Practice for a blood test. She says she had an upsetting experience because she is uncomfortable with needles. The phlebotomist had trouble finding a vein and chose to use her right arm. Miss A says she told the phlebotomist she preferred blood to be taken from her left arm.

16. Miss A says she tried to stop the blood test and had a panic attack, but the phlebotomist continued to try and take blood. Miss A eventually stopped the blood test and left the Practice.

Knee injury

20. Before we decide if we should do a detailed investigation of a complaint, we look at if there are signs the organisation got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not seen any signs that something went wrong.

21. We considered whether the Practice wrongly diagnosed Miss A’s knee injury and delayed a scan.

22. Based on Miss A’s presentation at each of her appointments before being referred, there was no sign of a meniscal tear.

23. In line with the GMC guidance the medical records show the Practice examined Miss A’s knee on 16 December 2021, 1 March 2022 and 4 and 6 April 2022. These examinations did not find a cause for her pain, although the GP thought the condition was likely regional pain syndrome of the knee. The results of the examinations did not show a meniscal tear.

24. The medical records show at the orthopaedic appointment on 29 September 2022, Miss A’s MRI scan result was unremarkable in appearance (no serious issues were found) with no damage to cartilage. Miss A was discharged from the clinic.

25. Based on this information we have not seen any sign of failings in the Practice’s care as it monitored and examined her knee in line with the GMC guidance.

26. We considered whether the Practice refused to discuss Miss A’s knee injury during the telephone consultation on 15 June 2022.

There is no evidence to say the doctor refused to discuss her knee.

27. We see no sign of a failing by the doctor booking Miss A in to see another doctor who had dealt with her knee problems before. This action is in line with the RCGP guidance that says clinicians should ‘highlight the patients ‘usual doctor’ in the records system and make this doctor the default option for this patient’.

28. We understand Miss A’s concerns about this care and we are sorry to hear about her distress. After reviewing the information, we have not seen any signs that something went wrong, and we will not continue to investigate this issue further.

Blood test

29. We considered whether the phlebotomist listened to Miss A’s concerns when attempting to draw blood in June 2022.

30. When we discussed this with Miss A, she said she would be satisfied if the Practice added an alert about her blood test preferences to her medical records.

31. We contacted the Practice and it agreed to this. The Practice emailed us to confirm an alert has been added to Miss A’s medical record. The alert shows Miss A has a fear of needles and prefers blood to be taken from her left arm.

32. Where we can agree a resolution with the organisation to bring a satisfactory outcome for the complainant, we will not investigate further. We have done this here and there is no need to take further action.

33. We thank Miss A for bringing this complaint to us and we hope she finds our explanation clear.

1. The Parliamentary and Health Service Ombudsman has carefully considered Miss A’s complaint about a practice in the Harrow area (the Practice).

2. We have decided to take no further action on Miss A’s complaint about the care she had from the Practice after a knee injury, because we see no sign that anything went wrong.

3. We have decided not to investigate the complaint about a blood test at the Practice because we are satisfied the Practice has done enough to put things right.

4. We realise how important Miss A’s complaint is to her and recognise it has been a difficult time. We are sorry to hear about how traumatic she found the blood test and appreciate she was worried the care led to a delay in specialist treatment for her knee injury. We explain the reasons for our decision in this statement.