A 17-year-old woman saw her GP several times in the months following the unexpected death of her mother, complaining that she was continually tearful.
The GP reviewed the patient on several occasions and on the fourth visit, the patient complained she was even more depressed and was having difficulty motivating herself to go into college or see her friends. In addition, she described a loss of appetite and sleep disturbance. The GP prescribed antidepressants and asked the patient to return in two weeks.
On the patient's next visit, the GP was concerned that the patient looked unkempt and appeared to have superficial wounds to the inside of her wrists. As the patient admitted to having suicidal thoughts, the GP referred the patient to the local psychiatric services. He did not see the patient again because soon afterwards she moved out of his area and her files were transferred to her new GP practice.
Nothing more was heard from the patient for four years until the GP received a complaint from her. She alleged that she should not have been put on antidepressants as at the time she had been suffering 'the normal affects of bereavement'. Furthermore, she alleged that she had become dependent on the antidepressants, which she believed to have caused a real and debilitating depression.
The patient said she had first wanted to make a complaint a year ago but she had been too unwell. However, she now wanted to receive a response to her concerns.
The GP, an MDU member, phoned the MDU advice line to ask whether or not he should respond to her complaint as it fell outside the normal time limits of the NHS Complaints Procedure (2004) which states that a complaint must be made within six months of the date on which the incident occurred, or within six months of the date of the complainant becoming aware that they might have a reason to complain.
The MDU adviser explained that even if a complaint is received outside the usual time limits the NHS Regulations allow a complaint manager to investigate if they consider the complainant has good reason for not complaining earlier and if it is still possible to investigate the complaint efficiently.
The adviser also pointed out that the GMC's Good Medical Practice (2006) places no time limit on the period in which a complaint should be answered, and advises practitioners that patients who complain have the right to expect a prompt, open and constructive response (paragraphs 30 and 31). In addition, the GMC may investigate a complaint under its fitness to practise procedures if it occurred within the last five years.
At the adviser's suggestion, the practitioner forwarded copies of the correspondence so that he could be offered further advice. From this, it became apparent that the complaint was of a potentially serious nature, and the allegations were directed at two hospital consultants and the complainant's new GP, as well as the MDU member.
As the doctor had no recollection of the complainant, and only incomplete records available on the practice computer system, it was not initially possible for the member to make a formal response.
However, he was keen to investigate as he felt sure he would not have prescribed antidepressants without good reason. With help from the MDU, the member contacted the patient and sought her consent to have access to the handwritten clinical records relating to the time that the patient was registered with him. The patient agreed to this disclosure by the new GP.
The member was then able to provide a response based on his contemporaneous medical records. These showed that he had only prescribed antidepressants when the patient had mentioned suicidal thoughts, that he had regularly reviewed the patient and documented his findings thoroughly; and had referred her to specialist care when he was concerned about the possibility of self-harming. His clear letter of response was able to satisfactorily resolve the complaint.
This page was correct at publication on 01/05/2009. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.