Cambridgeshire and Peterborough NHS Foundation Trust

3. Miss M complains about care provided to her by the Trust. Specifically, Miss M complains the Trust; • made her wait an unreasonable time for an ADHD assessment • failed to tell Miss M how long the waiting time was and why she was turned down for an expedited assessment in February 2024.

4. Miss M told us she has suffered the effects of her untreated ADHD for over four years and has had to pay for a private diagnosis. She says her stress and anxiety levels are high and she is barely functioning. Miss M has experienced anxiety because she has not been kept informed by the Trust.

5. Miss M also complains about care provided to her by the Practice. Specifically, Miss M complains the Practice; • failed to inform her she could seek an ADHD diagnosis via right to choose • has refused to prescribe her ADHD medication based on a policy of not entering into shared care agreements.

6. Miss M says she missed the opportunity to register with a different Practice where she could have got shared care because she did not know about right to choose. The Practice’s refusal to prescribe her ADHD medication has meant she pays £111 a month to receive this treatment.

7. As an outcome of her complaint, Miss M is seeking an apology, service improvements, and financial compensation from both organisations. Miss M would like the Trust to reconsider her position on the waitlist. She also wants the Practice to reconsider its decision to not enter into a shared care agreement.

8. Miss M was seen by her Practice in May 2021. The Practice referred Miss M to the Trust for an ADHD assessment.

9. In August 2021 the Trust added Miss M to its Adult ADHD assessment waiting list.

10. In January 2025, Miss M was still waiting for an ADHD assessment from the Trust. She found a private clinic to assess her, but it was unable to provide her with medication. Later that month, the Practice informed her it was also unable to provide the medication as it could not enter into a shared care agreement.

14. The Law says a person needs to make their 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 the complainants delay in coming to us was reasonable.

15. In line with the Law, we have considered when Miss M knew she had a reason to complain about each complaint part. We call this Miss M’s date of knowledge. We have also considered how long both complaint processes took. We have discussed with Miss M any reasons for time delays in bringing this complaint to us.

Miss M’s date of knowledge

Issue one: The Trust made her wait an unreasonable time for an ADHD assessment

16. We have considered when Miss M had reason to complain about this issue. Miss M was referred to the Trust for an ADHD assessment in August 2021. Miss M told us when she was first referred to the Trust, she was told the wait time would be approximately six months. Miss M thought this was a reasonable time to wait and felt she had no cause to complain at this stage.

17. Miss M waited just over six months before contacting the Trust for an update in April 2022. Miss M asked the Trust if it could give an indication of how long she should wait to be assessed. The Trust responded to say the current wait time was 18 to 24 months from the date of referral, and she could expect to be assessed by August 2023.

18. Miss M told us she could not understand how she had been on the Trusts waiting list for 8 months and her wait time had increased and not decreased. Miss M told us this was the first time she thought the wait time was becoming unreasonable and she was unhappy.

19. We consider Miss M was first unhappy in April 2022 and had good reason to complain about the waiting time at this stage.

20. To be within our one-year time limit, Miss M should have brought this complaint to us by April 2023. Miss M made her complaint to us in full on 4 July 2025. This means this complaint part is two years and three months outside of our time limit.

Issue two: The Trust failed to tell Miss M how long the waiting time was and why she was turned down for an expedited assessment in February 2024

21. We have considered when Miss M had reason to complain about the Trust. On 12 December 2023, Miss M emailed the Trust and asked, • Can you tell me why I have been turned down for and ADHD referral expedite?

• Can you tell me the waiting time?

22. The Trust responded on 14 February 2024. It said it could not expedite Miss M’s ADHD referral. The Trust did not explain why. The Trust said it could not advise a time frame of wait.

23. As 14 February 2024 was the date Miss M received this email, we consider this was the date she knew she had cause to complain.

