A GP practice in the Durham area

4. Mrs A complains about the Practice’s care and treatment between July and November 2021. She complains: • in July it refused her request for a bone density scan • in November it failed to communicate her diagnosis to her.

5. Mrs A says had the Practice followed through on her request for a bone density scan in July, she would have known the cause of her aches and pains. She then could have made changes to her lifestyle. She says because of not being told she had osteoporosis (when bone strength weakens making them fragile and likely to break), she would have continued to take medication without knowing the reason.

6. She would like an apology, service improvements and financial compensation.

7. In July 2021, Mrs A spoke to her GP about her concerns with her bone health and asked for a bone density scan. The GP refused her request as they said she did not meet the criteria.

8. In October, Mrs A went back to her GP with the same concerns and again asked for a bone density scan. The GP agreed and arranged for Mrs A to have the scan.

9. In November, Mrs A had an appointment with the GP. The GP told her the results of the scan and wrote down they told Mrs A she had osteoporosis.

Bone density scan

13. The law says we should not investigate a complaint if it is brought to us more than one year after the person first became aware of their reason to complain, unless we think there is good reason to.

14. Mrs A is unhappy the Practice would not do a bone density scan in July 2021. Mrs A did not complain to us about this until February 2023.

15. Mrs A told us she first became aware she had reason to complain in December 2021. She says she got the results and thought she would have had a diagnosis sooner if the Practice had agreed to do the scan when she first asked for it. We think Mrs A was aware of her complaint sooner, in July 2021. This is because this was when she had concerns about her bone health, asked for the scan and was unhappy with the Practice’s decision.

16. The law says Mrs A needed to make her complaint to us by July 2022. Mrs A came to us in February 2023, so the complaint is seven months out of time.

17. We have discussed this with Mrs A to understand the reasons why she could not bring her complaint to us sooner. We also looked at how long the Practice took to respond to her concerns to see whether we should put the time limit to one side.

18. In October 2021 Mrs A went back to her GP and again asked for a bone density scan. This time the GP agreed. Between July and October 2021, Mrs A told us she was focused on improving her health and was taking vegan approved medication. She said this was why she did not complain to the Practice sooner. When we asked if her symptoms stayed the same or changed, Mrs A told us she could not remember but believes her pain and aches got worse. She put this down to age. While we recognise this was a difficult time, it is not possible for us to say she had good reason for not complaining sooner.

19. In November 2021, the GP told Mrs A the results from the bone density scan. Mrs A complained to the Practice quickly after this, so there was no delay at this time.

20. The Practice gave its response in January 2022. The response did not tell her about our service. On 15 February, Mrs A contacted an advocate to support her with her complaint about the Practice. On 17 February, Mrs A had a meeting with the Practice to discuss her complaint.

21. From December 2021 to mid-February 2022, Mr A was going through the complaint process. There were no delays at this time.

22. Between mid-February and April 2022, Mrs A told us she was speaking with her advocate. We spoke to the advocate who told us they got Mrs A’s signed consent form on 9 March. Mrs A sent the advocate all correspondence relating to her complaint on 17 March. On 23 March the advocate spoke to Mrs A to address her outstanding concerns and they sent Mrs A the draft letter for her to review. The advocate told us she made several calls to Mrs A for her comments but, there was a wait before Mrs A replied. This meant Mrs A did not make her complaint to the Practice until May.

23. There was a three-month gap between Mrs A getting an advocate in mid-February and returning to the Practice in May. We can see her advocate was proactive in moving Mrs A’s complaint forward. Mrs A caused some delay in giving her comments to the advocate. We cannot say all of this three-month period was reasonable.

24. In July the Practice sent Mrs A a second complaint response. The Practice said it had addressed all her concerns, apologised for the delay in her diagnosis and said it had nothing more to say.

25. In October, Mrs A’s advocate asked for a meeting with the Practice. We asked why Mrs A waited almost three months after getting the response to go back to the Practice. Mrs A told us she could not remember. Her advocate said she had made several calls to Mrs A to discuss what she wanted to do. We do not think this delay of three months was reasonable. And, we note the Practice had already told Mrs A it had nothing more to add. Although she wanted a meeting, we cannot say this stage of the process was necessary.

26. In November, Mrs A went to a meeting with the Practice. In January 2023 the Practice sent Mrs A a final complaint response stating it had nothing more to add to her complaint.

27. Mrs A then waited another month before she brought her complaint to us. She was not able to explain why she waited. Mrs A told us she was looking after her daughter in December 2022 but this does not explain why she did not come to us as soon as she got the final response.

28. We also looked at how long the Practice took to investigate and respond to the complaint. Mrs A first complained to it on 14 December 2021 and it responded one month later. Mrs A raised her further concerns on 19 May 2022 and it responded two months later. She went to a meeting on 30 November, and the Practice sent its final response two months later. The Practice took a total of five months to respond to this complaint. We have not seen that the Practice’s complaint handling unfairly delayed Mrs A from moving things forward quicker.

29. We are sorry to hear how Mrs A was affected by the actions of the Practice and we appreciate she had personal matters to take care of during the festive period. We do not consider Mrs A’s reasons for delay to be enough to put our time limit to one side.

Communicating her diagnosis

30. Before we decide if we should do a detailed investigation of a complaint, we look at whether 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 has gone wrong.

31. Mrs A told us the Practice did not give her a diagnosis when she went to her appointment in November 2021. She says it was only after she made a complaint, she learned she had osteoporosis.

32. GMC guidance says doctors, ‘‘must work in partnership with patients, sharing with them the information they will need to make decisions about their care, including their condition, its likely progression and the options for treatment, including associated risks and uncertainties’.

33. We reviewed Mrs A’s medical records. In the records on 25 November the GP recorded they discussed with Mrs A the results of the bone density scan and medication to strengthen her bones. They also recorded they advised her to read up on osteoporosis.

34. We discussed this with Mrs A and she told us the GP did not use the word ‘osteoporosis’, but she knew one of the medications had something to do with it.

35. The evidence tells us the GP did talk to Mrs A about her diagnosis in line with GMC guidance. And, Mrs A explained she did know some of her medication was related to osteoporosis. We cannot say she was taking her medication without knowing why. We have not seen any sign of a failing with the Practice’s communication.

36. Mrs A has clearly explained how unhappy she is with the Practice. We do not underestimate this. For the reasons we have explained, we will not be taking any further action on Mrs A’s complaint. We hope we have explained our decision clearly.

1. We have carefully considered Mrs A’s complaint about a GP practice in the Durham area (the Practice) and the care and treatment she had. We are sorry to learn of Mrs A’s distressing experience with the Practice and the impact it had on her.

2. The part of Mrs A’s complaint about being denied a bone density scan is outside of our time limit and we have not seen good reason to put the time limit to one side. This means we are not investigating this part of the complaint.

3. We looked into the complaint about the Practice failing to communicate her diagnosis to her. We note Mrs A’s disagreement. The evidence we have seen shows the GP spoke to Mrs A about her diagnosis when she went to her appointment in November 2021. We will explain our decision in more detail below.