A practice in the Southend-on-Sea area

4. Ms A complains the Practice did not thoroughly assess her medical history or specific circumstances when on 19 October 2023 it refused to backdate her fit note for statutory sick pay (SSP).

5. Ms A says this affected her eligibility for SSP causing her significant financial hardship. She says the Practice did not give adequate support or connect her to resources to enable her in a return to work. This worsened her condition and caused emotional distress.

6. Ms A wants the Practice to take accountability to ensure its doctors are up to date with the Equality Act 2010 and fit note guidance. She would like it to encourage more patient centred approach when assessing fitness for work and in providing necessary support. She wants compensation.

7. On 29 September 2023 Ms A went to the Practice for work related stress and anxiety which had caused her to leave work

8. The Practice issued a fit note for four weeks from date she was seen with a plan to review progress in a further four weeks’ time.

9. On 19 October 2023 Ms A returned to the Practice with work related stress. She said this had been going on for the previous two years and had significantly affected her asthma. Ms A wanted a fit note for the period 28 June 2023 to 28 September 2023. The Practice declined to provide one to cover that period.

12. The law says a person needs to make a 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.

13. Ms A knew about the matters she was complaining about on 19 October 2023, when the Practice refused the backdated fit note. To be in time she should have complained to us by 19 October 2024. Ms A complained to us on 3 April 2025. Her complaint is therefore over five months out of time.

14. Ms A complained to the Practice on 23 October 2023. The Practice responded by 8 November 2023. The main period of delay is between November 2023, when the Practice completed its complaints process, and April 2025.

15. We asked Ms A why it had taken so long to raise her complaint

16. Ms A told us of physical difficulties. She had a tremor and suffered pain and exhaustion making it difficult to submit written material as she was unable to write, type of use her phone or computer. This created a physical barrier to her communicating with us.

17. Ms A told us of cognitive and emotional difficulties. She had severe panic attacks leading to blurred vision, memory loss causing confusion and a loss of concentration. She struggled to read, remember or spell familiar words. She struggled to process information. She had blurred vision and would struggle to listen, leading to comprehension issues. Formal letters and emails caused panic attacks which created emotional distress and led to disorganisation. Ms A said she lacked focus, motivation and to prioritise tasks. Her daily functioning as affected by this.

18. Ms A has struggled with her sleep and being fatigued. She has been affected by the menopause and suffered night sweats, restlessness and chronic tiredness. Her ability to concentrate and communicate effectively was affected by this.

19. Ms A said she has difficulty advocating for herself and has struggled with her mental health. We are sorry for the difficulties Ms A had and how this has affected her health.

20. We are not persuaded these taken together would mean Ms A was unable to complain all this time. She could have submitted a verbal complaint or obtained assistance to make her complaint.

21. Ms A demonstrated the ability to make a complaint in October 2023 (without requiring support) and received a final response in November 2023. We also know Ms A was in communication with the Department for Work and Pensions over her SSP up to April 2024.

22. This indicates she was able to function sufficiently during the main period of delay to bring a complaint to another organisation and communicate with them. We have not seen enough evidence to say Ms A was not able to bring a complain to us during this period, or access information or support to enable her to do this sooner.

23. In summary, Ms A’s complaint is out of time. We are not persuaded she could not have complained sooner than she did. We have seen no strong evidence to set aside our time limit on this occasion. We will therefore take no further action.

24. We recognise how important this complaint is to Ms A, and this is not the outcome she hoped for. Although our decision may be disappointing, we hope she is assured that we have carefully considered her explanations of delay and that we have explained the reasons for our decision clearly. Our decision is not intended to diminish the problems she has with her health since 2023.

1. We have carefully considered Ms A’s complaint about a Practice in the Southend-on-Sea area (the Practice). Clearly it was a difficult time for Ms A when she was seeking a backdated fit note from the Practice. We thank her for providing the information we needed to make our decision.

2. We have decided the complaint falls outside of our time limit and there is no good reason for us to put our time limit aside to consider it further.

3. We explain our decision below.