A practice in the Basingstoke and Deane area

5. Miss B complains on behalf of her mother, Mrs A, that in May 2025 an Advanced Nurse Practitioner (ANP) prescribed Mrs A Prochlorperazine to treat vertigo despite Mrs A’s existing medical conditions. She also complains that the ANP overly relied on the computer systems as when asked about interactions, they stated, “the computer will tell me if they do”.

6. On 30 May 2025, Miss B attended the Practice in person to raise what she says were urgent safety concerns. She complains that staff at reception did not record this properly on the system and nobody followed up with Miss B or Mrs A.

7. Finally, she complains about the Practice’s complaint handling in that it repeatedly missed promised response deadlines, and its final letter was incorrectly dated as if her complaint was made on 8 May 2025, which suggests poor record-keeping. She also said the Practice have shown a lack of accountability as the Practice’s response focused on “reflection” and “learning” rather than providing resolution, corrective action, or alternative treatment.

8. Miss B says her mother has been left with untreated vertigo which has significantly reduced her quality of life and independence. She remains at risk of falls, injury, and further deterioration. She says the unsafe prescribing decision caused her anxiety and a loss of trust in the Practice. The failure to follow up has left her without reassurance, alternatives, or a recovery plan.

9. As an outcome to her complaint, Miss B is seeking an acknowledgement of failings, an apology, a review of her mother’s vertigo care, service improvements, and a financial remedy.

10. In May 2025 an Advanced Nurse Practitioner (ANP) prescribed Mrs A Prochlorperazine to treat vertigo.

11. During a consultation in May 2025, when Miss B asked about possible interactions with other medications, the ANP told her the computer would tell her if there were any contraindications.

12. Later that day, Mrs A and Miss B read the information leaflet that came with the medication. They were concerned as some of the cautions and warnings for taking the medication related to conditions Mrs A has.

13. On 30 May 2025, Miss B attended the Practice in person to raise what she says were urgent safety concerns. Unfortunately, staff at reception did not record this properly on the system and nobody followed up with Miss B or Mrs A.

14. Miss B then raised a complaint with the Practice in mid-June 2025.

Unsafe prescribing and over reliance on computer systems

18. 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.

19. Miss B raised concerns about the safety of prescribing Prochlorperazine to treat her mother’s vertigo in late May 2025. She highlighted that Mrs A is diabetic, had previously undergone goitre removal surgery (a procedure to remove all or part of the thyroid gland), was not eating well, and takes multiple medications. Miss B said the Prochlorperazine information leaflet included cautions relevant to these factors.

20. We reviewed the Prochlorperazine information leaflet Miss B gave us. In the section which describes warning and precautions, Mrs A had three of the conditions listed (outlined above) and is classed as elderly (65 years or over).

21. The Prochlorperazine guidance states caution is advised for patients in Mrs A’s age group and for those with diabetes.

22. Cautions in the BNF serve as supplementary guidance for healthcare professionals and patients, indicating situations where extra care is needed when prescribing, dispensing, or taking a medicine. They do not mean that medication cannot be prescribed but suggests there may be increased risks of adverse effects or reduce the medicine’s effectiveness.

23. Our adviser clarified if patients have some of the conditions mentioned under warnings and cautions for a particular medication it does not mean the medication cannot be prescribed. They said taking into account Mrs A’s symptoms and previous medical history it was appropriate to prescribe Prochlorperazine to treat vertigo.

24. As the Prochlorperazine guidance does not state that this medication cannot be prescribed for people with Mrs A’s medical history, we have not seen any indications of failings with this being prescribed.

25. The medicines adherence guidance states patients should be involved in conversations about their treatment, and staff should discuss the potential benefits and risks of medications, and allow for informed, patient-led decisions.

26. The records do not show that in line with the medicines adherence guidance, the ANP adequately discussed with Mrs A the individual benefits and risks such as her age and diabetes. We consider this is an indication of a failing.

27. Without this discussion, Mrs A and Miss B were left understandably anxious and uncertain about the safety of the medication when they read the leaflet.

28. In its complaint response to Miss B, the Practice apologised and acknowledged a more thorough discussion about the medication should have taken place to support Mrs A in making an informed decision about taking the medication.

29. The Practice said as a result of Miss B’s complaint it is taking steps to reinforce training across the Practice to ensure clinicians clearly explain medication decisions and safety checks to patients, especially those with higher risk profiles. The ANP reflected in a written document about how she can improve going forward. The Practice also discussed the complaint and the importance of discussing more thoroughly the risks and benefits of medications with patients during a significant events meeting in August 2025. This information was also shared in the staff newsletter for August 2025.

30. Miss B also expressed concern about the ANP’s comment, “the computer will tell me if they do,” when questioned about possible medication interactions when prescribing Prochlorperazine. Miss B felt concerned this meant the Practice were over relying on automated systems rather than applying clinical judgement.

31. In its complaint response to Miss B, the Practice said it recognised the ANP’s comment did not reflect the complexity or responsibility of safe prescribing practice. The Practice said its prescribing system includes electronic safeguards such as alerts for allergies, drug interactions, duplications, and relevant clinical warnings. It said the ANP accepts she should have explained this more clearly and reassured Mrs A and Miss B that both clinical systems and professional judgement inform all prescribing decisions.

32. Our NHS Complaint Standards say staff should give sincere apologies and be clear about how learning will be used to improve its service.

33. We can see that the Practice have acknowledged failings in not discussing the risks and benefits of the medication before prescribing this and for the ANP’s comment. It has apologised for the distress caused and explained how it has learnt from this complaint.

