Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust

8. Mrs J complains that the Trust cancelled a hip replacement surgery twice, once in late 2024 and again in early 2025. She says this caused her inconvenience, distress, and unnecessary pain while waiting for treatment.

9. Mrs J also complains that, during her admission, staff administered fentanyl twice and performed two nerve blocks, all without her consent, which she says left her feeling violated and upset. Mrs J says she had a negative reaction to the fentanyl, which she believes caused an itchy rash and left her feeling faint and tired.

10. Mrs J believes the fentanyl and/or the nerve blocks may have caused bleeding after her staples were removed and ongoing groin pain.

11. Additionally, Mrs J complains that a clinician prescribed lansoprazole unnecessarily. She says this caused annoyance and wasted her time.

12. Mrs J complains that, at a post-operative appointment, a doctor dismissed her reports of pain, which she found distressing.

13. Finally, Mrs J complains that the Trust delayed its response to her complaint and communicated poorly with her during the complaint process, which she found frustrating and meant her time was wasted.

14. By bringing this complaint to us, Mrs J is primarily seeking service improvements. She also asked for a financial remedy.

15. Mrs J underwent a left hip replacement at the Trust in March 2025. The surgery followed earlier attempts to schedule the procedure in 2024 and early 2025, which did not go ahead.

16. The records indicate that, before the surgery, Mrs J discussed her preferences for anaesthesia and pain management with clinical staff.

17. Clinical records document multiple discussions with Mrs J about general anaesthesia, nerve blocks, and pain relief medication. The anaesthesia plan recorded that Mrs J:

• did not want a regional nerve block (which numbs a broad area) near her spine • preferred to avoid pain medication after surgery • would accept opioid pain relief (fentanyl) if necessary.

18. The consultant anaesthetist also set out the plan in a letter, which was copied to Mrs J.

19. During her admission, Mrs J received general anaesthesia, a fascia iliaca block and a PENG block (which targeted specific nerves in the hip), and post‑operative pain relief, including two doses of fentanyl.

20. Mrs J was given fentanyl in recovery after her operation.

23. Before we decide if we should investigate a complaint in more detail, we look at a few different factors. We consider whether there are signs the organisation concerned has got something wrong. We do this by comparing what should have happened with what did happen. If what happened fell far short of what should have happened, we call this a failing. We also look at whether what happened had a negative impact on the person in question. If we think it did, we will go on to consider what, if anything, the organisation has done to try to put things right.

24. If we think there was a failing, and that this had an impact that has not been put right, we will usually investigate in more detail.

25. We have applied this approach to Mrs J’s complaint and not found any indication that anything went wrong with the anaesthesia, pain relief, or scheduling of her surgery. We recognise Mrs J felt she had made her wishes clear in advance and that the treatment she received did not reflect those wishes, which she found distressing. Although Mrs J’s initial list of preferences was not adhered to, changes were only made after appropriate discussion and agreement.

26. Although there appears to have been a problem with the prescription of lansoprazole, we do not think this had a negative impact on Mrs J.

27. The Trust has already acknowledged, and apologised for, delays and poor communication during the complaint process. We think that was enough to put right the impact of any poor complaint handling.

Postponed procedure

28. Mrs J told us that her hip replacement surgery was unnecessarily delayed because of disagreement about the anaesthetic plan. She said this took away her autonomy over decisions about her care.

29. The Trust said it rearranged the surgery following a consultation with a Specialist Doctor in Orthopaedics. It said Mrs J requested general anaesthesia and a specific post-operative care plan, which the original facility the surgery was planned to take place at could not support. The Trust said it arranged a consultation at a high-risk patient pre-operative assessment clinic, where a Consultant Anaesthetist finalised the plan and identified a suitable facility for the procedure.

30. The guidance on consent to anaesthesia recognises that the range of techniques available will depend on what is appropriate and feasible in a particular setting. It also recognises that, where a clinician is unable to provide care consistent with a patient’s preferences, they may decline to proceed and should make reasonable attempts to identify a suitable alternative, such as arranging treatment at a different facility.

31. The records indicate that Mrs J’s surgery was postponed so that risks could be assessed and an appropriate plan developed. Following the assessment, the procedure was rescheduled at a different facility able to support the agreed anaesthetic plan.

32. This is consistent with the guidance, which recognises that clinicians may delay or rearrange treatment where a patient’s preferences cannot be safely provided in a particular setting.

33. We appreciate that the delays may have been disruptive and that Mrs J continued to experience pain and difficulty while waiting for surgery.

34. The evidence indicates the Trust delayed the surgery to assess risk and identify a suitable facility, rather than because of any failing in its care. Where a patient’s preferred treatment cannot be delivered safely in a particular setting, clinicians should ensure treatment is provided in an appropriate environment. Patients cannot insist that treatment to go ahead in circumstances clinicians consider unsafe.

35. In these circumstances, while again recognising the inconvenience and ongoing pain she suffered, we have not found any indication that anything went wrong in how the Trust managed the timing and location of the surgery.

Consent to nerve block procedure and pain relief

36. Mrs J told us she did not agree to the use of nerve blocks or opioid pain relief and felt that staff made decisions about her care without her agreement. She also said she only agreed to opioids if they were necessary, and that she did not consider they were necessary in this case. She said that, when a nurse offered her fentanyl, she had capacity to decide whether to accept pain relief and did not consent its use.

