A practice in the Bury area

4. Ms V complains about Practice A and Practice B.

5. Ms V says that Practice A:

• removed her from its patient list in May 2025 without giving her the required notice • accused her of being ‘violent’ in the waiting room in front of other patients and therefore made her have a chaperone to all appointments, including personal examinations, which made her feel uncomfortable • made numerous false allegations against her saying that she did not have many of the medical conditions that she was diagnosed with and was a ‘disturbed individual’ who lies in order to get medication • refused to give her medical treatment due to a relative of hers having a criminal conviction and refused to remove this information from her medical records.

6. Ms V says that Practice B:

• removed her from its patient list on 26 June 2025 within a few minutes of her first appointment with it and said that she had asked to be removed even though this was not the case • stopped her essential repeat prescription medications (diabetes and bowel medication) with no discussion about this • falsely recorded a urine test on her records as ‘negative’ even though she had not done one.

7. Ms V says that as a result of this she has been without her medication or any healthcare meaning that she has suffered multiple side effects of her conditions. Ms V also says that she is now ‘terrified’ of medical professionals and this has severely affected her mental health.

8. Ms V says she feels ‘victimised’ and has been left without healthcare due to the ‘lies’ on her medical records.

9. Ms V seeks:

• a financial remedy • an apology • service improvements.

10. Ms V was a patient at Practice A from 19 July 2023 to 28 May 2025.

11. Ms V a difficult relationship with Practice A throughout her time as a patient. At one stage Practice A advised Ms V that she would need to have a chaperone to all of her appointments with it.

12. On 25 April 2025 Ms V received an email from Practice A that told her that due to a ‘relationship breakdown’ it would be deregistering her as a patient. Ms V explained that it gave her 28 days from the date of the letter for her to find a new GP Practice.

13. Ms V then registered as a patient at Practice B, at the end of May 2025.

14. On 26 June 2025 Ms V attended Practice B for her initial medication review appointment. In this appointment Practice B advised her that the collection of medications that she was taking was potentially dangerous, and it did not want to prescribe Ms V all of the medications she had previously been prescribed.

15. Ms V was unhappy with this, and the records indicate that she asked to be deregistered as a patient following this appointment. Practice B advised Ms V that it would not deregister her until she had found a new GP Practice.

16. Ms V continued to express her frustration at the choice of Practice B to not prescribe all of her medication. Practice B deregistered her due to a ‘relationship breakdown’ shortly after this incident.

20. 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.

Practice A

Removal as a patient in May 2025

21. Ms V explained that Practice A removed her as patient in May 2025 without giving her the ‘required’ 28 days’ notice to find a new Practice. Ms V says that this has affected her mental health, and she feels that she was ‘victimised by Practice A’.

22. In its complaint response on 15 August 2025 Practice A said that the advice Ms V was given regarding her removal as a patient was in line with the relevant General Medical Council (GMC) guidelines.

23. Ms V’s medical records show that she was advised on 25 April 2025 that she was being removed as a patient at Practice A due to a ‘relationship breakdown’. The Practice explained to her that it had asked Primary Care Services England to remove her from the Practice list within the next 28 days.

24. Our GP adviser explained to us that Practices are under no obligation to give patients an extended period of time to find a new GP Practice before it removes patients. They said that Practices can remove patients immediately and without notice if they wish to do so in line with a ‘zero tolerance policy’.

25. The patient removal guidance explains that an ‘8 day removal’ is a common way that a patient is removed from a GP Practice. It explains that if a Practice is removing a patient due to a ‘relationship breakdown’, it should give the patient 8 days to find a new healthcare provider, before removing them.

26. Practice A gave Ms V 28 days to find a new Practice when it removed her as a patient. This is in line with the patient removal guidance, which explains that 8 days is the minimum amount of time that a patient should be given to find a new healthcare provider. Based on the advice provided to us, and the information in the patient removal guidance, we consider Practice A followed the relevant guidelines in the removal of Ms V as a patient.

27. We recognise that it will have been frustrating for Ms V to have to find a new GP Practice. After consideration, we have seen no evidence that Practice A were wrong to give Ms V 28 days to find a new GP Practice before it removed her as a patient. We will therefore not be considering this complaint further.

Accusations of Ms V being ‘violent’

28. Ms V told us that Practice A have incorrectly labelled her as a ‘violent’ patient. She says that it has written this in her medical records, and she feels that this has impacted her ability to get future medical care.

29. In its complaint response on 15 August 2025, Practice A explained that it is not recorded anywhere on Ms V’s medical records that she is ‘violent’.

30. We have reviewed Ms V’s medical records, and they do not mention that she is a violent patient. We understand that it will be difficult for Ms V to feel that she is unable to access healthcare as she feels she has been labelled as ‘violent’. We have seen no evidence that this was, or is, written in her medical records by Practice A. We will therefore not consider this complaint further.

31. Ms V said that as a result of Practice A feeling that she is ‘violent’ towards them, it asked her to have a chaperone to attend all of her medical appointments, including intimate examinations. Ms V said this made her feel uncomfortable.

