Has anyone been through NHS complaints process? Advice please!

MrsMs_2

I'll try and give as much info as possible, although, this could get long. Grab yourself a cuppa as I'm going to try and include as many facts as I can!

July 8th - I fell down the stairs and broke my ankle. I had a hairline fracture of the tibia, hairline fracture of the lateral malleolus and a spiral fracture of my fibula. I was taken to A&E via ambulance and was seen straight away. The A&E consultant wanted to keep me in to be operated on the following day, but I had no clean clothes, no family nearby, and I promised I'd return the following day so I was discharged after they'd applied a plaster of Paris half cast up to my knee.

July 9th - I was called by the trauma surgeon, who told me she'd reviewed my X-ray and I'd receive a call at some point up to the 13th to go in for outpatient surgery to insert plates and screws to hold the break together.

July 11th - I received a call to attend the fracture clinic that afternoon. When I got there I saw that the consultant that day was a Dr I'd had dealings with before. My dealings with him were unpleasant as I have a long time shoulder issue dating back to a car accident - he said there was nothing wrong with me and was very rude (which in turn triggered my anxiety) and to this day I still have issues with my shoulder and can't lift my arm above my head. I decided to give him the benefit of the doubt as by this time, my temporary cast was digging in due to the swelling. I saw him and he was very dismissive and decided the break didn't need operating on. He didn't look at the cast digging in and told the plaster room they couldn't reapply a temporary cast. The plaster room didn't believe he didn't even look at the cast and despite a second request from them he said they weren't to touch the temporary cast.

July 13th - Attended fracture clinic- had another X-ray and my cast was changed to a below knee lightweight cast. I was told at this appointment that the bone was in a good position and was given a 6-8 week timescale for the bone to heal & was prescribed clexane injections as I had to be non weight bearing due to the break being up my bone.

July 18th - cast became loose so had to have this changed.

July 20th - X-ray to check the bone position and was told the bone was in a good position so I didn't need further X-rays for 4 weeks.

July 26th - cast became loose so had to have it changed again (cast #4 at this point)

July 28th - by this time I was staying with my parents 90 miles away from home, as they live in a bungalow. the newest cast was applied incorrectly and had a ridge in it, which was digging in to my skin and it was causing a blister. I had to go to my parents local hospital and wait in A&E so that they could refer me to their fracture clinic.

July 29th - Attended fracture clinic and a new cast was applied. They commented that they were surprised the break wasn't operated on and they showed me the X-ray, which was quite shocking to see the extent of the break.

August 17th - fracture clinic at my local hospital - X-ray showed minimal healing so I had to have another new cast (number 6) and was told still no weight bearing and to come back in a couple of weeks for another review. I saw a Dr who has a special interest in ankles this time, and he said it should have been operated on. He refused to put this in writing.

August 31st - X-ray taken and still very little healing. i begged for the cast to come off and was given a removeable boot for support. This actually felt more supportive than the cast but this time I could see my skin which was understandably dry and cracked and swollen, and the bruising was still really bad. I also had atrophy in my calf from non use of my leg. I was told I could be referred to physio so that they could get me weight bearing slowly.

September (mid month) - I saw my GP. By this time I was getting depressed and very very concerned that there had been so little healing, to ask for a second opinion. I saw the 'on the day' GP, not my usual GP, and he refused to refer me for a second opinion. He said that as I'd seen more than one consultant in the fracture clinic and they had disagreed (although not in writing) with the decision to not operate, I'd therefore had my second opinion. I didn't have the energy to argue.

September 27th - X-ray again showed little healing, was told only touch toe weight bearing and refered for physio. He said I could try taking one or two paces without the boot and he was pretty concerned about things. He said that if the break hadn't significantly improved by my next appointment, I'd be refered for a CT scan and they'd look at the possibility of operating and surgically repairing it, however, it'd become a more complex surgery as there is some healing and this would all need to be cut away to make the bone sit flush, and with the length of time I'd been off my feet already, the healing process may take longer. He showed me the X-ray, which previous consultants at this hospital had refused to do.

September 30th - first physio session. I was told to try and make small movements with my ankle but the break was still not healed enough to start physio properly. I was told to come back after I'd seen the consultant again.

October 3rd - I took 2 paces without my boot and my ankle gave way and I fell. I called NHS direct to get advice as I was still under the fracture clinic. They referred me to an out of hours GP, who said I needed to go to A&E. I explained that I'd been unhappy with my current fracture clinic based on all of the above and because every consultant gave conflicting advice, so he said I could attend a different A&E, which I did.

