A practice in the North Tyneside area

3. Mrs E complains that a GP from the Practice did not investigate her husband’s cancer symptoms between 17 October 2022 and 17 January 2023. She says her husband experienced pain and distress that could have been avoided. She questions whether he could have lived longer with earlier treatment. She says his family was denied the opportunity to spend time with him to discuss his wishes.

4. Mrs E wants the Practice to acknowledge its failings and apologise for the impact they had. She wants to ensure there is learning from her complaint so that other patients do not have a similar experience.

5. On 17 October 2022 Mr E attended an appointment with Dr A (a GP at the Practice). Mr A had been experiencing episodes of numbness and tingling on the left side of his body. Dr A examined him and arranged blood tests. The blood test results did not show any significant abnormalities.

6. Mr E had a telephone consultation with Dr A on 4 November 2022. During the conversation Mr A explained that the episodes of numbness and tingling had stopped. Dr A arranged for further blood tests which were again normal.

7. Mr E next attended the Practice on 17 January 2023 and had another consultation with Dr A. Mr E described new symptoms including lethargy, forgetfulness and headaches. Dr A examined him and found signs of facial weakness. He planned to seek advice from a neurologist.

8. Later that day Mrs E called the Practice and spoke to Dr A. She was concerned about changes in her husband’s personality. Dr A arranged for an urgent MRI scan of the brain to take place within two weeks and did not consider Mr E needed to attend a hospital.

9. Mr E attended his local hospital the next day. A scan showed he had advanced brain cancer. Sadly, Mr E died from the cancer on 21 March 2023.

10. Mrs E complained to the Practice in August 2023. The Practice replied in October 2023 and Mrs E then contacted the Integrated Care Board (ICB) responsible for commissioning local NHS services. The ICB said it was satisfied with how the Practice had investigated and responded to Mrs E’s complaint. She remained dissatisfied so complained to us.

13. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not found any indications that something has gone wrong.

14. Mrs E says her husband had been asking for help from Dr A since November 2022. She said he had been struggling with a tingling sensation in his hand and headaches. She says he later developed confusion and personality changes. She believes it was not sufficient for Dr A to arrange a scan within two weeks. She questions whether further tests should have been arranged and says Dr A showed a lack of concern.

15. Good Medical Practice says doctors must provide a good standard of care. This includes carrying out adequate assessments, taking account of the patient’s history and examining them if necessary. Doctors should also arrange timely treatment and appropriate investigations or referrals if needed.

16. The NICE Guideline says clinicians should consider an urgent MRI scan of the brain to be done within two weeks when someone presents with worsening neurological function.

17. The GP Adviser said the clinical record for the consultation on 17 October 2022 shows Mr E was having short-lived episodes of numbness or tingling on the left side of his body (known as paraesthesia) for a few days. Dr A carried out a neurological examination and this was normal. Dr A also arranged blood tests and these were mostly normal, showing only a mild elevation on one of the liver blood tests that was unrelated to the cancer diagnosis. By 4 November the symptoms appeared to have stopped.

18. The GP Adviser said Dr A’s actions appeared to be in line with Good Medical Practice. He seems to have carried out an adequate assessment and examination and followed this with appropriate investigations. There was no sign at this stage of any loss in neurological function.

19. By 17 January 2023 Mr E’s symptoms had changed. Dr A carried out a detailed neurological examination which revealed abnormal changes. After a further conversation with Mrs E later that day, Dr A made a referral for an MRI scan. This was a suspected cancer referral which should have been processed within two weeks. The GP Adviser said this was in line with the NICE Guideline. There was no requirement for any further action to be taken at that stage, such as requesting a hospital attendance.

20. The GP Adviser told us there is no evidence Mr E’s cancer was missed or that Dr A failed to properly investigate his symptoms.

21. Based on the evidence we have seen we consider Dr A followed Good Medical Practice and the NICE Guideline at the consultations with Mr E between October 2022 and January 2023. We can see no indication of any failings by Dr A or the Practice.

22. We recognise how shocking it must have been for Mrs E and her family to discover her husband’s diagnosis when the cancer was already so far advanced. We hope she is reassured that we have seen nothing to suggest Dr A fell below the relevant standards during his consultations with her husband.

1. We have carefully considered Mrs E’s complaint about the Practice. We have decided not to start a detailed investigation of Mrs E's complaint. This is because we have seen no indication that anything went seriously wrong.

2. Mrs E complains about the aspects of the care a GP at the Practice gave to her husband in the last few months of his life. We can see how devastating these events have been for Mrs E and her family. We offer them our sincere condolences for their loss.