Trust failings delayed funding application

What happened

In spring 2012 Mr T was diagnosed with an inguinal hernia (in his groin) and was told by his consultant gastrointestinal surgeon that he needed surgery. The next month the consultant wrote to Mr T's GP about making an exceptional funding application and after an exchange of letters, the consultant made a funding request. In summer 2012 Mr T booked himself in for a private procedure. Two days earlier the Primary Care Trust (PCT) had written to Mr T turning down his application because of insufficient evidence and offering him an appeal. However Mr T replied that he was in too much pain and he feared the appeal would take too long so he went ahead with the private operation.

What we found

The Trust contributed to the 14-week delay in Mr T having his funding application considered. In addition, we found that the consultant failed to provide enough information in the application to secure funding.

There were no failings in how the Clinical Commissioning Group (CCG, formerly the PCT), handled the case.

Putting it right

The Trust acknowledged the failings outlined in our report and apologised for them. It paid Mr T 75% of the NHS fee for the operation.