Decision Report 201507872

Summary

Mr C, who works for an advocacy service, complained on behalf of Mrs B. Mrs B's husband, Mr A, was a patient at the medical practice. He initially attended with left-sided chest pain that he reported had been present on and off for months. An x-ray was arranged but this was normal. He went on to report neck pain and urinary symptoms. Mr A was later diagnosed with lung cancer which had spread to the vertebrae in his neck. His urinary symptoms were found to be unconnected to this diagnosis.

Mrs B was concerned that the practice had not provided an appropriate level of care to Mr A. She said that his condition could have been diagnosed earlier and made particular reference to a scan which she felt should have been arranged.

After taking independent advice from a GP, we found that Mr A had not been provided with appropriate medical treatment. While we found that a scan could not have been arranged for Mr A by the practice, he should have been referred to the local NHS board's respiratory team after he reported chest pain being present on and off for months, even though the x-ray was normal. The adviser highlighted that this action was supported by the Scottish Referral Guidelines for Suspected Cancer. We found that the other aspects of Mr A's care were reasonable.

Recommendations

We recommended that the practice:

• apologise to Mrs B for the lack of respiratory referral;
• ensure that all relevant staff are familiar with the Scottish Referral Guidelines for Suspected Cancer; and
• ensure this case is discussed at the next appraisal of the doctor who saw Mr A at the relevant consultation.