Trust did not accommodate patient's complex needs after knee replacement surgery

What happened

In early summer 2013 Mrs T had a total knee replacement in her right leg. She was discharged to the physiotherapy department at The Royal Marsden NHS Foundation Trust for ongoing treatment.

Mrs T had an outpatient appointment with a locum physiotherapist. She then raised concerns about the conduct of the physiotherapist and it was agreed she would be seen by different physiotherapists at subsequent appointments. There was a delay in some of the Trust's responses, which upset Mrs T.

What we found

The Trust took relevant and proportionate steps to apologise for the delays in responding to Mrs T's complaint, and to address the issues about the physiotherapist's attitude and behaviour as part of its complaint response. The Trust appropriately identified that the physiotherapist should have referred Mrs T to her GP for pain relief during the appointment, and said that it would remind her to do this in future. However, we felt that the Trust should apologise to Mrs T that this did not happen at the time.

There was not enough evidence to conclude that the physiotherapist acted inappropriately during the appointment when she raised the issue of home exercises with Mrs T; when she referred Mrs T for counselling; or when she attempted to bend Mrs T's knee. Instead, given Mrs T's complex clinical history, she should have been given enough time in an appointment in a more specialised clinic with a physiotherapist whom she knew and who could respond to her needs. Because this did not happen, Mrs T would have felt unsupported, and this would have caused her unnecessary upset at a difficult time.

Putting it right

The Trust apologised for its failings. It agreed to put together an action plan to demonstrate that it had learnt from its mistakes.