Mrs F was on a waiting list for a knee replacement. But instead of having her surgery within 18 weeks, as set out in the NHS Constitution, Mrs F waited for 42 weeks for her operation and was in pain during this time.
What happened
Mrs F's GP referred her for knee replacement surgery in summer 2012. The Trust assessed her and put her on the waiting list one month later. She went for another assessment and expected surgery later that year, but heard nothing from the Trust. Despite following this up several times with the orthopaedic team and the Patient Advice and Liaison Service team, she was still not admitted for surgery. The Trust sent her a letter saying delays were partly due to a backlog of operations from the previous winter.
Mrs F told us that during this time she experienced pain and frustration, and that she also developed ankle swelling for which she needed treatment.
The Trust eventually admitted Mrs F in early summer 2013, but postponed her operation because of her high blood pressure. While the decision to postpone the operation was good practice from a clinical point of view, by that point Mrs F had already been waiting 42 weeks. The Trust arranged for her GP to treat her blood pressure, and Mrs F had the surgery three months later.
What we found
The NHS Constitution says: 'You have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral, unless you choose to wait longer or it is clinically appropriate that you wait longer'.
This did not happen in Mrs F's case. There were failings by the Trust as there was a significant delay in arranging Mrs F's operation and poor communication with her over what was happening with her treatment. The Trust's explanation that 'winter pressures' were the cause of the delay was unacceptable because Mrs F was not referred until July, long after the previous winter's pressures would have tailed off.
These failings caused Mrs F unnecessary frustration and anxiety while waiting for surgery, and prolonged her pain for a significant period of time. However, we did not find that the delay caused Mrs F's later ankle swelling.
Putting it right
The Trust apologised to Mrs F and paid her £1,000 in recognition of the failings we found. It also produced an action plan to improve waiting times and communication with patients.
James Paget University Hospitals NHS Foundation Trust
Norfolk
Did not apologise properly or do enough to put things right
Apology
Compensation for non-financial loss
Recommendation to learn lessons or draw up an action plan