Critical Health Issues Requiring Immediate Attention

Legal Frameworks 

Based on the evidence reviewed – clinical and systemic breaches

I. NHS Constitution – Rights and Pledges

Right 3 – Access to Services

“You have the right to access services commissioned by NHS England. NHS services must reflect … the needs of patients.”

Right 6 – Involvement in Decisions

“You have the right to be involved in all decisions about your care and treatment.”

Application:

Despite documented complex vulnerability (diabetes, weight loss, neurological symptoms, medication intolerance), the patient was not examined, weighed, or monitored at the recent GP consultation. Neither access nor involvement in clinical decision-making was provided. This reflects failure to uphold Rights 3 and 6 under the NHS Constitution, as the patient’s care was neither assessed nor managed in accordance with need.

II. GMC – Good Medical Practice (GMC)

Good Medical Practice – Assessment

“You must make the care of your patient your first concern. You must provide a good standard of practice and care… take all reasonable steps to assess the patient’s condition.”

Good Medical Practice – Records and Review

“You must record your findings… ensure that records are complete and legible… respond promptly when patients ask for information or help.”

Application:

No physical examination, observable clinical measurements, or baseline monitoring were conducted. Prior intolerances and symptom history were neither reviewed nor reconciled. Clinician did not record vital signs or undertake required evaluation, violating multiple GMC standards for assessment, monitoring, and record use.

III. GMC – Duty of Candour and Communication

Good Medical Practice – Openness

“You must be honest and act with integrity… you must be open and honest when things go wrong… explain clearly and promptly to patients when things have not gone as planned.”

Application:

The submitted written letter and clinical updates were not read or acted on. The failure to engage with documented patient evidence and to explain omissions breaches the duty of candour and professional communication expected of clinicians.

IV. NHS England – Continuity of Care and Clinical Coordination

NHS England Care Standard

NHS services have an obligation to ensure continuity of care, including integration of medical history and proactive coordination following clinical transitions.

Application:

Following transfer and deletion of prior records, no continuity plan was established. Clinical handover, reconciliation of history, and coordinated management were absent. The result was fragmented care, unmanaged risk, and complete reliance on patient self-direction for stability.

V. Equality Act 2010 – Reasonable Adjustments (s.20)

Equality Act 2010 s.20 – Duty to Make Reasonable Adjustments

“Where a provision, criterion or practice… puts a disabled person at a substantial disadvantage… reasonable adjustments must be made.”

Application:

Despite documented complex health conditions and vulnerabilities, no adjustments were made to assessment or management. Uniform clinical omissions (no examination, no tests, no monitoring) placed the patient at a substantial disadvantage relative to others with comparable clinical risk.

VI. Equality Act 2010 – Public Sector Equality Duty (s.149)

Equality Act 2010 s.149 – Public Sector Equality Duty

“A public authority must, in the exercise of its functions, have due regard to the need to… eliminate discrimination, advance equality of opportunity, and foster good relations.”

Application:

Proceeding with minimal clinical engagement despite known vulnerability demonstrates failure to have due regard in the exercise of healthcare functions, undermining equality of opportunity and non-discrimination.

VII. Human Rights Act 1998 – Article 8 (Private Life/Health)

Human Rights Act 1998 – Article 8 (incorporating ECHR rights)

“Everyone has the right to respect for his private and family life… including physical and psychological integrity.”

Application:

The omission of basic assessment, baseline investigations, or monitoring in the face of documented risk interfered with the patient’s physical integrity and autonomy, engaging Article 8 protections.

VIII. Human Rights Act 1998 – Article 3 (Prohibition of Inhuman or Degrading Treatment)

Human Rights Act 1998 – Article 3

“No one shall be subjected to torture or to inhuman or degrading treatment or punishment.”

Application:

While not alleging intent, the systemic denial of clinical care in the context of acute risk and vulnerability equates to inhuman or degrading treatment through omission, engaging Article 3 safeguards against degrading medical neglect.

IX. UK GDPR and Data Protection Act 2018

UK GDPR – Accurate and Complete Records

Controllers must ensure personal data is accurate, complete, and processed fairly.

