Mr Y complained that the Health Board exceeded the referral-to-treatment target for cancer waiting times for treatment of prostate cancer and that due to the delay in providing him with treatment, and the potential impact of any delay, he sought private treatment.
The Welsh Government’s “Rules for Managing Referral to Treatment Waiting Times” (“the RTT Rules”) at the time of the events complained about stated that: “Newly diagnosed cancer patients that have been referred as urgent suspected cancer, and confirmed as urgent by the specialist to start definitive treatment within 62 days from receipt of referral …”
The Ombudsman found that the Health Board would have missed the RTT Rules timescale in Mr Y’s case by at least 106 days taking into account the estimated waiting times at the time of Mr Y’s diagnosis (3 months). Considering the professional advice that early radical treatment was essential in high-risk disease, a 3 month wait for definitive treatment was unacceptable regardless of the RTT Rules. This was a service failure.
In Mr Y’s case, the delay for treatment, and concern about the potential impact on his clinical condition from any delay, led to his decision to seek private treatment. The delay, well in excess of the 62-day target in Mr Y’s case, caused him significant distress and anxiety, and his decision to seek private treatment sooner (rather than wait for the Health Board to provide treatment) did not lessen the impact of the Health Board’s service failure on Mr Y at a very worrying time. At the time Mr Y sought private treatment, he was concerned that the cancer would spread if he waited for NHS treatment. This was an injustice to Mr Y. The complaint was upheld.
The Health Board agreed to the Ombudsman’s recommendations that, within 6 weeks of the date of the final report, the Health Board should:
a) Provide Mr Y with a fulsome written apology for the failing identified in this report.
b) Make a redress payment of £8,171 to Mr Y to represent the cost of his private treatment.
The Health Board agreed to the Ombudsman’s recommendation that, within 4 months of the date of the final report, the Health Board should:
c) Refer the report to the Board and ask it to set up a Task and Finish group to review the Urology service to identify where it can improve service delivery, in particular in relation to cancer treatment targets, to ensure that patients’ (particularly high-risk patients) care and treatment is not compromised.