Royal Devon University Healthcare NHS Foundation Trust

3. Mr W complains Royal Devon University Healthcare NHS Foundation Trust delayed placing him on the waiting list for spinal surgery between 2022 and 2025.

4. Mr W says the delay made him believe his referral had been forgotten, caused him to experience pain, distress and affected his ability to work and enjoy life.

5. Mr W wants an apology, service improvements, and a financial remedy.

6. Mr W was referred by his GP to the Trust in early October 2020 for back pain.

7. The Trust with Mr W by a telephone appointment in mid-January 2021. Mr W explained he had back pain since 2019 when he had a disc bulge and since then he gets sciatica and pain in his spine.

8. The Trust spoke with Mr W on 18 November 2021 to discuss spinal decompression surgery. On 11 January 2022 Mr W told the Trust he wanted to be considered for the surgery. The Trust told him his case would be discussed at a virtual clinic with surgeons and it would contact him.

9. On 18 January, the Trust wrote to Mr W saying he would have an appointment organised to speak to a spinal surgeon. The surgeon would decide if he would have the spinal surgery.

10. Mr W had a face-to-face appointment at the Trust on 26 September 2024. He signed the Trusts consent form to have decompression surgery and the Trust confirmed Mr W was added to the surgery waiting list.

13.Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation 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.

14. Mr W complains between 2022 and 2025 the Trust delayed placing him on the waiting list for spinal surgery.

15. The Trust said it added Mr W to the surgery list in 2024. He unfortunately waited two years for a review by the specialist consultant due to capacity issues.

16. NHS outpatients and day patient advice says ‘Before your appointment, you'll receive a letter, email or text message from the hospital that includes everything you need to know about your appointment. During your appointment, your healthcare professional will talk about: • your symptoms or how you manage your health or condition • your medical history • whether you need any tests • how to get your results for any tests you’ve already had • options for treatment so you can decide what would be best for you • how to use devices or equipment you’ve been given to manage your condition.’

17. The advice also says ‘Together you can decide a plan for your ongoing care. This might mean another appointment with them, with another specialist, or with your GP.

You might be asked to arrange future appointments only when your symptoms or your circumstances change'.

A couple of weeks after your appointment, you should get a letter or email with a summary of your consultation. The healthcare professional will describe what they discussed with you on the day and explain what the next steps are. If you do not understand the letter, contact the hospital, clinic, or your GP.

If you need another appointment, you'll get a letter, text, or email about this.’

18. The records show Mr W was referred by his GP to the Trust for back pain. Mr W had a telephone appointment in mid-January 2021 because of restrictions on NHS services due to the COVID-19 pandemic.

19. The Trust advised Mr W to stay active as no action was needed at the time. The Trust noted he would be reviewed again once services resumed.

20. In early May 2021, the Trust had a face to face appointment with Mr W for a follow up review. Mr W told the Trust he had lower back and buttock pain which affected his ability to walk.

21. The Trust encouraged Mr W to improve his mobility, advised weight loss, and referred him to physiotherapists. The Trust planned to review Mr W again in three months and said it would consider taking imaging of Mr W’s back. This is in line with NHS outpatient advice, as a plan for care was organised and discussed with Mr W.

22. The Trust arranged for Mr W to have a spine magnetic resonance MRI scan in September 2021, which took place on 3 October. The Trust reported Mr W had significant spinal stenosis (narrowing of the spaces in the back) and disc protrusion (inner disc soft gel pushes out) with neural compression at L four and L five. This means the bone or tissue puts pressure on the spinal cord or nerves.

23. The Trust had a telephone appointment with Mr W in mid-November 2021 to discuss decompression surgery and made a plan for the Trust to follow up with him in six weeks allowing Mr W time to consider this surgical option. This is in line with the NHS advice as Mr W’s care and treatment options were discussed with him and he was given the option to consider this choice of treatment.

24. On 11 January 2022, the Trust spoke with Mr W where he said he wanted to be considered for decompression surgery. The Trust told him his case would be discussed at a virtual clinic with surgeons and it would contact him again.

25. The records show on 18 January the Trust wrote to Mr W saying it organised an appointment so he could speak to a spinal surgeon. The surgeon would have the final decision to go ahead and add him to the surgical list for the suggested spinal surgery, and he would receive a surgical clinic appointment in due course.

26. Mr W had a face to face appointment with a consultant spinal surgeon on 12 March 2024 and an up to date MRI scan was requested. This is in line with NHS advice as the Trust ensured testing was completed so Mr W’s clinical information was up to date to plan next steps of his treatment.

27. On 26 September, the Trust listed Mr W for spinal surgery.

28. Our adviser said clinical services across the country were affected by the pandemic causing long delays for patients however, the relevant information was taken from the patient appropriately and recorded.

29. Our adviser also said the waiting times to see a specialist surgeon varies due to not having enough specialists, so a two or three year wait is reasonable due to the increased number of patients needing specialist care.

30. We understand Mr W felt his care had been incorrectly delayed after seeing a clinic letter advising he had been listed for surgery in 2022.

31. Based on the evidence we have seen, the Trust acted in line with NHS advice in assessing Mr D for spinal surgery and placed him on the list in September 2024.

32. We have not seen any evidence that suggests Mr W was listed for surgery in 2022 but that a referral was made to the consultant spinal surgeon. We recognise it was frustrating waiting two years to see the consultant spinal surgeon.

33. We acknowledge the pain, distress, and frustration Mr W experienced. We hope our explanation goes some way to explain how the Trust acted appropriately with the care, investigations, and surgical plans it completed.

1. We have carefully considered Mr W’s complaint about Royal Devon University Healthcare NHS Foundation Trust (the Trust). We are sorry to hear about the difficulties Mr W experienced with being referred for spinal surgery. We understand how frustrating it is to feel you are not getting the care you need.

2. Having investigated his complaint, the evidence suggests the Trust treated Mr W appropriately in line with relevant advice. We hope he is reassured by what we have seen.