Data Protection Act 2018 – Principles of Processing

“Personal data shall be processed lawfully, fairly, and in a transparent manner.”

Application:

Complete deletion of historical records and failure to incorporate documented clinical history violates the principles of accuracy and completeness under GDPR and DPA 2018, impeding proper clinical decision-making.

X. NICE Guidelines – Diabetes and Specialist Referral Standards

NICE Guidelines – Diabetes Care

Endocrinology referral is recommended for patients with poor glycaemic control and medication intolerances not responding to standard primary care management.

Application:

Despite documented intolerances, poor metabolic control, and repeated episodes of destabilisation, no specialist referral was initiated, contrary to NICE clinical guidance.

XI. Common Law Clinical Negligence – Duty of Care and Foreseeability

Common Law Principle – Duty and Breach

A clinician owes a duty to take reasonable care to avoid foreseeable harm. This includes appropriate assessment, diagnosis, monitoring, and follow-up.

Application:

Failure to examine, measure, test, monitor, or manage foreseeable risk constitutes breach of the common law duty of care in clinical practice.

XII. UN Convention on the Rights of Persons with Disabilities (CRPD) – Article 13

CRPD Article 13 – Access to Justice

“States Parties shall ensure effective access to justice for persons with disabilities… through procedural accommodations.”

Application:

Failure to make procedural accommodations and adjustments in care for documented vulnerability engages CRPD obligations regarding effective access to health justice.

Supporting Evidence Summary

This disclosure is supported by the following comprehensive visual evidence:

Source Documentation: All visualizations derived from official SAR data, GP records, hospital correspondence, and consultant reports.

Analysis Period: June 2018 - December 2025 (7.5 years)

Documents Reviewed: 6 comprehensive medical files

Legal Frameworks: GDPR 2018, GMC Good Medical Practice, Human Rights Act 1998, Equality Act 2010, NHS Contract

Current Clinical Status and Recent GP Surgery Encounter

Present Care Position

At the time of publication of this disclosure, the patient is not receiving coordinated, supervised, or ongoing medical care. Current physiological stability has been achieved through self-management rather than clinical oversight, following a period of significant health deterioration.

Jardiance (Empagliflozin) – Prescription Context and Aftermath

Empagliflozin (Jardiance) was prescribed during a period of severe physiological stress, irregular nutrition, and a sugar-free diet. In this context, the medication resulted in dizziness and symptoms consistent with hypoglycaemia, requiring self-adjustment by the patient for safety.

No follow-up blood tests, medication review, or monitoring framework was initiated after prescription. The patient remained outside any supervised diabetes management pathway following this episode.

Recent GP Surgery Consultation – Absence of Clinical Examination

During the most recent consultation at Theale Medical Centre, this being the first direct encounter between the patient and the clinician, no physical examination was conducted. No baseline clinical assessment was undertaken.

• No blood tests were ordered
• No weight measurement was taken
• No blood pressure or cardiovascular observations were recorded
• No neurological examination was performed
• No assessment of documented nerve damage took place

Medication Escalation by Nursing Staff (Metformin)

The patient raised concern regarding a prior instruction by nursing staff to double the dose of metformin, despite a documented history of intolerance and adverse reaction. In response, the clinician stated that the nurse was a diabetic nurse and was therefore permitted to adjust dosage.

No clinical reassessment, verification of suitability, or review of tolerance was undertaken during the consultation.

Significant Weight Loss – Acknowledged but Not Assessed

During the consultation, the clinician acknowledged that the patient had lost approximately 21 kilograms. Despite this acknowledgement:

• The patient was not weighed
• No timeframe or metabolic impact assessment was undertaken
• No investigation or follow-up was initiated in response

Current Risk Position

As a result of the above, the patient currently remains without a baseline clinical assessment, monitoring plan, or structured follow-up. Medication history, intolerance, neurological risk, and metabolic stability remain unmanaged within formal care pathways. Responsibility for ongoing stability continues to rest with the patient.