A practice in the City of Bristol area

4. Ms L complains about the Practice regarding delays in diagnosing stage 4 bowel cancer, which was confirmed in 2024, and a shoulder condition which was diagnosed in 2025.

5. She says: • the Practice failed to arrange appropriate investigations since 2013 to establish the cause of her persistent digestive symptoms.

• the Practice failed to address the cause of persistent shoulder pain between March 2022 and August 2025, which subsequently was diagnosed as three separate shoulder conditions requiring following an MRI arranged by her oncology team.

6. Ms L says the failing led to her cancer being diagnosed later than it should have been and her prognosis being worse due to this. She also says failing to address her shoulder condition left her in continuous pain for a significant avoidable period. She says her life has been significantly impacted for the last ten years due to these failings.

7. Ms L seeks an apology, systemic improvements, and a financial remedy.

10. The law says a person needs bring 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 do so. We have discussed this with Ms L to understand the reasons why she could not do so. We have also considered the time the Practice took to respond to her concerns.

11. We recognise that often a person will not be able to complain to us within a year of events happening as complaint procedures can sometimes take over a year to be exhausted. To be able to justify there was good reason why a complaint is made to us outside the time limit we need to establish that this happened for reasons outside the persons control and there were no avoidable delays on their part.

12. For example, if a person had to wait for a response for some time, these waits take up a significant portion of the time prior to us receiving a complaint, and they had made reasonable attempts to chase up periodically, we could make allowances for this. If there are significant gaps unaccounted for where they could have acted to progress matters but did not, such as prior to acting, or after getting a response, we cannot justify making allowances.

13. We asked Ms L if she could explain any long gaps between the events in question and her approaching the Ombudsman. We noted that she would have been aware, at the latest, of her unhappiness with the Practice’s care on 6 February 2024. This is the date she received her diagnosis of cancer and had cause to feel her prior care had missed signs of this.

14. We note her concerns about her shoulder are a secondary matter, and have not been responded to by the Practice as yet. There may be some argument to claim her awareness about this was as late as August 2025 when she received a diagnosis. However, we note her issues with this date back to 2022 and she was already unhappy with the care she received from the Practice for some time and had lost confidence in its service. It is likely, on balance of probability that she was aware of the need to complain about this also some time sooner. Nonetheless this is not the primary focus of her complaint and there seems little benefit in separating this out to be considered as a separate issue.

15. We therefore looked at what has happened between the point she had cause to complain in February 2024 and when we received the complaint, in January 2026. We see that once she did complain, in November 2025, the Practice provided a response almost immediately, on 26 November that month. She escalated matters to her local Independent Clinical Board shortly after on 4 December, which immediately signposted her to the Ombudsman that day. We received her complaint on 28 January 2026.

16. Taking all this into account we can see Ms L acted in a timely manner once she made a complaint and there appears to be little delay in progressing the complaint to us thereafter. We still must accounted for the 20 months initial delay, which has resulted in her complaint being made to the Ombudsman, nearly a year out of time.

17. Her stated reasons for the delay are: • Following her diagnosis in February 2024 she was too ill to complain. She explains she underwent surgery in April 2024 and needed a 6-month recovery period after.

• She provides an email showing she contacted her local MP in January 2025 during a break in treatment as evidence of her effort to obtain assistance • She was informed her cancer had returned in February 2025 and was in treatment until July 2025. She says she was physically and emotionally unable to engage with any complaints processes during this time.

• In August 2025 she was on a break from treatment and able to engage advocacy support. She provides an email replying to one from her MP’s from February 2025 at this time as evidence.

18. We understand for how challenging and distressing events were, and still are, for Ms L since her diagnosis. We understand how this can be especially demotivating. We can see how making a complaint about her GP care would not been her focus, and how emotionally stressful this time will have been. Similarly, we also can see that there will have been periods where she would have been too unwell to attend to her affairs. We are aware she is a single mother of several young children and needing to attend to their needs also.

19. We are unable to see how these difficulties can account for nearly two years of inactivity. There are some practical barriers to progressing complaints during this time, specifically some periods of hospitalisation for treatment, and we have made allowances for these. The illness and surgery would partly account for some of it, as it is reasonable to consider there would be periods she was too ill to manage tasks such as letter writing.

20. Regrettably we cannot see how this would account for 20 months. The complaint letter submitted to the GP is a simple two-page complaint which would not require much time to write and submit. We should consider Ms L would have the ability and opportunity to write such letter of complaint to the GP sooner than she did, particularly with an awareness she had a limited time left to resolve matters. Had this been done in a timely manner, it is likely the complaint would have reached us within the time limit. We can usually only set the time limit to one side when a complainant can provide evidence they were prevented coming to us sooner by some practical barrier.

21. The events complained about also span many years and the more recent of these are now unfortunately several years ago. This presents practical difficulties in investigating matters due the passage of time, as staff often move on or their recollections fade. We must also consider these factors when looking at whether we have grounds to set aside the time limit.

22. For these reasons we have decided we should not set aside the time limit on this occasion. We must be consistent on how we alloy the time limit set for us by law. While we have great sympathy for Ms L’s plight, this is in line with how we would apply the time limit on other cases.

1. We have carefully considered Ms L’s complaint about the Practice. The complaint falls outside of our time limit, and we have decided there is no good reason for us to put our time limit aside to consider it further.

2. Unfortunately, the key issues of Ms L’s complaint were raised with us significantly outside the time limit set for us by law. We can appreciate what a distressing and stressful time it will have been for her and her family having received a late-stage cancer diagnosis in 2024, and how this will have impacted her ability to do things like make complaints about her care.

3. Considering the contents of the eventual complaint made to the Practice, and the length of time between having cause to raise concerns and making that complaint to the Practice, we have concluded Ms L would have been able to do this, and so bring a complaint to us to us much sooner than she did.