South Tyneside and Sunderland NHS Foundation Trust

6. Mr N complains about the way the Trust handled his surgical treatment and subsequent concerns.

7. Specifically, he says the Trust: • delayed his access to surgery from January 2025 and provided inconsistent information about whether his HIV status could affect surgical scheduling and waiting list management • failed to provide clear information about theatre procedures and arrangements relating to surgery of patients with HIV and other blood-borne viruses (BBV) • issued a Red Card following an incident in July 2025 without adequately considering his account of events.

8. Mr N was scheduled for surgery with the Trust on 18 January 2025. He raised concerns about potential discrimination of his HIV status after being informed that his position on the surgery list went from fourth to last on the day.

9. On 5 March 2025, Mr N formally complained to the Trust about alleged discrimination and treatment delays. In its response dated 8 April 2025, the Trust assured him that his HIV status would not influence surgery scheduling. The Trust also referred to its Theatre Standard Operating Procedure (SOP) for patients with blood-borne viruses, stating that the SOP was under review. Mr N later received correspondence dated 3 September 2025 suggesting that HIV status ‘may dictate’ waiting list positioning, which he viewed as contradictory and discriminatory.

10. Mr N also raised concerns about a Red Card issued on 16 July 2025 following an incident in the podiatry department. He alleges this decision was based on a single staff allegation without supporting evidence, and that he did not have an opportunity to provide his account.

11. Mr N says these issues contributed to delays in treatment, uncertainty about his surgery proceeding, and significant emotional distress. He reports that his PTSD and autism-related anxiety worsened, and he endured ongoing physical pain due to the delays.

12. Mr N, dissatisfied with the Trust's response and having completed its internal complaints process, escalated his complaint to us for independent review.

The Operating List

16. Mr N said the Trust delayed his surgery because of his HIV status by routinely placing patients living with HIV at the end of the operating list. He said the Trust also gave him inconsistent information about whether his HIV status affected his position on the waiting list.

17. The evidence shows that at the time, the Trust's Theatre SOP resulted in patients with HIV being scheduled last on an operating list because of infection prevention concerns.

18. The NHS England National Infection Prevention and Control Manual for England does not require patients living with HIV to be managed differently from other patients solely because of their HIV status. Some infections do warrant scheduling a patient later in the day due to specific clinical risks, but HIV is not one of those infections.

19. Following Mr N's complaint, the Trust reviewed its practice and introduced a revised Standard Operating Procedure which no longer requires patients living with HIV to be placed at the end of an operating list.

20. While the earlier procedure appears inconsistent with national guidance, the Trust has reviewed and amended its practice to align with current NHS England guidance. This means it has taken action to address the issue identified.

21. We recognise Mr N's concerns that his HIV status affected the way the Trust planned his care. The planned operation did not go ahead because Mr N decided not to wait. We have seen no evidence that the incident resulted in an identifiable clinical disadvantage. In changing its policy, we consider the Trust has put things right as far as we can reasonably expect and therefore, we do not need to take further action.

The Red Card

22. Mr N also complained that the Trust issued him with a Red Card without properly considering his account of events, and that this contributed to delays in his treatment. A Red Card is a formal warning issued by some NHS Trusts to patients whose behaviour is considered aggressive, abusive, or threatening. It typically outlines restrictions on how the patient can access services or communicate with staff.

23. The evidence available indicates the Trust followed its policy when issuing the Red Card. While we appreciate Mr N disagrees with the Trust's decision and considers it unfair, we have not seen evidence of procedural failings in the Trust's decision-making process.

24. We have therefore seen no indication of maladministration in relation to this aspect of the complaint.

1. We have carefully considered Mr N’s complaint about South Tyneside and Sunderland NHS Foundation Trust (the Trust).  We recognise Mr N has been distressed by his experience and the uncertainty around the delay to his surgery.

2. In relation to Mr N’s complaint about the Trust’s theatre scheduling arrangements, we identified one aspect of the Trust’s previous practice which was not consistent with national infection prevention control and guidance.

3. Although the Trust's previous practice meant his surgery was moved to the end of the operating list, we have not seen evidence this resulted in a significant delay to his treatment. The available evidence indicates Mr N later chose to self-discharge and subsequently declined further offers of surgery from the Trust.

4. The Trust has since reviewed its practice and introduced a revised Standard Operating Procedure which aligns with current national guidance. As the Trust has already addressed the service issue, we do not think there is any further action we can expect it to take.

5. In relation to Mr N's complaint about the Trust's decision to issue a Red Card, we have not seen evidence the Trust failed to follow its relevant policy. The contemporaneous records support the Trust's account that the decision was based on staff concerns about behaviour rather than Mr N's HIV status. We have therefore seen no indication of maladministration in relation to this aspect of the complaint.