37. Mrs J said she felt pressured to agree to the inclusion of opioids in her pain management plan, as she believed the surgery would not otherwise go ahead.

38. The Trust explained what steps were taken to discuss and agree on pain management with Mrs J and set out the reason she was given fentanyl and nerve blocks.

39. The Trust also said that nerve blocks were used to reduce the need for opioid pain relief, taking into account Mrs J’s preferences.

40. The guidelines on consent for anaesthesia describe consent as an ongoing process involving discussion and agreement, and that patients may give ‘qualified consent’, accepting some aspects of treatment but not others. They also say clinicians should ensure patients understand the information provided.

41. The guidelines recognise that clinicians are not required to describe every individual component or variant of anaesthetic technique in detail. They say they should explain the overall approach in a way that is meaningful to the patient.

42. Mrs J and the anaesthetist specifically discussed her wishes prior to the day of surgery. The records include a letter, copied to Mrs J, confirming the agreed plan. We think this was in line with the applicable guidance. Although it is evident that Mrs J was not entirely happy with the plan, she did agree to it and proceeded to have the operation knowing what to expect.

43. The preanaesthetic record indicates the anaesthetist discussed and agreed a fascia iliaca block with Mrs J on the day of surgery. The anaesthetic record shows that both a fascia iliaca block and a PENG block were given during the procedure.

44. The absence of specific reference to PENG blocks in the consent records does not necessarily indicate that the consent discussion was insufficient, as the guidance recognises that clinicians are not required to explain every individual variant of an anaesthetic technique (in this case, an additional peripheral nerve block) where the overall approach is agreed. Notably, Mrs J’s objection to the use of blocks appeared to have been specifically in relation to those used around the spine. The PENG block does not fall into that category, so it appears consistent with Mrs J’s recorded preference.

45. Turning to Mrs J’s concerns about the use of opioids, the recovery notes show that nursing staff offered fentanyl, that Mrs J accepted it, and that staff checked with her before each dose.

46. This was consistent with the plan Mrs J had approved in advance.

47. Mrs J says she felt under pressure to agree to opioids, and we recognise her concerns were fundamentally about bodily autonomy and being able to make informed choices about her care. Setting conditions for safe care does not, in itself, amount to coercion. The records indicate that Mrs J was able to decide whether to accept opioid pain relief, and that staff acted in line with that decision.

48. The records do not support that treatment was given without consent.

49. We have therefore not found any indication that anything went wrong in how consent for anaesthesia and pain relief was obtained or applied, and we will take no further action on this aspect of the complaint.

Other peri-operative care

50. Mrs J complains that lansoprazole was prescribed for her when she did not need it. We have chosen not to consider this matter further because it had no discernible impact on Mrs J. She did not take any of the medication, so any impact appears limited to annoyance and minor inconvenience. While we understand this may have been frustrating, it does not justify further investigation.

51. Mrs J also told us that, at a post-operative appointment, a doctor who assessed her surgical outcomes dismissed her reports of pain, and she found this distressing.

52. In its response, the Trust said the doctor did not intend to cause upset and offered an apology. It said Mrs J later attended a further consultation and had an opportunity to raise questions or concerns.

53. We are sorry to hear that Mrs J felt that her pain was dismissed. It is entirely understandable that she felt distressed by this. We thought about what action would be appropriate to put right this distress.

54. We consider the Trust’s apology and follow‑up consultation were sufficient to address this, and we will take no further action on this part of the complaint. Although this cannot change her experience, we think the Trust acted appropriately in acknowledging and apologising for it.

Complaint handling

55. Mrs J said the Trust delayed its response, did not keep her updated during the complaint process, and that it later acknowledged this and apologised.

56. The NHS Complaint Standards say organisations should respond to complaints in a timely way, keep people informed about delays, and maintain communication.

57. Even if the Trust’s handling of Mrs J’s complaint fell below the expected standards, the Trust has already acknowledged and apologised for the delays and poor communication.

58. We appreciate that the complaint process may have been frustrating for Mrs J. We took this into account when assessing whether any further action would be needed to put this right.

59. We consider that an apology is sufficient to put right the impact this had on Mrs J. We will therefore take no further action.

60. In summary, we recognise that Mrs J’s experience was not fully in line with what she had hoped for. It is clear there were difficulties in reaching agreement on how clinicians would manage her care before, during and after surgery. We have carefully considered these concerns, and we hope this explains why we will not take further action.

1. We have carefully considered Mrs J’s complaint about Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (the Trust).

2. We recognise that Mrs J had a difficult and distressing experience during her care, particularly regarding consent and pain management during her hip replacement surgery, and that she felt her wishes were not followed.

3. We also recognise that Mrs J suffered ongoing pain and inconvenience when her surgery was delayed.

4. We have seen no indication that anything went wrong in how the Trust provided her care, or that it was wrong to postpone the procedure, although we appreciate the impact the delay had on Mrs J.

5. Regarding the prescription for lansoprazole and Mrs J’s experience at the post-operative appointment, we consider the Trust’s apology and follow-up are adequate to address these concerns.

6. Finally, we recognise that delays and poor communication during the complaint process added to Mrs J’s frustration. We consider the Trust’s apology sufficient to put this right.

7. We have, therefore, decided not to investigate Mrs J’s complaint in more detail or take any further action.