32. Practice A explained in its complaint response on 13 November 2023 that it asked a chaperone to attend Ms V’s appointments as there had been previous incidents where there was a difference in accounts of what happened in the appointments, and it felt that this would help confirm what was discussed in them in the future.

33. Practice A said that the chaperone was a female member of Practice staff, and was on the other side of the room, sat down, throughout the appointment. It said that the presence of the chaperone was not meant to be intimidating, and apologised if Ms V found it to be so.

34. In its complaint response on 15 August 2025, Practice A explained that it had reviewed Ms V’s records and concluded that it was acceptable and reasonable to request that Ms V had a qualified female practice chaperone attend her appointments with her. This was because Practice A felt that the patient doctor relationship with Ms V was under significant strain and the presence of a third party may help to reduce the chance of any further miscommunication occurring.

35. Our GP adviser said the reason given by the Practice for the presence of a chaperone was an appropriate response to the communication issues faced.

36. The reasonable adjustments guidance explains that patients must be entitled to reasonable adjustments that allow them to continue to access healthcare. Our GP adviser said that Practice A requesting that Ms V have a chaperone at appointment was an appropriate reasonable adjustment to ensure that Ms V could continue to receive her healthcare with it.

37. In line with the guidance on reasonable adjustments, we consider it was appropriate for the Practice to request that Ms V have a chaperone with her when she attended her appointments with it. We therefore will not consider this complaint further.

38. Ms V also told us that on 20 November 2023, a GP at the Practice called her ‘violent’ in front of other patients in the waiting room. Ms V said this made her feel humiliated.

39. In its complaint response on 7 December 2023 Practice A apologised for the conduct of the GP who called her ‘violent’ and agreed to discuss this incident with them.

40. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the events complained about had a negative effect which the organisation has not put right. Having done so we have seen Practice A has already done enough to put right the impact of these events.

41. Our NHS complaint standards say when a service falls below the standards expected, organisations should identify suitable ways to put things right for people. Staff should give meaningful and sincere apologies that openly reflect the impact on the people concerned. We can understand why it will have been distressing for Ms V to have heard the GP calling her violent.

42. We consider that in line with Our NHS complaint standards Practice A have apologised and have spoken to the GP in question about their conduct. As such, we do not feel that anything further needs to be done to remedy this aspect of the complaint.

Information in medical records

43. Ms V told us that Practice A have said that she does not have a lot of the medical conditions that she is diagnosed with, and that she has lied in order to obtain medication. She also said that Practice A have recorded in her medical records that a member of her family has a criminal record. Ms V said that she feels that this is impacting her accessing healthcare.

44. We have reviewed Ms V’s medical records and they do not mention that she is lying about her medical conditions in order to obtain medication. They also do not mention that a member of her family has a criminal record.

45. We understand that it will be difficult for Ms V to feel that she is unable to access healthcare due to this. We have seen no evidence that this was, or is, written in her medical records by Practice A. We will therefore not consider this complaint further.

Practice B

Initial appointment

46. Ms V told us that when she became a patient at Practice B, she had an initial appointment with it, and it told her that it would not be able to give her any repeat prescription medication. Ms V says that as a result of this she was without medication or healthcare, and that this affected her mental health.

47. In its complaint response on 1 July 2025 Practice B explained that after reviewing Ms V’s medical records, it had identified that there were several concerns with her medications and safety of these, and that the Practice pharmacist had wanted a GP to discuss these with Ms V. The Practice pharmacist also asked that the GP explain to Ms V why it thought that the stopping of some of her prescribed medications was appropriate. Practice B said that it continued to provide Ms V with her essential prescribed medications following this.

48. Ms V’s records show that on 10 June 2025 Practice B invited her to an initial medication review appointment on 26 June 2025. The records show that Ms V was upset that her medications were being reviewed, however reception staff reassured her that this was routine for new patients such as herself.

49. The records show that clinical staff at Practice B had a discussion around Ms V’s prescribed medications as she had requested a repeat prescription. It discussed that Ms V was taking a large number of prescribed medications, and that some of these could have potentially dangerous interactions.

50. The records show that Practice B discussed that Ms V had scored highly on the measure of anticholinergic burden (AB). AB is a measure of the effect of taking multiple medications at once, and patients with a higher AB score can be at higher risk of experiencing negative physical health symptoms. It concluded that she was at high risk of serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition that is caused by a person having too much serotonin in their body.

51. The records show that Practice B identified that there had been no improvement in Ms V’s diabetes since she started her alogliptin and empagliflozin medications, and therefore, there was no benefit to her continuing to be prescribed these. It also felt that as Ms V suffered from chronic constipation, her high prescription of opioid medications could have been causing this to worsen.

52. Ms V’s records show that she attended the initial medication review appointment at Practice B with her husband on 26 June 2025. The records show that Practice B told Ms V that it had identified that she was taking a collection of medications that had potentially multiple serious drug reactions that could be life threatening.

53. The records show that Practice B began to explain to Ms V each medication that it would be stopping, and why. The records then say that after Practice B had explained three of the medications it would be stopping, Ms V said that she did not want any of her medications to be stopped, that she made a mistake registering at Practice B and that she no longer wished to be a patient there. Practice B explained to Ms V that it would be unable to deregister her until she was registered with a new practice.

