The investigation focused only on whether Mr A’s consultations with the GP Practice clinicians between July 2023 and February 2024 should reasonably have led to him being referred to secondary care for investigations.
The investigation found that at each consultation up to and including 27 December 2023, the diagnoses, treatment and actions of the clinicians were within the range of acceptable practice. In addition, referrals made between August 2023 and January 2024 were clinically appropriate (spirometry test and 2 chest X-rays); there was no indication that further secondary care referrals were necessary before this time.
Whilst the diagnosis and treatment at the 27 December 2023 consultation was clinically appropriate, Mr A should have been provided with safety-netting advice (advice to seek medical care if symptoms worsen or do not resolve) due to his condition. This was a shortcoming. In addition, we found that the actions in the consultations on 30 January and 6 February 2024 may or may not have been within the bounds of acceptable clinical practice in relation to reports of coughing up blood, either because this was not explored sufficiently, or at all. However, by 19 February there was an opportunity to refer Mr A to secondary care with suspected cancer and not doing so amounted to a service failure. That said, this would not have made a difference to his prognosis or planned treatment. On this basis, the complaint was not upheld.