An independent provider in the Liverpool area

3. Mr F complains about aspects of care provided by the Hospital both in the care received and the administrative functions of the service received.

Claimed consultant failings:

• his shoulder specialist repeatedly refused to discuss pain relief options • there was no referral made to a pain management clinic, despite his ongoing severe pain • after a cubital tunnel syndrome test, no follow-up appointment was scheduled with the consultant • an alarm was activated by the consultant during an appointment in which Mr F was visibly upset.

Claimed administrative failings

• he attended an appointment where the consultant he was booked with was not present • the secretary was not aware that Mr F already had the cubital tunnel syndrome test done • multiple follow-up appointments were either not scheduled, or mismanaged.

4. Mr F states that the repeated failures have caused him prolonged pain, loss of mobility, emotional distress, and a complete loss of confidence in both his consultant and the Hospital. He states how he has spent years chasing communication and results that should have been routinely provided.

5. Mr F states that physically his condition has worsened and now he faces the need for shoulder-replacement surgery earlier than expected. He states that emotionally he has felt dismissed and unsupported. Mr F highlights the incident in which an alarm was activated as particularly impacting on his confidence and wellbeing.

6. Mr F seeks financial redress for the pain, suffering, and inconvenience caused by the claimed failings of the Hospital at a level 5 on our scale (£3,750 - £12,450).

7. Mr F would like an investigation, recognition of failings and improvements to be made.

8. What follows is a summary of the complaint components. We have not included all the details as all parties to the complaint are aware of them.

9. Mr F attended the Hospital on 22 September 2021 after receiving a formal letter of invite. When he arrived, Mr F was told that the consultant was not in (as it was his regular day off) and he was not offered a consultation with an alternative consultant. He then went home unseen.

10. Mr F was placed under the care of the named consultant on 15 December 2023.

11. Throughout 2023, contact with the Hospital continued and Mr F was informed that both of his shoulders would eventually require replacement surgery. Mr F had repeated steroid and ultrasound-guided injections but gained no relief and no long-term plan was offered.

12. At an appointment in 2024, Mr F was told that his shoulder would not improve and that he would need replacement surgery. The consultant though informed Mr F that he would not perform the surgery until he was closer to 60. Mr F became visibly upset at this news and states that the consultant then pressed an emergency alarm button. A nurse entered and remained for the rest of the consultation. Mr F states that this was distressing and humiliating.

13. On 22 August 2024, Mr F attended a follow-up appointment with the named consultant and was referred for an ultrasound guided injection to the left glenohumeral joint. Mr F was advised that this would be reviewed in the clinic in a few months’ time.

14. On 22 October 2024, Mr F attended the Radiology Department for the ultrasonic guided injection.

15. On 2 February 2025, Mr F attended the named consultant’s clinic for a review.

16. Mr F reported worsening shoulder and elbow pain, and he was referred for a cubital tunnel syndrome test in March 2025, with the actual test happening on 3 April 2025. Mr F states that he received no results or follow-up appointments, and that he had to make numerous requests for these results. Mr F eventually had to obtain them in person and forward them onto his GP and physiotherapist.

17. Mr F’s GP Surgery contacted the consultant’s secretary on 9 October 2025 to advise that they had not received the report from the test on 3 April 2025 or a follow up appointment for Mr F with the consultant. The secretary advised that they would speak to the consultant and would be in touch soon.

18. On 13 October 2025, Mr F was called by the Hospital to offer him a short-notice appointment at 16:30 on 16 October 2025. Mr F declined as he was unavailable that day. Mr F states that despite declining the offer, he received an automated email cancelling the appointment. The secretary stated that this automated email occurred as they had scheduled the appointment prior to the telephone call, hence why Mr F received the automated email. The secretary apologised for the confusion caused.

19. Mr F made a formal complaint to the Hospital on 13 October 2025 and sent an addendum on 14 October 2025.

20. Mr F received a response to his complaint on 15 December 2025.

21. Mr F then sent his complaint to PHSO on 18 December 2025. It was returned though to Mr F as the complaint was premature.