October 3rd/4th - I was xrayed at a different hospital and they got my records from the other hospital. I was told there was no new break, but as the pain was now on the opposite side of my ankle, it was likely I'd sustained a sprain. I saw this X-ray and took a photo on my phone. The bone is still not even together on the spiral break!

October 25th - saw fracture clinic and saw the consultant. He said that I'd been under the fracture clinic long enough now and didn't need to see them anymore! Based on what the consultant had said previously, and because I'd had the fall earlier in the month, I insisted on an X-ray. He eventually agreed and I saw the X-ray as it was being done. The bone still wasn't together. The consultant saw me afterwards and said it was all healed and I was being discharged to the care of the physics. By this time, I'm very depressed and just didn't have the energy to argue, so I left.

October 26th - went to physio. She said she could tell I'd been doing the movements she asked me to try and gave me a resistance band. I was really upset about the previous day and she advised me to pursue a second opinion. I spoke to my GP and booked in to see my regular GP but had to wait till he was next available.

November 2nd - another physio appointment. Ankle still bruised, swollen, tender and I'm still taking strong painkillers daily.

November 14th - GP appointment - he's concerned about the limited movement in my ankle so accessed the computer to review the latest X-ray report...no report was attached to the X-ray, which he wasn't impressed with. The most recent letter to him was just to state I was healed and discharged to the care of the physics. He said he'd start the process of a referral for a second opinion.

November 21st - physio appt. now it gets interesting. I go through where the pain is and explained about no report being sent to the GP as she was asking where I was up to with the second opinion. She said that she'd have a look at the most recent X-ray...she came back with the senior physio to tell me that they'd found another break from the fall on October 4th and they didn't know what to do. This time on the medial malleolus where part of the bone has chipped off. They spent 45+ mins calling the fracture clinic to review the X-ray (who refused to see me) and talked about me going to A&E. The senior physio said that she was appalled I'd been discharged from fracture clinic and I needed to really persue this second opinion as the break was not only missed by the other hospital I went to, but by the hospital I was under too. She doesn't want me putting any impact through the leg in case the break worsens.

November 22nd - 2nd opinion letter comes through and it's to the hospital whose A&E I attended after the fall who have missed the new break too, so I've completely lost faith in them to advocate for me. I called my GP and have arranged another appt for next week (not with my usual GP as he's not available for 2+ weeks) and this new appt is this Wednesday.

I spent that day looking online for advice and I spoke to PALS. I've not got my notes about that in front of me, but they pretty much just said that all that they could do was ask the fracture clinic to see me again, which I don't want. I also spoke to AvMA who said to persue the 2nd opinion.

I'm now 5 months down the line and still have a broken ankle and my salary is due to reduce next month. Currently I've not driven for 5 months and have no other way of getting to work. I am still in a great deal of pain and taking painkillers, which I think I am addicted to (although, I've not tried stopping them). I'm also suffering with depression, having not left the house other than to attend appointments for the last 5 months and being unable to do anything that brings me joy, like walking my dogs, visiting family and friends. I'm ridiculously lonely.

Ideally, I want to be referred to a hospital I have faith in. There is a specialist orthopaedic hospital near my parents house, although this is 90 miles away. Does anyone know if it's likely they'll allow me to be referred somewhere so far away?

I'm seriously considering making a formal complaint. A lot of people are telling me to sue the hospital as my ankle should've been operated on in July, but I'm not after money. I wouldn't mind them covering any expenses I incur if my salary goes down and the crazy amount I've spent on taxi fares, but I'm not even sure if this does count as medical negligence - they didn't operate and missed a second break. I have a photo of the breaks on 27/9/16 and 4/10/16 side by side and now I know what I'm looking at, the chipped bone is obvious. I just don't want this to happen to anyone else.

Has anyone made a complaint to the NHS? What was the outcome and how easy was the process? Did you have an advocate, or make the complaint yourself?

I'd also welcome any opinions about whether I'm right in my thoughts that my treatment has been below par and not acceptable? I'm not sure if myself and my family/friends are just a bit too close to the situation to take an objective look at it.

Sorry for the novel. If you've got this far, I appreciate you reading and any comments. :beer:

MrsMs_2

Just to add, I'm happy to share photos of the X-rays if someone can explain how I do this? I'm technology challenged!!

