Report Date


Case Against

Hywel Dda University Health Board


Clinical treatment in hospital

Case Reference Number



Voluntary settlement

Miss A complained about inappropriate delays from February 2019 in carrying out her vascular surgery.
The investigation established that Miss A’s Consultant had agreed to undertake the procedure for her as a fee-paying patient at one the Health Board’s facilities. When the surgery had not taken place after several months, Miss A indicated that she was going to complain about the delay. The Consultant then took steps to end the doctor-patient relationship and as the Health Board’s only vascular surgeon at that time, the decision left Miss A without access to NHS care.

The Ombudsman found that the offer of private care and the decision to end the doctor-patient relationship did not comply with professional guidelines. There was a failure to ensure a clear separation between the private and NHS treatment on offer and to provide Miss A with enough information to make an informed choice between private and NHS care. In the absence of proper reasons having been given by the Consultant for ending the doctor-patient relationship, it also appeared that Miss A was left without care because she had wanted to complain. Miss A did not understand that by agreeing to pay, she would be leaving the NHS waiting list. Had Miss A been added to the NHS waiting list in February 2019, her procedure would have taken place in December 2019. Miss A was still waiting for her surgery 2 years later and had experienced bleeds requiring emergency care in the interim. The Health Board’s complaint investigation also failed to address the concerns that Miss A had raised and the opportunity to learn from the complaint was missed.

The Health Board agreed to apologise and to make financial redress payment to Miss A in recognition of the failings identified and of the impact on her. The Health Board also agreed to remind all consultants of the professional guidelines and to review its procedures for undertaking private practice.