GP's poor complaint handling

What happened

Mr B had a complex health history. He was in his eighties when he went to his GP with new and distressing symptoms of alternating constipation and diarrhoea.

For two years the GP Practice treated Mr B's alternating symptoms with medication. He was also referred to hospital for rectum and colon investigations, however, no specific cause for his symptoms was found. Mr B was also admitted to hospital twice during this time with suspected sepsis. Although, on these occasions, Mr B recovered and was discharged, he was readmitted again in summer 2013 when he was diagnosed with possible bowel obstruction. Mr B did not recover and subsequently died.

Mr C, Mr B's carer, complained to us about the GPs' care, particularly that he thought it was not appropriate to prescribe codeine phosphate to Mr B because of his constipation. Mr C also raised concerns about the treatment of Mr B's carpal tunnel syndrome and a bladder stone.

What we found

The Practice's management of Mr B's alternating symptoms was appropriate and in line with National Institute for Health and Care Excellence (NICE) guidelines. It was correct to prescribe codeine for the treatment of constipation, and Mr B had reportedly said and that this was the only medication that appeared to give him any relief. The Practice had also taken advice from the hospital on this.

There were no failings in the Practice's management or treatment of Mr B's bowel symptoms, carpal tunnel syndrome or bladder stone.

However, we could see that although these points had been raised in Mr C's complaint, the Practice had not given a response to them. This was a failing in the handling of Mr C's complaint.

This contributed to Mr C's lack of reassurance about the Practice's action. We were able to give Mr C responses to his complaints which he had not had before. It is for this reason that we partly upheld the complaint.

Putting it right

We discussed the complaint handling failing with the Practice. The Practice manager said the Practice's usual process is for a doctor to respond to complaints about clinical issues. However, he agreed that he would now check that all points raised are responded to in full before the response is sent to the complainant.