GP failed to examine patient's painful knee

What happened

Miss T has a history of arthritis from her childhood. When she consulted the GP Practice with a flare–up from her knee in late 2012 she said that the GP did not examine her knee. Six weeks later Miss T returned to the Practice as she was still in pain. A different GP agreed to refer her to a specialist. However when Miss T contacted the Practice again the following year, it was discovered that the referral had not been received. Miss T saw the original GP again and another referral was made.

Miss T complained to the Practice. The first GP said he was unable to recall if he had examined her knee. However the Practice told Miss T she had received the 'standard treatment'. Miss T remained unhappy and asked us to investigate.

What we found

There was no evidence that the first GP examined Miss T's knee. This was not consistent with published NICE guidance. Miss T should have been referred by the first GP and should not have needed to return again six weeks later. We were satisfied that the referral to a specialist was sent, and we found no evidence the Practice was aware of any problem until Miss T contacted them again the following year.

A rheumatology specialist told us there was no evidence that the delay had any significant impact on Miss T's condition and explained her treatment would have been the same even if the referral had been made sooner. However they agreed that an earlier referral would have been likely to rapidly improve

Miss T's symptoms. We partly upheld the complaint.

Putting it right

The Practice apologised to Miss T and paid her £250 in recognition of the delay in making the original referral. The GPs have made sure they are up to date with the latest guidance on the management of knee pain.