24. We consider by 14 February 2024, Miss M could have complained about the Trusts refusal to communicate this information. To be within our time limit, Miss M should have brought her complaint to us by 14 February 2025. Miss M made her complaint to us in full on 4 July 2025. This means this issue is six months outside of our time limit.

Issue three: The Practice failed to inform her she could seek an ADHD diagnosis via right to choose

Issue four: The Practice has refused to prescribe her ADHD medication based on a policy of not entering into shared care agreements or prescribing ADHD medication

25. We have considered when Miss M had reason to complain about the Practice. We have looked at email evidence sent to us by Miss M. The Trust involved in Miss M’s care sent her an email on 14 February 2024. In this email, the Trust said Miss M had the option of right to choose and could discuss alternative ADHD assessment providers with her Practice. We can see Miss M responded to this email and said she had discussed the right to choose option with the Practice and had found out it did not offer a shared care agreement.

26. This means Miss M knew she had cause to complain about the Practice on 14 February 2024 for both issues. To be within our time limit Miss M needed to bring her complaint to us by 14 February 2025. Miss M made her complaint to us in full on 18 March 2025, one month outside of our time limit.

Reasons for delays

27. Miss M had reason to complain about her position on the waiting list from April 2022. Miss M knew about the other three issues by February 2024. We asked Miss M about her delays between April 2022 and February 2024.

28. Miss M told us she deals with a lot of health issues including chronic fibromyalgia, stage 4 endometriosis, exocrine pancreatic insufficiency, and she is prone to chest and sinus infections. Miss M told us this was a barrier to her complaining.

29. We can see Miss M was tested for celiac disease in April 2022. Her wheat intolerance caused her to have exhaustion, tiredness, bloating and a bad stomach. In June 2022, her fatigue was so severe she had days she had to cancel all plans. Miss M also experienced fatigue from March to September 2022 because her body was not absorbing iron orally.

30. Miss M was ill due to a flu jab between 15 and 19 September 2023. She was ill again from a Covid-19 booster jab between 28 and 31 October 2023.

31. Miss M told us she attended a family friends funeral in June 2022 and another family members funeral on 12 October 2023. We are extremely sorry to hear of both losses and do not doubt the impact this grief would have had on Miss M.

32. We are extremely sorry to hear of the various health conditions Miss M has had to deal with over the past few years. We have considered whether these were a barrier to her daily life.

33. We can see Miss M was able to complete administration tasks between April 2022 and February 2024. Records show Miss M attended a dietician appointment in April 2022. Miss M took her parents to medical appointments in July, October and December of 2022. Miss M attended a review of her contraceptive pill in July 2022 and reapplied for her blue disabled badge in August 2022.

34. Miss M called her GP about HRT in February 2023 and attended therapy appointments in the early part of 2023. Miss M was able to have a phone call appointment with her doctor on 11 August 2023 and on 22 August 2023. She was also able to attend medical appointments such as her health check and cervical screening on 5 September 2023.

35. We can see Miss M had a lot of difficult health conditions throughout this period which were difficult to manage and cope with. We cannot see they were a barrier to Miss M carrying out administration tasks. For this reason, we consider Miss M could have brought her complaint about issue one to us at any stage from April 2022 to February 2024.

Reasons for delays issues two, three and four

36. Miss M knew about the rest of the issues in February 2024. We considered her reasons for the 12-month delay in raising her complaint to the Trust between February 2024 and March 2025, when she came to us.

37. Miss M gave us specific dates she struggled with her health. We can see on 20 February 2024 she was prescribed medication for her back. On 8 March 2024 she had an allergic reaction to milk. On 30 April 2024 she had a sinus infection. Miss M also had bad pain attacks on 20 May, 4 August, and 24 August 2024. Miss M had a chest infection between 14 and 16 June 2024.

