3. Miss H complains the Trust should have marked her father, Mr H's, lung function test as urgent in August 2024.
4. Miss H says if staff had marked the test as urgent, her father may have been given antifibrotic medication which could have extended his life.
5. Miss H wants the Trust to apologise and make service improvements to avoid this happening again.
6. Mr H was on long term oxygen therapy for interstitial lung disease and fibrosis (refers to a group of disorders that cause inflammation and scarring of lung tissue, leading to breathing difficulties and reduced oxygen intake).
7. Mr H had a lung function test in late February 2024.
8. The Trust made a referral to another hospital to find out if Mr H would be eligible for antifibrotic medication in mid-March 2024. The other hospital decided he was not suitable due to his general health.
9. In mid-August 2024, the Trust requested a second lung function test which was booked for late January 2025. This request was routine and not marked as urgent.
10. The appointment did not go ahead as Mr H did not attend.
11. Mr H sadly died in early April 2025.
15. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation 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 the Trust got anything wrong.
16. Miss H told us her father had an infection whilst the original lung function test was done. She told us she asked the doctor whether this would have an impact on the results, and they said yes, and this is why the Trust arranged another test.
17. The records show Mr H was treated for an infection during his hospital admission in January 2024. The records do not show any mention of Mr H having an infection when he had the test in February. Our adviser said if Mr H had an infection in the middle of January, having the test four to six weeks later would not have impacted the results significantly.
18. The records show the lung function test in late February 2024 showed Mr H’s lung capacity was low and his FVC (forced vital capacity) was 47%. FVC measures how much air you can forcefully exhale after taking a deep breath.
19. NICE guidance for anti-fibrotic treatment recommends treatment only to people with an FVC between 50% and 80% predicted. As Mr H’s result 47% in February 2024, he did not meet the criteria.
20. The records show there was an MDT (multi-disciplinary team) discussion, and they decided Mr H was not eligible for anti-fibrotic treatment.
21. The NHS website defines MDT as:
‘An MDT is a group of health and care staff who are members of different organisations and professions (e.g. GPs, social workers, nurses), that work together to make decisions regarding the treatment of individual patients and service users.’
22. Our adviser said there is no specific guidance about requesting a second lung function test. They said in their clinical experience, clinicians may arrange a second routine lung function test to monitor any decline in lung function, and this may be done after six, eight or 12 months but this is based off clinical judgement. The MDT reviewed all of the information available and decided Mr H did not need a repeated lung function test.
23. Our Principles of Good Administration state organisations must act in accordance with recognised quality standards, established good practice or both when delivering clinical care. Therefore, in this situation, we will use the professional judgement of our adviser which is based on established good practice.
24. The Trust referred Mr H’s case to another hospital for review and in May 2024 they decided he was not a candidate for anti-fibrotic treatment. They sent a letter to Mr H in early June 2024 explaining they felt the treatment would not benefit him due to his overall health as he had a lot of other comorbidities. This decision was not due to his lung function test results.
25. In mid-August, the Trust’s chest specialist relayed this information to Mr H and referred him for a second test. That doctor explained lung fibrosis is a progressive condition and Mr H was not eligible for lung transplant. We have seen nothing to indicate that this lung function test should have been requested urgently.
26. Mr H also visited a private fibrosis lead in September 2024 who explained they had also concluded he was not eligible for anti-fibrotic medication or a lung transplant. They added that Mr H’s lung function was no better on their readings which shows Mr H had a second lung function test which did not change things.
27. We agree with our adviser’s view that there is nothing to indicate that an urgent test was required or that the lung function test being repeated sooner would have changed the outcome.
28. The decisions made by the Trust, the different hospital and the private consultant that Mr H was not a suitable candidate for anti-fibrotic treatment, were made on the basis of his general health rather than solely from the lung function test result. Repeating the test urgently (when he was referred again in August 2024) would not have altered Mr H’s eligibility for anti-fibrotic treatment.
29. We recognise the events were very upsetting for Miss H and it was very difficult for her to witness her father’s deterioration.
30. We think the Trust acted in line with established good practice when it arranged a routine lung function test in August 2024 instead of urgent. We do not think the Trust did anything wrong and we will take no further action.
31. We hope the information we have provided within this statement is reassuring for Miss H to know.
1. We have carefully considered Miss H’s complaint about The Dudley Group NHS Foundation Trust (the Trust). We are very sorry to learn about the sad death of Miss H’s father, Mr H, and the events leading up to his death. We recognise this has been a difficult time for Miss H and that it was very upsetting for her to witness her father’s health deteriorating.
2. We have seen no indication that the Trust did anything wrong by arranging Mr H’s second lung function test as routine.