Report Date


Case Against

Cwm Taf Morgannwg University Health Board



Case Reference Number



Upheld in whole or in part

Mr B complained that, following his diagnosis of polyps in his colon in January 2020, the Health Board failed to take appropriate action to provide him with treatment within a reasonable timeframe and failed to keep him informed about the impact of the COVID-19 pandemic on the Health Board’s ability to provide care to him.

The investigation found that Mr B waited 3 months from his GP referral until a referral for definitive treatment was made and a further 6 months to start treatment, which was inappropriate and unreasonable. It found that earlier treatment could have precluded the need for Mr B to undergo significant and invasive surgery. This uncertainty and potential missed opportunity was a significant injustice to Mr B. The investigation also found that the Health Board failed to keep Mr B informed about it’s ability to provide care to him due to the impact of the COVID-19 pandemic. This caused Mr B additional stress and worry about his condition; he remained unsure whether he had cancer or how the disease might be progressing in the meantime. This was a significant injustice to him.

The Health Board agreed to apologise to Mr B, offer him redress of £1,000 in recognition of the clinical failures which, on balance, resulted in repercussions for him, and £500 in recognition of the failures to provide him with appropriate information. It also agreed to remind relevant staff of the importance of good communication and appropriate record keeping. In addition the Health Board agreed to review the tracking process and record keeping for urgent suspected cancer patients and review all urgent suspected cancer cases in the Endoscopy Service waiting during the same time period, to address any similar shortcomings in care and ensure that all patients are appropriately clinically prioritised.