Healthshare

3. Mr R complains about the care and treatment Healthshare gave him. He complains Healthshare: • delayed referring him to a senior physiotherapist • failed to record the details of his consultation on 20 July 2022 in his medical records • did not do an MRI scan to see how serious his injury was.

4. Mr R told us the delay in referring him to the senior physiotherapist and not doing an MRI scan led to a delay in him getting a diagnosis of a tear of his anterior cruciate ligament (the ACL is one of the ligaments inside the knee that joins the thighbone to the front of the shinbone) and his meniscus (C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between the shinbone and the thighbone). He feels this put him at higher risk of arthritis. He was left concerned there were no notes of his appointment in his medical records.

5. Mr R would like a payment to recognise the impact of his delayed diagnosis and for the cost of a private MRI scan. Mr R would also like to be reassured that none of his information is at risk of a data breach.

6. In September 2021 Mr R had a sports injury to his knee. His GP referred him to Healthshare to have physiotherapy.

7. On 10 January 2022, Mr R had an appointment with the physiotherapist. Due to the COVID-19 government measures, the appointment was by phone. Healthshare said Mr R reported his pain level as low and it recommended some exercises.

8. On 20 June Mr R had another appointment with the physiotherapist. Mr R told us the exercises he was advised to do were not working and the physiotherapist recommended a face-to-face appointment.

9. On 20 July Mr R had the face-to-face appointment. Mr R told us he had buckling (when one of the knees, or both of them, gives out or feels weak) continuously and the exercises were not working. He said he was not sure of his diagnosis and asked the physiotherapist if he could be referred for an MRI scan. The physiotherapist did think this was necessary and spoke to a senior physiotherapist for a second opinion. The senior physiotherapist did not think he needed an MRI scan.

10. Mr R had more physiotherapy and his knee buckled again causing severe pain. Mr R decided to book a private MRI scan, which he had on 20 September. The results of the MRI scan showed he had a tear in his meniscus and a torn ACL.

11. Mr R shared the results of the MRI scan with Healthshare. He was referred to an NHS Trust’s orthopaedic department. This team told him his injury was severe and he would have to have surgery. In September 2023 Mr R had a partial meniscectomy procedure (to remove all or part of a damaged meniscus in the knee or, if possible, to repair a meniscus) and is on the waiting list for ACL reconstruction.

Medical records

14. Before we decide if we should do a detailed investigation of a complaint, we look at whether there is an organisation that is better placed to deal with the concerns and give the outcomes wanted.

15. Mr R complains that Healthshare did not include the notes from his appointment on 20 June 2022 in his medical records. He wants assurance that none of his information is at risk of a data breach.

16. We explained to Mr R that complaints relating to information in medical records and breaches of data are better placed for the ICO to consider. The ICO can look at complaints where someone thinks an organisation did not handle personal information responsibly and if someone is concerned there has been a date breach. It is more appropriate for Mr R to speak to the ICO about this part of his complaint.

Delay in referring him to a senior physiotherapist and not doing an MRI scan

17. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

18. Mr R wants a financial payment as the outcome of his complaint. He explained he also wants reimbursement of the cost of the private MRI scan which cost a few hundred pounds. He is also looking for several thousands of pounds to recognise the clinical impact on him. It seems the amount he wants may be more than the amount we would recommend if we were to uphold the complaint. A solicitor might be able to achieve more if they decide to take the case on.

19. We spoke to Mr R who told us he would be happy to go down the legal route. He did not tell us about any barriers to him doing this.

20. Mr R has the option of speaking to solicitors who offer ‘no win no fee’ claims arrangements, or he could speak to his local Citizens Advice Bureau. Mr R can also contact AVMA (Action Against Medical Accidents).

21. We think it is reasonable for Mr R to look into legal action for his clinical concerns and he has agreed to do this. We will not be taking any further action at this time. We thank him for taking the time to come to us.

1. We have carefully considered Mr R’s complaint about Healthshare Ltd (Healthshare) and the care and treatment he received. We are sorry to learn about his distressing and painful experience.

2. We think Mr R could take legal action to resolve the clinical parts of his complaint and this is the best route for him to take. We think it is more appropriate for Mr R to make his complaint about his medical records to the Information Commissioner’s Office (ICO). We explain our decision in more detail below.