38. We can see Miss M was able to carry out administration tasks in this period. Miss M wrote a letter to her MP, Citizens Advice Bureau, Rethink and Mind Legal on 26 February 2024 about her ADHD assessment. Miss M was able to attend a meeting about building works on her flat on 10 April 2024. Miss M made a phone call about PIP on 24 April 2024 and attended a charity fundraising event on 4 May 2024. Miss M had meetings at Cambridge Women’s Resource Centre (CWRC) about universal credit between May and July 2024.

39. On 13 August 2024 Miss M asked a support worker from CWRC to help her make complaints about her ADHD assessment, the complaint she brought to us. Miss M asked her support worker to arrange a meeting on 28 August 2024. This was arranged for 5 September 2024, but the support worker cancelled. Miss M said she chased this up with CWRC every week and did not hear anything.

40. On 17 January 2025, Miss M met with a new CWRC support worker who agreed to help with her ADHD assessment complaint. We can see this support worker helped Miss M make her complaint to us on 18 March 2025.

41. We have considered the above evidence and the ongoing health conditions described in paragraph 22. We can see the new health conditions Miss M dealt with that are described in paragraph 28 were short term. We can see Miss M’s health conditions were not a barrier to her attending charity events or making enquiries about PIP and universal credit.

42. We can see Miss M wanted an advocate to help with her complaint and made considerable efforts to access one. We appreciate this must have been frustrating.

43. We consider she was able to contact the Practice and write letters to various organisations without advocate support. For these reasons, we consider Miss M could have come to us from any stage after February 2024.

Complaint to the Practice

44. Miss M complained to the Practice on 8 January 2025 without assistance. The Practice responded to her complaint on 23 January 2025. The time the Practice took to respond to her complaint was outside of Miss M’s control.

Complaint to us

45. Miss M decided to go to the ICB with her complaint about the Practice on 17 February 2025, four weeks after she received the Practice’s response. She did not approach us.

46. We understand Miss M suffers with dyslexia and dyscalculia, and she finds writing particularly difficult. We want to recognise Miss M’s needs here.

47. The Practice did not direct Miss M to us in its final response. We consider contacting the ICB was a reasonable next step for Miss M to take, and we consider this time delay was outside of Miss M’s control.

48. The ICB signposted Miss M to us on 18 February 2025. Miss M made her complaint to us on 18 March 2025, causing a delay of one month. Miss M told us as well as her needs described in paragraph 46, she was housebound with a virus for weeks during this period. We consider this reasonable mitigation for her delay.

Complaint to the Trust

49. When Miss M contacted us on 18 March 2025, she had not complained to the Trust about these issues. Miss M was advised to make a complaint to the Trust which she did on 14 April 2025. We can see this took Miss M one month. Miss M told us she had a post viral fibromyalgia pain flare and was prescribed a strong painkiller. This made concentration difficult, particularly with her needs described in paragraph 46. We consider this reasonable mitigation for her delay.

50. The Trust responded to Miss M’s complaint on 17 June 2025. This two-month delay was outside of Miss M’s control. Miss M brought the Trusts final response to us on 4 July 2025, two weeks after the date she received this. Miss M told us she had a flare up in her herniated disc during this time which halted her concentration. We consider this reasonable mitigation for her delay.

Conclusion

51. Miss M’s complaints about the Practice and the Trust are outside of our time limit. Whilst we have seen some mitigation for the delays in progressing her complaint from the Practice to us, we cannot see that she was prevented from making the complaint sooner. This means despite some justification for her delays, overall, we consider she had the opportunity to complain sooner but did not.

52. We cannot take further action on Miss M’s complaint for these reasons.

1. We have carefully considered Miss M’s complaint about Cambridgeshire and Peterborough NHS Foundation Trust (the Trust) and a GP Practice in Cambridgeshire (the Practice).

2. Miss M’s complaint falls outside our one-year time limit. After carefully considering the evidence available to us, we have decided we cannot see sufficient reason to set aside the time limit in her case. We recognise this may be disappointing news for Miss M. We have explained the reasons for our decision below.