Mr B complained about the care and treatment received by his late wife, Mrs B, from the Health Board. The investigation considered whether the care provided to Mrs B, following her diagnosis with pancreatic cancer on 21 March 2025, was clinically appropriate and timely.
The Ombudsman found that the care provided was in line with the expected guidance, but there were delays in carrying out investigations and in providing an Oncology clinic appointment. These were service failures. However, earlier intervention would not have made a difference to the sad outcome for Mrs B. Neither was it likely to have prolonged the time she had left. That said, the Ombudsman also found that more timely investigations and referrals might have led to an earlier Palliative Care referral and palliative management/intervention being put in place sooner than in fact occurred. The uncertainty of not knowing the outcome sooner, and not providing Mrs B and her family with more time to prepare for the end of her life, represented an injustice to them. It was to this limited extent only that this aspect of Mr B’s complaint was upheld.
The Health Board accepted the Ombudsman’s recommendations. This included an apology to Mr B; sharing the investigation report with relevant clinicians and staff involved in Mrs B’s care for reflection and learning; and considering a review of its resources, to better meet the recommended timeframes within the Wales Cancer Network, National Optimal Pathway for Pancreatic Cancer.