Manchester University NHS Foundation Trust

3. Mrs U has a history of breast cancer and complains about the Trust’s care and treatment saying it failed to:

• tell her that CT scans done in 2018, 2019, 2020 and 2022 showed changes to her lung • share results from outpatient appointments and investigations with her GP between 2018 and 2023 • arrange a repeat CT scan within three months of her scan on January 11 2020 (the scan was eventually done in April 2022) and tell her it needed to do another scan • action the results from her April 2022 CT scan • tell her it was referring her to the rapid assessment hub in September 2023.

4. Mrs U says the Trust’s actions caused her to have a worse clinical outcome than she would have had if it had done the scans earlier.

5. She also says its actions re-triggered the post-traumatic stress disorder (PTSD) she developed due to breast cancer in 2016. Mrs U says if the Trust told her earlier that there may be a problem, she would not now be experiencing PTSD again. She says the shock of suddenly being told she had a cancerous lump on her lung, when she had been told before that her mammograms (tests) were clear, triggered the PTSD.

6. Mrs U says the Trust’s actions meant she had to take long-term sick leave from work and is unsure if she will be able to return. She says this is due to the PTSD symptoms, physical symptoms and the number of appointments she has needed in a short amount of time. She describes being bombarded with appointments because her treatment needed fast-tracking. Mrs U says there has been a big financial impact because she has only been getting statutory sick pay, which is a quarter of her usual wage.

7. Mrs U would like the Trust to accept what it got wrong, apologise, make a financial payment and make service improvements.

8. Mrs U has a history of breast cancer, which the Trust diagnosed and treated in 2016. Mrs U also has a history of PTSD.

9. As part of its follow-up treatment for breast cancer, since 2017 the Trust asked Mrs U to have yearly CT scans and mammograms. Mrs U had these apart from in 2021, when COVID-19 restrictions prevented follow-up scans taking place.

10. On 1 September 2023, the Trust called Mrs U and asked her to attend the rapid hub on 5 September. It explained its breast clinic referred her because it found a node (lump) on her lung. Mrs U says this was the first she knew about the referral. In its complaint response the Trust apologised and said it should have called Mrs U to keep her informed.

11. On 5 September, the Trust diagnosed Mrs U with suspected lung cancer. She says the consultant told her there had been abnormal results on her scans since 2018, with a change in density in 2020 and more significant changes in 2022. Mrs U says at no time before September 2023 did the Trust tell her about any abnormalities or changes on her scans.

12. The Trust’s complaint response says that after it did Mrs U’s CT scan in January 2020, the consultant requested a follow-up to be done by April 2020. Due to a typing error in the referral, the Trust did not do this CT scan until April 2022. The Trust also accepts that it should have followed up on the April 2022 scan but it did not. It explains this was due to the consultant retiring and the breast team not picking this up.

13. In January 2023, Mrs U called the Trust as she thought the breast clinic should have seen her in November 2022 for potential discharge. She says the Trust told her she had been ‘lost in the system’. It then arranged for a mammogram, which took place in April 2023 and a CT scan, which took place in June 2023.

14. After the June 2023 CT scan, the Trust referred Mrs U to the lung multidisciplinary team (lung MDT) meeting for advice. The team decided to allocate Mrs U an appointment, which led to the call it made to her on 1 September 2023, asking her to attend the rapid assessment hub.

15. In December 2023, the Trust operated to remove a tumour from Mrs U’s lungs. She is currently waiting for a biopsy of the tumour to confirm what stage of cancer she has. This will inform further treatment plans.

16. Mrs U says Trust consultants described her tumour as slow growing. She thinks that had the Trust completed the follow up scan by April 2020, her outcome and prognosis would likely be much better than it now is.

17. Mrs U also reports that the Trust did not give her GP any information about the outcome of her scans or outpatient appointments with the breast clinic between 2018 and 2023.

20. The law says we cannot investigate a complaint where a person has the option to take legal action, unless we consider this is unreasonable in the circumstances. We have discussed this with Mrs U to understand her circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

21. Mrs U believes the Trust failed to diagnose and treat her cancer over a three-year period. She also complains it failed to share results of outpatient appointments and assessments with herself and her GP over a five-year period.

22. She says the Trust’s actions caused her to lose the opportunity for a better outcome. She says her quality of life has been greatly affected, causing her PTSD to come back. She says she is no longer able to work.

23. Mrs U could make a clinical negligence claim to get the financial payment she is looking for. She wants the payment to make up for the loss of opportunity for a better outcome, loss of earnings and emotional trauma. This outcome can be achieved by legal action.

24. Mrs U also wants the Trust to acknowledge its mistakes, apologise and make service improvements. There is no legal route available for these outcomes, as a court cannot formally order them. But they are likely to happen as a by-product of successful legal action. If on completion of legal action Mrs U does not feel her outcomes have been achieved, she can bring her complaint back to us. We could then consider any outcomes she had not achieved through legal action.

25. Legal proceedings are not the only way for Mrs U to achieve her outcome of financial payment. If we upheld her complaint, we may recommend a financial payment.

26. Mrs U reviewed our guidance on financial payments and thought how she was affected by what happened to be on level five or above on our scale. She was also concerned about future loss of earnings. This likely puts the amount Mrs U wants at £3,000 to £9,950. Given the impact Mrs U told us about, it may be that a court could achieve a greater sum than this. It is also important to note that we cannot make recommendations for future loss of earnings, but this is something that a court can look at.

27. Mrs U did not tell us about anything that would stop her getting legal help. She stated she cannot afford to pay for a solicitor. She said she could get legal advice on a ‘no-win no-fee’ basis with the support of her brother-in-law.

28. Considering the seriousness of the claimed failing, the legal route available and the level of financial payment she wants, we think it is important for Mrs U to explore her legal options. It is also important not to disadvantage her by keeping her case open because there are time limits to making a legal claim.

29. We have explained to Mrs U that if solicitors do not accept her case, she is able to return to us. At that stage we would need to consider how far her legal claim progressed and what outcomes she had achieved. We would also need to consider our time limit, so we would advise her to take legal action quickly. We can only set aside our one-year time limit if there are strong reasons to.

30. We cannot provide legal advice and cannot say whether her claim will be successful.

31. We are very sorry to hear about the circumstances that led to Mrs U bringing her complaint to us. We understand how important this complaint is to her and how this continues to be a difficult time.

1. We have carefully considered Mrs U’s complaint about Manchester University NHS Foundation Trust (the Trust). We are very sorry to hear about her recent cancer diagnosis and the ongoing impact this is having on her physical and mental health.

2. We have decided to take no further action on Mrs U’s complaint because we think she could take legal action.