University Hospitals Sussex NHS Foundation Trust

4. Mr P complains about the waiting time for surgery to treat his pilonidal sinus infection at the Trust in 2025. Mr P was booked in for an outpatient appointment on 29 July 2025 to investigate if he needed this surgery. Due to industrial action, the Trust cancelled the appointment and asked him to wait until 9 September 2025 for a rescheduled appointment. Mr P states this waiting time was unbearable and he decided to seek private medical treatment.

5. Mr P says the delay in receiving treatment led him to seek treatment privately at a cost of £3,459.

6. Mr P adds, the infection caused him intolerable pain which significantly disrupted his work, personal life and mental wellbeing. He says not having surgery sooner unnecessarily prolonged his pain.

7. As an outcome, Mr P would like the Trust to make improvements to avoid a repeat of his experience. He also seeks full financial reimbursement of £3,459, the cost of his private treatment.

8. Mr P first noticed a hard lump in his natal cleft (the area between the buttocks) in June 2024. In January 2025, he reported this lump had become significantly painful.

9. On 1 April 2025, Mr P attended his GP surgery regarding this lump. The GP prescribed antibiotics and referred him to general surgery at the Trust. On 28 April 2025, Mr P attended an ultrasound appointment where the sonographer observed recurrent lumps in the natal cleft in keeping with a pilonidal sinus infection. Mr P states his infection persisted after completing the course of antibiotics and he returned to his GP in ‘constant pain’ on 22 May 2025.

10. Mr P attended the Trust’s A&E on 2 June due to persistent pain. A surgeon reviewed him and decided he needed an outpatient review with the consultant to confirm his symptoms and book a surgical appointment. The Trust scheduled this for 29 July.

11. Mr P visited A&E a second time on 23 July due to persistent pain and concern around symptoms of sepsis. Staff checked Mr P’s vital signs and confirmed he did not have sepsis. Mr P reports leaving without further clinical assessment of the cyst as he believed it would result in the same outcome as his previous A&E visit on 2 June.

12. On 24 July Mr P received a text message cancelling his appointment on 29 July due to industrial action. The next available appointment was scheduled for 9 September. Mr P felt he could not endure another seven weeks wait for an appointment. On 4 August he attended a private consultation, and had the cyst removed on 3 September by the private health organisation at a cost of £3,459.

16. 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.

Waiting time for surgery

17. Mr P complains the waiting time for surgery to treat his pilonidal sinus infection was too long. Mr P’s outpatient appointment to investigate if he needed surgery which was scheduled for 29 July 2025 was cancelled due to industrial action. The next available appointment was scheduled for 9 September. Mr P argues he could not wait for this period of time and attended a private consultation. He had the cyst removed on 3 September by the private health organisation at a cost of £3,459.

18. As we have explained in paragraph 10, Mr P attended A&E due to his ongoing pain. Our advisor told us, though Mr P was in pain and discomfort, treatment for a pilonidal sinus is classed as routine because the condition is not life threatening. Our adviser explained that when the Trust reviewed Mr P on 22 May, his condition had improved and was in flux, further indicating his symptoms were those of a routine patient.

19. The NHS Constitution sets out that patients have a right to start non-urgent consultant led treatment within 18 weeks of being referred. Following the COVID-19 pandemic, most NHS organisations have not met this standard. Since 2022 the NHS has been working to reduce waiting times as set out in the elective care recovery plan. This aims to improve waiting times to a point where, by March 2029, 92% of people are receiving treatment within 18 weeks.

20. Publicly available data shows at the time of these events the Trust’s average waiting time for non-urgent treatment was 43.5 weeks.

21. Though Mr P waited longer than 18 weeks, his waiting time was not indicative of service failings. Mr P’s condition resembled that of a routine patient, therefore, we would expect him to be seen within the Trust’s typical waiting time for a routine patient of 43.5 weeks from the date of referral. Specifically, Mr P’s GP referred him on 1 April 2025 so we would expect him to receive treatment by 30 January 2026.

22. Mr P attended A&E a second time on 23 July 2025. During this appointment Mr P voluntarily left before a clinical assessment could be undertaken, meaning the Trust did not have the opportunity to reassess his condition. In the Trust’s view, Mr P therefore remained a routine patient, with no requirement for his treatment to be expedited.

23. The Trust cancelled Mr F’s outpatient appointment on 29 July due to a five-day nationwide doctor’s strike from 25 to 30 July, as detailed in the NHS England Industrial Action by BMA resident doctors communication. This period of industrial action caused significant disruption to NHS services. As listed in the communication, priority was given to maintaining emergency care, maintaining flow, maintaining elective care to the fullest extent possible and maintaining priority treatments. Particular focus was given to planning urgent elective surgery, cancer care and long waiters. Outside of these, the communication said the NHS will only cancel appointments where necessary.

24. We appreciate it would have been frustrating for Mr P’s appointment to be cancelled and for his wait time to be prolonged. As Mr F’s appointment did not fall within these priority categories, we cannot say it was a failing for the Trust to cancel his appointment. The Trust offered Mr P a rescheduled date for this outpatient appointment of 9 September. This outpatient appointment was within the Trust’s average waiting time of 43.5 weeks. As Mr P remained a routine patient, we cannot say the timescale for the rearranged appointment was a failing.

25. We understand Mr P was experiencing significant pain, which led him to seek private treatment with the expectation to be seen within a shorter waiting time. Mr P attended a consultation appointment with the private health group on 4 August. He underwent private surgery on 3 September. We are happy to hear this treatment was successful and alleviated Mr P’s pain.

26. Overall, we are sorry to hear of the discomfort and distress the waiting time for treatment of his pilonidal sinus infection caused Mr P. As the Trust arranged Mr P’s appointment within the expected timescale for a routine patient, we can see no indication the Trust should be expected to reimburse the cost of Mr F’s private care to treat his pilonidal sinus infection. We hope our decision provides Mr P some assurance about what happened with his treatment.

1. We have carefully considered Mr P’s complaint about the Trust. We appreciate Mr P’s pilonidal sinus infection (an infection of the skin in the area between the buttocks, at the base of the spine) caused him significant discomfort and pain. We recognise the cancellation of Mr P’s appointment will have been frustrating as he was in so much discomfort.

2. We have considered the evidence carefully and seen no indication of failings in relation to Mr P’s complaint about the Trust’s care and treatment. This is because Mr P remained a routine patient throughout the duration of his time spent on the waiting list. Mr P’s waiting time for surgery was in line with standards and guidelines relating to routine care.

3. As we have seen no indication anything went wrong, we have decided to take no further action. Our decision is not made without recognition of the pain and discomfort Mr P has endured waiting for surgery. We have explained the reasons for our decision below.