Brereton Surgery

5. Mr L complains about the care provided to him by a GP Practice in the Staffordshire area (the Surgery) from March 2024 to January 2025.

6. Mr L says that the Surgery did not take his symptoms seriously or arrange the appropriate referrals and tests to diagnose him.

7. Mr L feels that the Surgery did not take him seriously as he has mental health problems, and it feels that he is exaggerating or making up his symptoms.

8. Mr L says that as a result of this:

• he is experiencing ongoing painful and distressing physical health symptoms • he has lost money due to having to seek private healthcare • he has lost faith in the NHS and doctors • his mental health has declined.

9. Mr L would like:

• an apology from the Surgery • service improvements to ensure that this does not happen again • a financial remedy.

10. Mr L also complains about the investigation into his complaint about the Surgery that was done by Staffordshire and Stoke-on-Trent ICB (the ICB).

11. Mr L says that the ICB:

• are siding with the GP surgery • made its conclusions without considering the evidence • came to the incorrect conclusion in its investigation.

12. Mr L says that this has impacted his mental health and caused him significant distress.

13. Mr L would like:

• the ICB to make service improvements to ensure that this does not happen to anyone else • the ICB to re investigate his complaint • a financial remedy of around a level 2 or 3 (£120 - £1,200).

14. In March 2024 Mr L first attended the Surgery with worries about his physical health.

15. Between March 2024 and February 2025 Mr L attended the Surgery on multiple occasions with a variety of concerns about his physical health. Mr L also called the 111 service and attended A&E during this period about his symptoms.

16. Mr L attended the Surgery with symptoms including testicular pain, cognitive issues, and erectile dysfunction. He also expressed his worries about a potential urinary tract infection, a feeling that he may have a macronutrient or testosterone deficiency and worries about the size and shape of his ears and penis. Mr L also thought that he may have circulation issues.

17. Mr L felt that his symptoms were as a result of a serious undiagnosed neurological condition.

18. Mr L had blood tests, multiple ultrasounds, and was referred to neurology and endocrinology by the Surgery. Mr L also had a private MRI scan.

19. Mr L felt that the Surgery were not taking his concerns seriously and so made a complaint. The ICB investigated Mr L’s complaint and reached the conclusion that there was no evidence that the Surgery did anything wrong in its care and treatment of Mr L.

Lack of investigation into symptoms

23. Mr L says that the Surgery did not take his symptoms seriously or arrange the appropriate referrals and tests to diagnose him. He feels that the surgery did not take him seriously as he has mental health problems, and it feels that he is exaggerating or making up his symptoms.

24. The Surgery explained to Mr L that they feel that his symptoms may be exacerbated by his mental health, and that the results of the tests they have done show no serious cause for concern.

25. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.

26. On 12 March 2024 Mr L had an appointment at the Surgery for it to examine his testicle as he was having pain in it. The Surgery diagnosed Mr L with epididymitis, a condition when the epididymis tube, behind the testicles, becomes swollen and tender. It prescribed him antibiotics for this.

27. The epididymitis guidance explains that this can be commonly caused by a sexual transmitted infection and that a referral to a sexual health clinic for testing should be considered. The Surgery did not refer Mr L to a sexual health clinic.

28. The records show that Mr L later had a urine test, that showed that there was no sexually transmitted infection present. Our adviser explained that although the Surgery should have referred Mr L to a sexual health clinic when he was initially diagnosed with epididymitis, as Mr L did not have a sexual transmitted disease, this had no impact to Mr L, and that a course of antibiotics was otherwise the correct course of treatment.

29. Mr L’s testicular pain continued despite the antibiotics that he was taking, and he attended the Surgery on multiple occasions complaining of ongoing pain.

30. Mr L’s records show that the Surgery referred Mr L for an ultrasound on his testicle to investigate his ongoing pain on 29 April 2024. On 10 June 2024 it received the results of Mr L’s ultrasound. The results did not show any cause for Mr L’s ongoing pain. The Surgery referred Mr L for a follow up ultrasound and to endocrinology and urology.

31. Mr L told the Surgery that he was concerned that he had a serious neurological condition and told it of a range of symptoms relating to this including ‘episodes’ where he would get ‘brain fog’ and feel weak amongst other symptoms.

32. On 15 April 2024 Mr L attended the Surgery with his mother where they explained that Mr L had a ‘episode’ the previous day, where he went blank, started rubbing his legs, said that his toes were cold, he went stiff, lost his balance, had brain fog, was irritated, agitated and weak. Mr L’s mother also said that Mr L was telling her that he had the urge to scream, kick, and shake his hands.

33. Following this, the Surgery referred Mr L to neurology, and he was booked in for an MRI later that month.

34. On 3 April 2024 Mr L contacted the Surgery and told it that he felt that he was thiamine deficient. Thiamine is a type of B vitamin. The Surgery prescribed Mr L a course of thiamine following this. On 15 April 2024, Mr L also told the Surgery that he believed he may be macronutrient deficient.

35. The Surgery explained to Mr L that the previous blood tests that he had showed no evidence of any deficiency. On 25 March 2024 the Surgery also referred Mr L to have his testosterone levels checked. The results of this test were also normal.

36. On 7 May 2024 Mr L contacted the Surgery to tell it that he believed that he had a urinary tract infection (UTI). He explained that he felt that the UTI had travelled to his kidneys. The records show that Mr L also told the Surgery that his urine was ‘neon yellow’, had a bad smell, and it was stinging when he passed urine.

37. On 9 May 2024 the Surgery arranged for Mr L to have a repeat blood test and urine test. The records show that both tests came back as normal, that there was no evidence of a UTI, and that it felt that the colour and smell of his urine was normal.