MonkeyDr

Hi

(NHS hospital Dr, not orthopaedics, not offering any actual medical advice).

I'm sorry to hear about what you have been through. It sounds extremely frustrating, not to mention painful and inconvenient.

I would certainly complain. Ask PALS how to do it? If they ask for a letter, I would do a simple one asking for a case review as you have had contradictory advice and a poor outcome, and attach another document including all your appointments as per your OP (but keep it strictly factual, remove references to previous encounter etc).

The bar for medical negligence is basically doing (/not doing) something that a majority of experienced medical colleagues would find unreasonable. There has to have been consequent harm too.

I don't know enough about your case or orthopaedics in general to know whether your experience does constitute negligence. To operate or not on certain fractures is not clear cut. It may be that on the whole your type of fracture gets better quicker without surgery (even if not in you)? I don't know. Plus it may be that the treatment and outcome from the 2nd fracture would have been the same whether it was missed or not.

But, it does seem that you have seen a million professionals who have offered many differing opinions, and this is certainly less than ideal. And, maybe you should have been operated on at the start. Again, I don't know.

So, do complain. Will you feel happier if you get an apology and explanation of the conflicting care, even if it turns out your treatment at every stage was reasonable? That is a possible outcome. Maybe the hospital will review its fracture clinic systems to ensure more continuity, or build in case review meetings to discuss difficult cases? Both would be useful for future patients.

You write clearly and eloquently so I wouldn't have thought you need an advocate.

Good luck

MrsMs_2

MonkeyDr wrote: »

Hi

(NHS hospital Dr, not orthopaedics, not offering any actual medical advice).

I'm sorry to hear about what you have been through. It sounds extremely frustrating, not to mention painful and inconvenient.

I would certainly complain. Ask PALS how to do it? If they ask for a letter, I would do a simple one asking for a case review as you have had contradictory advice and a poor outcome, and attach another document including all your appointments as per your OP (but keep it strictly factual, remove references to previous encounter etc).

The bar for medical negligence is basically doing (/not doing) something that a majority of experienced medical colleagues would find unreasonable. There has to have been consequent harm too.

I don't know enough about your case or orthopaedics in general to know whether your experience does constitute negligence. To operate or not on certain fractures is not clear cut. It may be that on the whole your type of fracture gets better quicker without surgery (even if not in you)? I don't know. Plus it may be that the treatment and outcome from the 2nd fracture would have been the same whether it was missed or not.

But, it does seem that you have seen a million professionals who have offered many differing opinions, and this is certainly less than ideal. And, maybe you should have been operated on at the start. Again, I don't know.

So, do complain. Will you feel happier if you get an apology and explanation of the conflicting care, even if it turns out your treatment at every stage was reasonable? That is a possible outcome. Maybe the hospital will review its fracture clinic systems to ensure more continuity, or build in case review meetings to discuss difficult cases? Both would be useful for future patients.

You write clearly and eloquently so I wouldn't have thought you need an advocate.

Good luck

Thanks very much for your reply.

I have a name for a lady in PALS and she seemed to think the only thing she'd be able to do is speak to the consultant that discharged me from the fracture clinic, to see if he would see me again. I declined that offer. I did open the conversation by asking for advice regarding a complaint, so maybe I need to call her back and find out the process, rather than how she can/can't help me.

I will certainly remove the info about the initial consultant I saw and stick to facts if a letter is required. I requested not to see him again via the fracture clinic so that may be on my notes anyway.

I do have an appointment with the GP on Wednesday and I've written a list of questions. I will also ask for him to print out any letters from the hospital as despite me asking for copies at every appointment in the fracture clinic, none have been sent to me. I'm hoping he or she will allow me to be referred to the specialist orthopaedic hospital near to my parents, despite this being quite far away.

I'm not really sure what outcome I want. Perhaps that's something I need to really think about before starting the complaints process. My number one priority is getting my ankle sorted properly and in a timely fashion. 5 months (and counting) seems ridiculous for a broken bone in a young and healthy person. I need to drive again, I need to go back to work, I need to have some independence again and the pain needs to reduce significantly. After getting everything sorted for myself, I want to ensure that this never happens to anyone else.

Perhaps requesting a sit down with someone would be beneficial to have answers about how this has happened and whether there's any realistic way this can be avoided in the future.

