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Posted: Fri 18th Dec 2020
An ombudsman investigation into delays in care for a prostate cancer patient has sparked a wider probe.
Public Service Ombudsman for Wales Nick Bennett is now investigating a further 16 cases at Betsi Cadwaladr University Health Board where patients potentially waited in excess of a 62-day target for treatment.
The case which sparked the wider probe centered on a patient known as Mr Y who was first referred for treatment in May 2019 and should have received definitive care for his cancer within 62 days.
He was told on August 13 that year the waiting time for urgent treatment was three months, which would have meant him being 106 days over the target date.
The report said: “Considering the professional advice that early radical treatment was essential in high-risk disease, a three month wait for definitive treatment was unacceptable regardless of the RTT Rules. This was a service failure.”
Fearing a potential impact on his health Mr Y sought care privately and the Ombudsman ruled he should receive a redress payment of £8,171, the cost of his therapy, and an apology from the health board.
Accepting the Ombudsman’s decision Gill Harris, acting chief executive of BCUHB, said: “We offer our sincere apologies to Mr Y for the delay in offering treatment and the additional distress this caused.
“We have considered the Ombudsman’s report very carefully and we are determined to translate the very significant points of learning identified into service improvements which ensure that people receive better, safer and more timely care.”
On top of an apology and reimbursing Mr Y the board also agreed to set up a task and finish group to review the urology service, particularly in relation to high-risk cancer patients.
However that was not the end of the matter as this case became the starting point for a wider investigation.
Section 44 of the Public Services Ombudsman (Wales) Act 2019 now allows the Ombudsman to conduct an “own initiative” investigation if he believes there are systemic issues related to a complaint – or if he receives a complaint about service issues from a whistleblower.
Speaking to the Local Democracy Reporting Service (LDRS) he said: “I have now commenced an ‘own initiative’ investigation into the matter as I believe there are many other patients who were potentially left waiting too long for treatment.
“Mr Y was left with a stark choice; wait for treatment not knowing what impact this would have on his prognosis and future treatment, or pay for private treatment to mitigate the uncertainty. This is clearly unacceptable.
“This time we had a look and realised there could be another 16 in the same boat as Mr Y.
“We don’t have to just draw the line now, publish the report and cross our fingers that something isn’t a systemic issue, we can have a look.”
In the past the Ombudsman could only look into the complaint presented and wait for others to come forward, even if he was aware there may be a systemic issue that potentially affected others. This new legislation gives him the power to go further.
Potentially it’s a game changer for public bodies who may be sitting on deeper issues – as the Ombudsman can even initiate consultations on matters without a complaint.
Mr Bennett added: “We don’t just have to be reactive. We’ve got the powers to look at the systemic aspect.
“We can say ‘Hold on, who else in the urology department in North Wales might have been in a similar position?’
“Who else has had a diagnosis of prostate cancer and hasn’t had their needs met within this target?”
Geoff Ryall-Harvey, chief officer of patient advocates North Wales Community Health Council said his organisation had been “concerned for a long time” about services provided to men with prostate cancer in North Wales.
He said: “The CHC successfully campaigned with Prostate UK and Stuart Davies to bring high resolution mpMRI scanning to North Wales – referred to in the Ombudsman’s report.
“Prior to this, many men with suspected prostate cancer had private scans and the CHC helped them to obtain refunds for these costs.
“North Wales CHC is grateful to Patient Y for the service he has done for others waiting for cancer treatment. No one should have to wait for urgent, lifesaving cancer surgery.”
Mr Bennett is the only Ombudsman in Great Britain who currently has the wider investigatory powers.
It was sponsored by North Wales AM Llyr Gruffydd, who raised the issue at committee stage in the Senedd.
Mr Bennett, who is originally from Anglesey, said: “There are real reasons to have these powers. With this case we can go further and see if there are any broader systemic failings for other patients in North Wales.
“I want everyone to know about our office and to know we are here for them if they feel they’ve had a serious service failing.”
By Jez Hemming – BBC Local Democracy Reporter
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