Decision Report 201406355

Summary

Mr C was referred to the ear nose and throat (ENT) department at the board by his GP following symptoms of hoarseness. He was examined at an out-patient appointment where no sinister findings were identified and was discharged back into the care of his GP. Mr C's symptoms persisted and his GP made a further ENT referral. This was assessed by a consultant who made a referral to speech and language therapy (SALT). Mr C was seen at a SALT out-patient appointment some time later and potential malignancy was identified in his voice box. An appointment with an ENT consultant was arranged for the following day. Mr C was subsequently diagnosed with cancer and underwent surgery to remove his voice box. Mr C complained that a proper examination had not been carried out during his initial appointment, that it was inappropriate to refer him to SALT following the further referral from his GP and that there was an unreasonable delay in offering him an ENT appointment following the further GP referral.

After taking independent advice from an adviser, who is a consultant surgeon specialising in head and neck cancers, we did not uphold Mr C's complaints. The advice we received was that all necessary examinations had been carried out during the initial appointment and that it was appropriate to refer Mr C to SALT following the further referral from his GP. We found that there was no reference in the ENT consultant's referral to SALT for follow-up after the assessment but noted that Mr C had had an ENT consultation the next day in any case. We made a recommendation to the board to draw the adviser's comments on this to the attention of the ENT consultant.

Recommendations

We recommended that the board:

• make the relevant consultant aware of the adviser's comments on ENT follow-up following SALT referrals and recording neck examinations.