38. On 15 May 2024 Mr L had a follow-up appointment at the Surgery. He explained that he wanted to be prescribed antibiotics despite the urine test coming back with no evidence of a UTI. He also told the Surgery in this appointment that he was worried about a lump in his testicle and thought that his testicles and penis were shrinking. The Surgery examined his genitals at this appointment and recorded that there was no lump present and that they appeared normal.

39. The GMC guidance says that practitioners should ‘promptly provide or arrange suitable advice, investigations or treatment where necessary and refer a patient to another practitioner when this serves the patient’s needs.’

40. The records show that the Surgery referred Mr L to neurology, urology, endocrinology and for ultrasounds. It also performed blood tests, urine tests and prescribed him with antibiotics and a first course of treatment prior to these referrals. Unfortunately, these tests did not show any cause for Mr L’s ongoing symptoms.

41. We asked our adviser if the Surgery referred Mr L appropriately to investigate the symptoms that he was experiencing. Our adviser explained that the outcome of Mr L’s tests and referrals did not show any cause for Mr L’s ongoing symptoms, and there was no occasion when the Surgery should have referred Mr L for further investigations, or referred him to the above specialities sooner.

42. We therefore consider that the Surgery acted appropriately and in line with the GMC guidance in the way it investigated and referred Mr L for further treatment for his symptoms.

43. We understand that it will be distressing for Mr L to be without a diagnosis for his symptoms. We do not consider that the Surgery could have done anything more for him than it did. We will therefore not be considering this part of the complaint further as we have seen no indication of any failings.

The Surgery’s concerns about Mr L’s mental health

44. Mr L told us that the Surgery suggested that his symptoms may be due to his mental health. Mr L told us that he felt that the Surgery did not take him seriously because of this.

45. The Surgery apologised to Mr L if he felt that it had dismissed his physical health symptoms. It explained that this was not its intention.

46. On 28 May 2024 the Surgery contacted Mr L and told him that although it believed that he was experiencing physical symptoms, it thought that these may be due to his mental health rather than an underlying physical health condition.

47. Our adviser explained to us that when a patient’s symptoms are medically unexplained it is appropriate for the practitioner to consider a mental health cause.

48. The unexplained symptoms guidance explains that ‘a GP will aim to rule out all the possible conditions that might be causing your symptoms. You may have a physical examination and blood tests.’ It continues that ‘physical symptoms can cause depression and anxiety, and these can in turn make physical symptoms worse, creating a vicious circle.’

49. In line with the above guidance, and as explained above, the Surgery carried out the appropriate tests to rule out any other conditions before considering that Mr L’s mental health could be the cause of his physical health symptoms. We have therefore not seen any indications of failings in the way that the Surgery considered the causes of Mr L’s physical health symptoms and in its discussions of Mr L’s mental health with him.

The ICB’s investigation of the complaint

50. Mr L told us that he feels that the ICB did not do a thorough enough investigation into his complaint, and that he did not agree with its outcome. Mr L told us that he feels that the ICB sided with the Surgery rather than listening to his views about his own health. We are sorry to hear that the ICB’s investigation has left Mr L feeling dismissed.

51. The NHS Complaint Regulations say a responsible body must investigate the complaint in a manner appropriate to resolve it speedily and efficiently. It must provide a report in writing which explains how the complaint has been considered, and the conclusions it has reached. It should also include details of the complainant’s right to take their complaint to us.

52. Mr L complained to the Surgery on 21 January 2025. On 9 May 2025 the ICB finished its investigation into Mr L’s complaint and sent him a response. The response provided its explanation of what happened and the reasons why it felt his symptoms were investigated and addressed appropriately. The response signposts him to come to us if he was unhappy with the complaint.

53. Our Complaint Standards say staff should give a clear, balanced account of what happened based on established facts. It also says organisations should support and encourage staff to be open and honest and be ‘accountable for their actions’.

54. In its complaint response, the ICB explained the referrals that the GP made to address each of Mr L’s concerns. We consider the ICB had enough information available to fairly and robustly investigate this complaint. We can see that it used all the available evidence, including reviewing Mr L’s records, considering Mr L’s view of his symptoms, and speaking to the GP’s involved. This is in line with Our Complaint Standards.

55. We are sorry that Mr L does not feel that his complaint was investigated appropriately. After our consideration, we have seen evidence that the ICB responded to the complaint in line with the NHS Complaint Regulations and Our Complaint Standards. The ICB responded to the complaint providing a clear explanation of what happened and why.

56. We have also come to the same conclusion that there were no indications of any failings in the care and treatment provided to Mr L by the Surgery. As such, we will not consider this complaint any further.

57. We are sorry that Mr L feels frustrated by the investigation carried out by the ICB. I hope our findings on this, alongside the findings we made in our investigation of the Surgery, reassure him that he was appropriately treated. We are sorry that Mr L is experiencing ongoing physical health symptoms, and we wish him well with any ongoing health care.

1. We have carefully considered Mr L’s complaint about a GP Practice in the Staffordshire area (the Surgery) and Staffordshire and Stoke-on-Trent ICB (the ICB).

2. We would like to thank Mr L for taking the time to bring his complaint to us. We recognise that Mr L has lots of symptoms that are making him worried about his health.

3. After consideration, we have not seen any indications that anything went seriously wrong in Mr L’s care. We have seen indications that the Surgery correctly assessed his symptoms and sent him for referrals when necessary.

4. We also consider that the ICB carried out an effective investigation into Mr L’s complaint. As we have not seen any indications of failings, we will not consider this complaint any further.