I have so much respect for everyone working in the NHS, and I do completely understand that everyone is overworked and departments are understaffed, but it should never be to the patients detriment, and I do believe that patients shouldn't be fobbed off. Equally, I also know I'm depressed. long term pain, isolation and loneliness, loss of independence and the threat of my wages reducing by 50%, along with other outside factors are possibly causing me to make a mountain out of a molehill.

Saying that, it's cathartic to write everything down though. Thanks for reading my ramblings!

MonkeyDr

Just a quick reply as am in a rush:

You are absolutely not making a mountain out of a molehill.

I am a firm believer in patients (and staff!) speaking up if they see something wrong, otherwise how will we ever improve?

At the same time, it is worth thinking about what you hope to achieve, so that you don't have unrealistic expectations. And accepting that sometimes (not necessarily in your case) the 'best' treatment still leads to crappy outcomes.

I don't mean that I think you do have unrealistic expectations, but some complainers certainly do. That shouldn't stop them complaining, but in some very tragic cases people invest a huge amount of emotion in a complaint and end up feeling very let down and even more upset when they are told (after independent investigation) that they (or their loved one) was just unlucky.

FBaby

So was your second opinion appointment cancelled? You are entitled to a second opinion at an NHS provider of your choice. There is no rule that says that you definitely cannot get a third, that would be the decision of your GP.

If your GP is happy to refer you to the hospital near your parents and it is a NHS provider, then it shouldn't be a problem.

missbiggles1

While you're still on full salary, why not invest some money in seeing a consultant of your choice privately?

sheramber

How to make a complaint about an NHS service

http://www.nhs.uk/chq/pages/1084.aspx?categoryid=68

How do I Get a Second Opinion

http://www.nhs.uk/chq/Pages/910.aspx

[Deleted User]

MrsMs wrote: »

Has anyone made a complaint to the NHS? What was the outcome and how easy was the process? Did you have an advocate, or make the complaint yourself?

Yes, I have. I'm currently 18 months into the complaints process and no further forward than the day I started. The system is corrupt, so beware: trust nobody!

I haven't got time to type a longer reply at the moment, so I'll get back to you with more details later, meanwhile you could read the following:

Patients Association report into the complaint system:
In Summary
In full

Pressure group campaigning against the corruption of the Health Ombudsman:
PHSO The Facts

Two words of warning: get your medical records before you start your complaint, and the independent advocacy service are not independent.

MrsMs_2

MonkeyDr wrote: »

Just a quick reply as am in a rush:

You are absolutely not making a mountain out of a molehill.

I am a firm believer in patients (and staff!) speaking up if they see something wrong, otherwise how will we ever improve?

At the same time, it is worth thinking about what you hope to achieve, so that you don't have unrealistic expectations. And accepting that sometimes (not necessarily in your case) the 'best' treatment still leads to crappy outcomes.

I don't mean that I think you do have unrealistic expectations, but some complainers certainly do. That shouldn't stop them complaining, but in some very tragic cases people invest a huge amount of emotion in a complaint and end up feeling very let down and even more upset when they are told (after independent investigation) that they (or their loved one) was just unlucky.

I think making a complaint would make me feel better because I certainly think that consistent advice should be given and in my case, it hasn't been.

It's been such a long road and I do want to get back to normal so badly, it might be that a complaint would give me some closure once I'm sorted. I do need to sit down and have a think properly about what I want to see happen as an outcome and what's realistic, that's certainly a good point.

MrsMs_2

FBaby wrote: »

So was your second opinion appointment cancelled? You are entitled to a second opinion at an NHS provider of your choice. There is no rule that says that you definitely cannot get a third, that would be the decision of your GP.

If your GP is happy to refer you to the hospital near your parents and it is a NHS provider, then it shouldn't be a problem.

I received a letter asking me to call and book an appointment. The hospital I've been refered to is where I went after my fall. The day before receiving the letter, I'd discovered via the physio that a break had been missed, so I have lost faith in my two closest hospitals now and didn't want to go back to the hospital that missed the break.

I called the GP surgery for advice and they suggested I make an appointment to discuss with a GP about getting referred somewhere else instead, so that's why I've booked this appointment for Wednesday.

I just really hope they agree to me going to the specialist orthopaedic hospital, even though it's 90 miles away. I've had friends use the hospital (one friend had a severe tibia/fibula fracture requiring external fixation) and my nephew is under their care too. With them focusing on orthopaedics, I think they will be my best bet for getting a completely unbiased second opinion.