54. Our pharmacist adviser explained that other healthcare professionals had raised concerns about the number of medications that she was taking before the Practice had its appointment with Ms V on 26 June 2025. The records show that while Ms V was under the care of Practice A, it had received a letter from a consultant psychiatrist advising it to consider stopping Ms V’s duloxetine and melatonin medication. Our pharmacist adviser also told us that a medication review is a standard practice for when patients first join a Practice.

55. Our pharmacist adviser explained that it was clinically appropriate for Practice B to stop some of Ms V’s medications, as it was correct to advise Ms V that taking some of these medications together may be making her conditions worse, for example, taking opioid medications such as tramadol, when constipated, may cause this to worsen.

56. Ms V’s records show that following the 26 June 2025 appointment Ms V was still prescribed metformin and insulin, for her diabetes. The records show that she also remained on sertraline, for her mental health, and mirtazapine for her pain relief. She was also still prescribed her laxative medication.

57. Our pharmacist adviser explained that these are the critical medications that Ms V needed to take for her medical conditions, and that there were no critical medications that were stopped from her prescription list.

58. The GMC prescribing guidance explains that if a patient asks for treatment or care that the prescriber does not think is clinically appropriate, the clinician is not obligated to provide this medication or treatment.

59. We recognise that it will have been confusing for Ms V to have had her previously prescribed medications stopped. We consider it was appropriate, and in line with the GMC prescribing guidance for Practice B to have stopped some of Ms V’s medications. Therefore, we will not be considering this complaint further.

60. Ms V told us that following her 26 June 2025 appointment, Practice B then removed her from its patient list within a few minutes of this initial appointment with no apparent reason for this.

61. In its complaint response on 1 July 2025, Practice B explained that in the initial appointment to discuss her medication, Ms V told it that she wanted to deregister as a patient and that she had ‘made a mistake’ registering at Practice B. It then said that Ms V spoke to the reception staff following her appointment and again requested to be removed from the patient list with immediate effect.

62. Ms V’s medical records show that Ms V left the 26 June 2025 appointment abruptly, and asked reception staff if she could be removed from the patient list. The records show that later that day, Practice B received a notification from the Healthwatch team in the local area that Ms V had reported that it had stopped all of her prescribed medications. Practice B explained to Healthwatch that it had not stopped all of Ms V’s medications, and that she was still prescribed her essential medications.

63. The records show that Ms V initially asked Practice B to be removed as a patient, however, Practice B told her that it was unwilling to do so until Ms V had registered at a new GP Practice. Practice B continued to provide Ms V with her prescribed medications, and she remained as a patient at Practice B after June 2025. There is no evidence in the records to suggest that Practice B removed Ms V as a patient.

64. As Ms V’s medical records show that she was still registered as a patient following the 26 June 2026 appointment, we have seen no evidence that Practice B removed her from its patient list. Therefore, we will not be considering this complaint further.

Urine test

65. Ms V told us that when she attended the Practice on 26 June 2025 for her first appointment the nurse at the appointment asked her if she had brought her urine sample with her. However she had not been told to bring one with her and so the nurse was unable to carry out the urine test at the appointment.

66. Ms V told us that it was recorded on her records that her urine test at the appointment was ‘negative’. Ms V feels that this is incorrect, as she did not have a urine test at this appointment.

67. In its complaint response on 30 June 2025 Practice B told Ms V that when inputting a urine test onto its system, the only two options available are ‘positive’ or ‘negative’. It explained that as she did not have a urine test done at the appointment, it was correctly recorded as negative, and a note was written that no urine test was carried out.

68. NMC’s the code says that nurses must keep clear and accurate records relevant to your practice.

69. Ms V’s medical records show that she had an appointment with a nurse at Practice B on 26 June 2025. The records say that at this appointment, Ms V’s urine protein test was negative, and her urine glucose test was negative. In the same appointment note, it then says that Ms V did not bring a urine sample pot to the appointment.

70. As Practice B have explained that the only two options on its system are positive or negative, and it has added a note which explains that Ms V did not bring a urine sample to her 26 June 2025 appointment, we do not feel that Practice B have incorrectly recorded Ms V’s urine test. Therefore, we consider the records are in line with NMC’s the code as they are clear and accurate.

71. We understand that it will have been confusing for Ms V to see this in her records. We do not consider this is an indication of a failing by Practice B. We will therefore not be investigating this complaint further.

72. We would like to thank Ms V for taking the time to bring her complaint to us. We recognise that it will have been stressful for Ms V to feel that she was unable to access healthcare. We have seen no indications of failings in the actions of Practice A or Practice B. We will therefore not be investigating this complaint further.

1. We have carefully considered Ms V’s complaint about two GP Practices in the Greater Manchester area.

2. We would like to thank Ms V for taking the time to bring her complaint to us. We can understand that it will have been stressful for Ms V to have to find a new GP Practice, and to feel that she was without her necessary medication.

3. After consideration of all the evidence in this case, we have seen no indications that anything went wrong in the care provided to Ms V at either GP Practice. As such we will not consider this complaint any further.