A practice in the Bradford area

4. Mr L complains about the care and treatment he received from the Practice during an appointment on 10 July 2025. He says the Practice failed to uphold The Armed Force’s Covenant.

5. Mr L says he is a veteran who was struggling with undiagnosed complex post-traumatic stress disorder (PTSD) at the time of the appointment. He says attending the appointment on 10 July sent him on a further downward spiral as he did not receive the appropriate support, care, or treatment that he needed. He says this meant he became further suicidal.

6. Mr L says the negative experience on 10 July has impacted his ability to trust professionals. He says he had to pay for a private assessment in order to be taken seriously.

7. By bringing this complaint to us, Mr L would like the Practice to apologise for its failings and acknowledge and improve its service to better support veterans. He would also like it to pay him a financial remedy for the impact its failing had on him.

8. Whilst in the Armed Forces, Mr L witnessed a shocking incident which traumatised him. Mr L is now a former member of the Armed Forces (veteran).

9. Mr L attended an appointment at the Practice on 10 July 2025 for support with his mental health.

10. Mr L has since been diagnosed with complex post-traumatic stress disorder (PTSD). This was not confirmed at the time of the appointment.

14. 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. Having done so, there is nothing to indicate the Practice did anything wrong during the appointment on 10 July 2025.

15. Mr L says the Practice did not give him the appropriate support, care, or treatment that he needed during an appointment on 10 July 2025. He says he was struggling with undiagnosed complex PTSD at the time and the negative experience he had during the appointment sent him on a further downward spiral.

16. GMC ‘Good Medical Practice’ guidance says doctors providing clinical care must: • adequately assess a patient’s condition(s), taking account of their history, including symptoms, relevant psychological, spiritual, social, economic, and cultural factors, and the patient’s views, needs, and values • promptly provide (or arrange) suitable advice, investigation, or treatment where necessary • propose, provide, or prescribe drugs or treatment (including repeat prescriptions) only when you have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment will meet their needs • propose, provide, or prescribe effective treatment based on the best available evidence • refer a patient to another suitably qualified practitioner when this serves their needs.

17. During the appointment on 10 July, the records indicate the GP took a detailed history from Mr L. It is noted that he had a traumatic childhood and had witnessed an awful and distressing incident involving his best friend whilst serving in the army.

18. It is also noted that he did not have a formal PTSD diagnosis, but the records are clear in that he reported getting flashbacks and that his housing situation meant there were loud noises. The notes suggest these things were contributed to his poor sleep and was putting him in a constate state of anxiety.

19. Additionally, the records indicate that Mr L rarely left the house and that he did not go out alone. The records suggest Mr L was poor with his self-care and often needed the support of his girlfriend.

20. The records state that Mr L had made the GP aware that he had made a self-referral to Op COURAGE and that he was awaiting an assessment and support from them. Op COURAGE is an NHS mental health specialist service for veterans, those serving in the Armed Forces, and their families.

21. The records indicate that the GP explained to Mr L that a referral to the community mental health team would be unlikely to result in an earlier or more effective service than the Op COURAGE team. The aim was to get Mr L a psychiatric assessment to hopefully get him some trauma informed care and support by the specialist service.

22. The records indicate the GP spoke about the positives in Mr L’s life and encouraged him to try to get out into nature with his girlfriend over the summer break and about the importance of getting daily exercise to help with his wellbeing.

23. The records also indicate that medication was discussed. It states that Mr L felt these had not helped previously so it was agreed to keep off medication at that time.

24. The records show the GP agreed to review Mr L four weeks later to see where he was up to with Op COURAGE input.

25. Our adviser explains that all of these things discussed and considered during this appointment were appropriate and there was nothing further that should have been considered.

26. The records also show that the Practice referred Mr L to a social prescriber. Social prescribing link workers give people time, focusing on ‘what matters to them’, to coproduce a simple personalised care and support plan, and support people to take control of their health and wellbeing. Social prescribing link workers also support existing community groups to be accessible and sustainable, and help people to start new groups, working collaboratively with all local partners.

27. Our adviser says this referral was also appropriate as Mr L had stated that he was isolated and disconnected to the community. This was something that could help reconnect him and improve his health and wellbeing.

28. Mr L says the Practice did not uphold the Armed Forces Covenant during the appointment on 10 July.

29. The Armed Forces Covenant is a promise by the nation to ensure that those who serve, or have served, in the Armed Forces, and their families, including the bereaved, are treated fairly. This is to ensure they do not face disadvantages compared to the general population, arising from military life, when accessing services. For example, a longer treatment programme due to a mobile lifestyle.

30. Our adviser explains that Mr L was not at a disadvantage as described in the Covenant. They explained that Mr L was already awaiting an assessment and support from an NHS mental health specialist service for veterans.

31. As a specialist provision was already being considered, there was nothing further, as outlined in the Covenant, that needed implementation during the appointment on 10 July 2025.

32. Having taken everything into account, we consider the Practice acted in line with GMC ‘Good Medical Practice’ guidance and there is nothing to indicate anything further needed to be done at this time.

33. The Practice considered Mr L’s symptoms and as a referral had already been made for specialist mental health assessment and support, it was appropriate that the Practice did not make a further referral at this time. The Practice considered medication, but as Mr L felt that this did not help, it did not prescribe any. The Practice did make a referral to help Mr L with his social issues and agreed to review him again to check that his referral had happened. For this reason, we will not be taking any further action regarding this complaint.

34. We recognise how difficult things have been for Mr L. We understand he was feeling at his lowest and went to the Practice in search of help and support. Therefore, we appreciate it was upsetting and further distressing for him to not get the additional support that he clearly wanted.

35. We understand how much time and effort goes into pursuing a complaint and the additional distress it causes to relive negative experiences. Therefore, we would like to take this opportunity to thank Mr L for bringing his complaint to us.

1. We are very sorry to hear about the trauma Mr L has suffered during his life. We recognise what a difficult time he has had and how this significantly impacts him on a daily basis. We also understand that this has prevented him from being able to work and has left him socially isolated. We appreciate the overall mental toll this has taken and how hard it has been for him to get access to the right services to support his needs.

2. We have carefully considered Mr L’s complaint about a GP Practice in the Bradford area. Having done so, there is nothing to indicate the Practice did anything wrong during the appointment on 10 July 2025.

3. We recognise how important this complaint is to Mr L as he feels he has been disadvantaged despite the sacrifices he has made for his country. This decision is not intended to cause any further distress. We hope we have clearly explained the reasons for our decision.