22. Mr F received a final response to his complaint from the Hospital on 6 January 2026 and returned to the PHSO on 8 January 2026, when the complaint was then moved on.

25. For any complaint the Ombudsman receives, the HSCA states the Ombudsman must first consider if there is a legal route to achieving the remedy sought.

26. This is contained within section 4(1)b of the act, which states the Ombudsman shall not investigate if there is a remedy by proceeding the complaint through any court of law.

27. Further to this, the HSCA states that the Ombudsman must be satisfied that in considering the personal circumstances of a complainant, it is not reasonable to expect the complainant to start legal proceedings.

28. This translates into our own policy referred to as a ‘two stage legal test’ that we must look at before any consideration of a complaint. The two stages being is there a legal route and is it reasonable for the complainant to pursue?

Is there a legal route?

29. From talking to Mr F, we recognise the strength of feeling that he considers negligence has occurred and is seeking a significant amount of financial redress between £3,750 and £12,450 (level 5 on our severity scale), as well as mixed outcomes. Mr F states that his physical condition has worsened and that his emotional condition has been negatively impacted.

30. We recognise on occasions through the determination of a court acknowledgements of failings and recommendations for improvements can also be a byproduct.

31. In reaching our view, we consider if a complaint has an alternative legal remedy in relation to their complaint, based on the remedy they are seeking, one that a court could reach determination on.

32. We consider Mr F does have a legal route (though we are not reaching a view on the success of a claim). This is because financial redress is significant and wide-ranging amounts can be made as a binding determination through the courts if negligence is found and upheld. We also recognise that as a biproduct of court, a recognition of harm and acknowledgement of impacts can sometimes be provided.

Is it reasonable to pursue a legal claim?

33. Next, after establishing if there is a legal route, we have gone onto explore with Mr F if it is reasonable for him to pursue.

34. When considering reasonableness, the factors we take into account are based on the individual circumstances of a complaint such as (though not an exhaustive list of considerations): if the costs are proportionate to the legal claim; if financial means to pursue a claim are in place; how long legal proceedings may take; the age and health circumstances of the complainant; if there are any other circumstances which may impact on this.

35. On 14 August 2026, we spoke to Mr F to better understand the complaint, the injustices he says he has faced resulting from his experiences and whether legal action would be reasonable for him to pursue.

36. We understand the events have had a lasting negative effect on Mr F and during the call Mr F made it clear that he can seek an alternative legal remedy.

37. Mr F has stated during our phone call and on his complaint form that he is waiting to find out the outcome of the investigation by the PHSO first before deciding on whether to take legal action as a secondary action.

38. It was explained during the call that the law says we cannot investigate a complaint if the aggrieved person should/should have pursued a legal remedy unless it is/was unreasonable for them to do so in order to achieve the outcome which they are seeking. We explained the tests that we need to do to decide on the reasonableness in sending a complainant to seek an alternative legal remedy and how they will be considered in Mr F’s case.

39. In summary therefore (from the information gathered from his complaint form and during the initial phone call), we consider it is reasonable for Mr F to pursue a legal route as we have not been made aware of any other present factors that may cause us to doubt this reasonableness.

In summary

40. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances. We have engaged with Mr F to understand his outcomes and if reasonable to pursue a legal route.

41. In doing so, we recognise Mr F’s worsening condition, and his claimed injustice is clinical negligence and his impact is a significant deterioration in his physical and mental health. He has told us he is seeking between £3,750 and £12,450 in financial redress and we recognise his other remedies, a recognition and acknowledgement of failings, alongside recommendations for improvement, may also be achieved as a biproduct of a court. Therefore, we consider there may be a legal route.

42. We recognise the claimed impact this has had on Mr F, not just his care but the claimed impact on his physical and mental health. We note (informed by our own policy section 2.298) that Mr F can return to us with any outcomes not achieved through the courts afterwards. In doing so, we strongly advise Mr F pursues matters as there are time limits to the Ombudsman considering complaints (details can be found here https://www.ombudsman.org.uk/making-complaint/what-we-can-and-cant-help)

43. For the reasons we have provided, we shall take no further action on the complaint as an alternative legal route exists and it is reasonable to pursue.