A couple were left without support when the husband was told he probably had cancer

What happened

Mr R was told by an oncologist that his condition was probably cancer and he was sent home to wait for tests. Then, during a specialist nurse assessment he was advised to attend A&E. He did so and waited almost 15 hours before he was admitted to hospital. Following a biopsy he was discharged home without support. A week later the results of the biopsy and the type of cancer Mr R had were known, and he was offered an appointment with a haematologist in two weeks' time. This was four weeks after seeing the oncologist and being told his condition was probably cancer.

Mr R and his wife were advised that the type of cancer he had was highly curable, and Mr R was admitted to hospital and started a course of chemotherapy.  His condition improved to the extent that doctors felt that he could tolerate a more aggressive form of chemotherapy. This was the normal treatment for his condition and could potentially cure it. Sadly this was not the case and he died.

What we found

There was no clinical indication that Mr R should have been admitted to hospital after being told that his condition was probably cancer. But there was a lack of consideration and support for the distress and upset Mr and Mrs R suffered.

The Trust apologised for the long wait in A&E but did not use an escalation policy which would have shortened the wait and reduced the upset suffered. The Trust has carried out appropriate and significant improvement work to avoid such situations happening again.

Mr R should have been referred to another oncologist within two weeks of being told his condition was probably cancer. While the oncologist could not have given specific advice, and it would not have altered the prognosis, it would have provided reassurance and an opportunity to discuss concerns and support that could be given. It would also have been in accordance with guidance. A referral to the haematologist could have followed this. This lack of communication caused Mr and Mrs R worry and frustration.

On the whole, Mr R's care in hospital was reasonable. There was an incident which involved a lack of dignity, which the Trust correctly responded to. We found a failing in that a drug to thin the blood was prescribed but not given, but this did not adversely affect Mr R.

The type of cancer that Mr R had is highly curable and a more aggressive chemotherapy treatment was appropriate.  All chemotherapy treatments are likely to cause a reduction in white blood cells. This was expected for Mr R, and he did develop infections because of this.

The Trust transferred him to the intensive care unit because it was hopeful his infection could be treated. This was not the case, and he died as a result of infection and a deterioration in respiratory function. We found no evidence that Mr R's death was avoidable.

Putting it right

The Trust acknowledged and apologised to Mr R's wife for the concern, distress and upset they both suffered when they heard that Mr R's condition was probably cancer, and that they were not given details about where they could get support.

It also acknowledged that a referral to another oncologist was not made, and this resulted in a significant delay in an opportunity to discuss Mr and Mrs R's concerns and give them support.

The Trust agreed to review its A&E policy and to make sure staff are made aware of its importance in its training.