Decision Report 201406354

Summary

Mr C was suffering from hoarseness and was referred to hospital by the medical practice for an out-patient appointment at the ear, nose and throat (ENT) department. He was seen by a consultant who identified no suspicious findings and he was discharged back into the care of the practice. Mr C continued to have the same symptoms and was re-referred some time later. He was later seen by a speech and language therapist who identified possible malignancy in the voice box and thereafter, Mr C was diagnosed with cancer. Mr C complained that there had been unreasonable delays in referring him for a further ENT appointment and that the practice's communication with the hospital had not been adequate.

After taking independent advice on this case from an adviser, who is a general practitioner, we did not uphold Mr C's complaint about delay in referral. We found no evidence that there had been unreasonable delay in making referrals and the adviser explained that it was reasonable for doctors at the practice to have been reassured when the initial ENT consultation revealed no sinister findings. Although the adviser considered the majority of the practice's communication with the hospital to have been reasonable, we upheld Mr C's complaint about communication as we found that the initial referral to ENT was categorised as routine, rather than urgent in line with the relevant guidance. The advice we received, however, was that this had no impact on Mr C as the subsequent ENT consultation had not identified any sinister findings. We made a recommendation to the practice to ensure they are aware of the issue.

Recommendations

We recommended that the practice:

• review both the Scottish Intercollegiate Guidelines Network (SIGN) and Greater Glasgow and Clyde guidance to ensure staff are familiar with the referral criteria and confirm to us that the review has taken place.