A practice in the Sandwell area

3. Mrs A complains the Practice did not refer her to the orthopaedic service on 13 September 2023. She also says when she complained on 9 April 2024, the Practice told her it would send her referral urgently, but it did not send it for a further two weeks.

4. Mrs A says the Practice wasted her time, caused her unnecessary pain and emotional distress. She says the lack of referral has had a big impact on her life and she has been unable to work and is now facing losing her job.

5. Mrs A told us she would like financial compensation. She also wants an explanation of what went wrong and service changes to prevent the Practice missing other referrals.

6. Mrs A experienced back pain and had an MRI (a magnetic resonance imaging scan shows the inside of the body) which showed damage to her L4 and L5 (fourth and fifth bones in the lower backbone) discs. It also showed she had foraminal stenosis (a narrowing that happens in certain places around the nerves that come out of the spinal cord). She attended an appointment with her GP on 13 September 2023. The GP advised they would refer her to the orthopaedic service and appointments could take up to 12 months.

7. Mrs A waited for an appointment and chased this on 9 April 2024. The Practice told her it had not sent her referral in September but it would send one, marked urgent. Two weeks later Mrs A chased it again and found out the Practice had still not sent the referral. It sent the referral shortly after this. Mrs A has not yet had an appointment with the orthopaedic service.

10. 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.

11. Mrs A complains the Practice did not send a referral to the orthopaedic service on 13 September 2023. She also says when she complained on 9 April 2024, the Practice told her it would send her referral urgently, but it did not send it for a further two weeks.

12. Mrs A complains there was an initial delay of seven months in sending her referral. When she telephoned the Practice and discovered the error, she complains it did not send her referral for a further two weeks which means she has not yet seen an orthopaedic specialist.

13. Mrs A told us she would like financial redress as she has been unable to work since the Practice was due to make the initial referral in September. She told us her employer reduced her sick pay and she is likely to lose her job as this is coming to an end. She says this could have been avoided had she seen a specialist and received treatment. Therefore, Mrs A is seeking a significant financial remedy. Based on what she has told us Mrs A could pursue a legal claim for clinical negligence as she is claiming the Practice’s negligence has caused her ongoing pain and has had a medical impact on her.

14. When we discussed financial redress with Mrs A, we appreciate she told us she would be happy with a lower amount of money. We have considered this. As Mrs A told us the impact of the delay in referral was a lack of earnings, we consider this would be considerably higher than the amounts we would usually recommend.

15. Therefore, upon consideration of Mrs A’s complaint and the impact this had on her, it appears the amount she hopes to achieve may be beyond the amount we might recommend if we upheld this complaint. A solicitor might be able to achieve more if they decide to take on this case.

16. Mrs A also seeks an explanation of what went wrong and service changes to prevent the Practice missing other referrals. The courts would not directly achieve these outcomes but could do as a bi-product. Therefore, we do not consider this should prevent Mrs A from pursuing a legal claim.

17. Mrs A explained she is tired and in pain due to her back problems which means she does not want to pursue a legal claim. We understand this must be very difficult. We consider the start of legal proceedings to be very similar to that of an investigation by our service and is likely to involve speaking with a solicitor to discuss her case as she would with a caseworker here. We are independent and a solicitor would work on her side which might make the process easier for her.

18. We understand Mrs A has not yet had her orthopaedic appointment. We do not consider this a barrier to obtaining legal advice or pursuing a legal case, as solicitors can carry out independent assessments to determine a medical impact.

19. Should Mrs A have difficulty funding a legal claim (due to her employment status), she has the option of approaching firms which offer no win no fee claims arrangements, or she could speak to her local Citizens Advice Bureau. Mrs A can also contact AVMA (Action Against Medical Accidents) for further advice.

20. We consider it is reasonable for Mrs A to pursue legal action in respect of her complaint. Therefore, we will not be taking any further action at this time. We thank Mrs A for taking the time to explain what happened to her, we do not underestimate how difficult this has been. We hope we have explained our decision clearly.

1. We have carefully considered Mrs A’s complaint about a practice in the Sandwell area (the Practice). We are sorry to learn about Mrs A’s ongoing back pain and the impact this has had on her.

2. In consideration of the delay in the Practice referring Mrs A to the orthopaedic service, we consider Mrs A could take legal action on the complaint she brought to us.