34. Therefore, we consider the Practice has done enough, in line with our NHS Complaint Standards, to put right this aspect of the complaint and as such, we will take no further action.

Failure to Follow Up

35. Miss B attended the Practice in person at the end of May 2025 to raise her concerns about her mother’s Prochlorperazine prescription. Despite assurances from reception staff, there was no follow-up from a clinician. Miss B subsequently made a complaint to the Practice in mid-June 2025.

36. In its response to Miss B’s complaint dated 18 July 2025, the Practice apologised sincerely for the failure to follow up and recognised it may have left her and her mother feeling ignored and uncertain.

37. It also said it has reviewed its internal processes and are reinforcing protocols to ensure all medication safety queries raised in person are properly logged, triaged, and responded to promptly by a clinician or pharmacist.

38. Our NHS Complaint Standards say staff should give sincere apologies that reflect the impact on the people concerned and be clear about how learning will be used to improve its service.

39. We can see that the Practice have apologised for the error in not following up with Mrs A or Miss B about the concerns raised. The Practice have acknowledged the impact caused and have explained what learning it will take to ensure this does not happen again.

40. Therefore, we consider the Practice has done enough, in line with our NHS Complaint Standards, to put right this aspect of the complaint and as such, we will take no further action.

Lack of Accountability

41. Miss B told us that the Practice’s complaint responses focused purely on “reflection” and “learning” rather than addressing her mother’s ongoing symptoms or offering alternative treatments for her vertigo.

42. Our NHS complaint standards say that organisations should recognise appropriate ways to put things right for people.

43. In its complaint response to Miss B, the Practice advised Miss B to book an appointment to discuss her mother’s vertigo if her symptoms were persisting. Miss B did not contact the Practice to book an appointment to discuss her mother’s vertigo.

44. Our adviser said Mrs A was given appropriate safety netting advice by the ANP during her initial appointment in May which was to call the Practice if symptoms persisted or worsened.

45. We can see from Mrs A’s medical records she was seen by the Practice five days before Miss B made a complaint. Mrs A did not mention her vertigo, or concerns or side effects from the prescribed medication during this appointment.

46. Mrs A’s medical records show she was seen three times between Miss B making her initial complaint to the Practice in mid-June and following up with a further complaint in late August 2025. During these consultations Mrs A did not mention symptoms of vertigo or ask to discuss her medication.

47. We have seen Mrs A had several opportunities to talk to the Practice about her vertigo and the medication. We can also see that in response to the complaint, Miss B was told to contact the Practice to discuss her mother’s vertigo but did not.

48. We consider the Practice acted in line with Our NHS Complaint Standards and advised Miss B to book an appointment for her mother to discuss any ongoing symptoms or alternative treatments. This was an appropriate way to put things right for her. Therefore, we have not seen an indication of a failing for this aspect of the complaint.

Complaint handling

49. The Practice received a formal complaint from Miss B on 16 June 2025. She raised concerns about unsafe prescribing, lack of follow-up, and continued symptoms of vertigo. The Practice responded on 31 July 2025.

50. Miss B had asked for a response within 20 working days, and she says the Practice did not respond by then and missed the deadline that it said it would reply by.

51. Our NHS Complaint Standards say organisations should try to resolve complaints as quickly as reasonably possible and will communicate a proposed deadline for response with a complainant. Where an organisation feels it cannot meet this deadline, a new one will be communicated to the complainant.

52. The Regulations state organisations must provide a written response to a complaint within six months commencing on the day on which the complaint was received.

53. The Practice took around six weeks to reply to Miss B’s initial complaint. This is in line with the timescale set out in the Regulations.

54. While we appreciate the Practice did not meet its initial deadlines for a reply, we can see it communicated this with Miss B. This is in line with our NHS Complaint Standards.

55. Therefore, we consider the Practice acted in line with the Regulations and Our NHS Complaint Standards and tried to resolve the complaint and responded in a timely manner. We have therefore seen no indication of failings for this aspect of the complaint.

56. Additionally, Miss B complains the date of her initial complaint was incorrectly recorded as 8 May 2025 in the Practice’s response dated 31 July 2025. She felt this suggested poor record keeping and complaint logging.

57. In its complaint response dated 22 September 2025, the Practice said this was due to human error and apologised. The Practice issued a corrected response with the correct date of her complaint one week after Miss B made the Practice aware of the error.

58. Our NHS complaint standards say that organisations should acknowledge when things have gone wrong and recognise appropriate ways to put things right for people.

59. We consider the Practice have acknowledged the error with the date and corrected this by sending out a letter with the correct date. This is in line with Our NHS Complaint Standards and we will not be taking any further action.

60. We realise this is unlikely to be the outcome Miss B was looking for when she approached us. We hope we have explained the thorough consideration we have given to our decision and clearly outlined the reasons for it. We appreciate that this was a stressful and worrying experience for Miss B and her mother would like to thank them for bringing their concerns to our attention.

1. We have carefully considered Miss B’s complaint about a GP practice in the Basingstoke area (the Practice). We have seen no indication that anything went seriously wrong.

2. We can see the events Miss B has complained about left her mum feeling uncertain, concerned, and that she had lost her independence.

3. We have seen an indication of a failing in the Practice’s communication about prescribing medication. We have seen the Practice has already apologised for the lack of communication about benefits and risks, and Mrs A’s relevant medical history. As such, we consider the Practice has already done enough to remedy the impact of this, so we will take no further action.

4. We have not seen any indication of failings in the treatment provided to Mrs A by the Practice or in its complaint handling.