NHS sorry after patient attended A&E five times before being diagnosed with bladder cancer

An NHS board has apologised after a patient attended A&E five times before being diagnosed with bladder cancer.

The patient had a history of recurring urinary tract infections (UTIs) and had been self-catheterising.

NHS Lanarkshire gave the patient a long-term catheter to be changed every three months.

Over the following several months, they attended A&E five times before being admitted and diagnosed with bladder cancer.

The Scottish Public Services Ombudsman (SPSO) received a complaint from the patient’s spouse.

In the complaint, the spouse was unhappy with the lack of arrangements to change the indwelling catheter, that their partner was only admitted after multiple A&E visits and they felt that requests for appointments were “ignored”.

The ombudsman took independent advice from a consultant urologist, a consultant in emergency medicine and a medical director specialising in palliative care.

It was found that as the long-term catheter was a trial, the board should have followed up on the patient’s progress.

There were also “unreasonable” delays in the patient being seen by the urologist and in being advised of their cancer diagnosis.

While the board found that it was reasonable that the patient was not admitted for examination sooner, it acknowledged a “missed opportunity”.

The watchdog also upheld the partner’s complaint that their spouse’s diagnosis and discharge were not clearly explained.

SPSO found NHS Lanarkshire had made a “reasonable effort” to explain the diagnosis, but did not communicate the “challenges” with the patient reaching the end of their life once discharged home.

It was also found, in relation to the handling of the complaint, that information that had been provided to the patient’s spouse and the SPSO was “inaccurate in places and incomplete”.

The ombudsman made a number of recommendations, including that the health board apologise to the patient’s spouse.

Additionally, when an adverse event occurs, this should be investigated, patients should receive “timely” follow-ups based on their clinical needs, and discharge planning should be “person-centred and holistic”.

Russell Coulthard, director of acute services at NHS Lanarkshire, said: “We fully accept the recommendations within the Ombudsman’s report and the lessons learned in this patient’s care will be shared with staff to help avoid similar occurrences in future.

“We have also written to the family offering our sympathies and our apologies.”