East Kent Hospitals University NHS Foundation Trust

3. Mr J complains about the care he received from the Trust in 2024. Mr J says the Trust:

• mishandled his urgent suspected cancer referral and did not inform him of the outcome of his MDT (multi-disciplinary team) meeting • refused to compensate him for the costs of his private treatment.

4. Mr J says he has previously had prostate and skin cancer and felt great anxiety when he struggled to get answers about his care. He says he had to undergo private consultation and surgery after his referral was mismanaged.

5. Mr J is seeking an apology, acknowledgment of failings and £546 to reimburse him for the cost of his private care.

6. Mr J has a history of skin cancers. In August 2024, he underwent an excision of a lesion on his left arm at a private hospital. In September, the hospital advised him the histology had reported concerning features. It advised him to ask his GP to refer him to the NHS two week wait cancer clinic, to be assessed by an MDT.

7. Mr J’s GP referred him to the Trust the following day. He attended an appointment at the Trust dermatology department on 21 October. The Trust advised him his case would be discussed at an MDT and he would be discharged back to his GP. The appointment form documents Mr J’s case was not applicable to the ‘two week wait’ cancer pathway.

8. At the start of November, Mr J contacted the Trust seeking an update. It incorrectly told him his case had not been referred to an MDT. In its final response, the Trust said the MDT had been delayed due to the need to obtain Mr J’s histology slides from another location, and his case was discussed in an MDT on 6 December 2024.

9. Mr J booked a private dermatology appointment for early December 2024. On 10 December, the Trust contacted him to arrange a re-excision, which Mr J declined. He underwent a private re-excision on 22 January 2025. The histology showed no malignancy.

11. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the events complained about had a negative effect which the organisation has not put right. Having done so we cannot link the events complained about with the negative impact Mr J has claimed.

12. Mr J’s complaint relates to clinical issues around his urgent suspected cancer referral and the Trust decision not to reimburse the costs of his private care.

13. The records show Mr J was referred to the Trust dermatology department on 1 October 2024 via the ‘two week wait’ cancer pathway. He attended an appointment on 21 October. The records show the doctor recorded the ‘two week wait’ protocol was not applicable. The Trust indicated to Mr J that it had discharged him to his GP, but had added his case to an MDT list.

14. The Trust told us the ‘two week wait’ protocol was not applicable to Mr J’s referral because this protocol related to patients who were undergoing a biopsy or a mole removal. It said because Mr J had already had the mole removed in private practice, the protocol did not apply. It said the clinic outcome sheet was incorrectly marked as having discharged Mr J to his GP, but said Mr J was added to an MDT list and would have been seen again and booked for further surgery if necessary.

15. The records show Mr J contacted private practice to arrange a re-excision of his arm in early December 2024 and booked an appointment for January 2026. That is because he thought the Trust had discharged him when it had not. Several days later, after the MDT, the Trust contacted Mr J asking him to attend a further appointment. Mr J declined this because he had already arranged to undergo the procedure privately.

16. We considered whether Mr J had given the Trust the opportunity to provide the care and treatment required before resorting to private care and whether he had contacted the Trust to escalate his concerns. As an organisation, we consider patients have a responsibility to return to their NHS provider if delays are impacting them, so the provider has the opportunity to escalate the care and treatment for the patient faster.

17. The records show Mr J contacted the Trust in November 2024 following his initial appointment to seek an update on the results of the MDT meeting. When he was advised the MDT meeting had not yet taken place, he subsequently arranged to be seen privately and booked an appointment for January 2025. He did not contact the Trust or his GP again to escalate his concerns and try and secure the treatment required.

18. When the Trust contacted Mr J in December 2024 to arrange a further appointment, Mr J declined on the basis he had already arranged to have the procedure privately. Even if there had been confusion as to whether the Trust had discharged him, from that point it was clear it had not done so. We consider Mr J could have cancelled the private appointment and continued along the NHS care pathway at this point.

19. We understand how worrying this situation was for Mr J given his history of skin cancers and understand why he made the decisions he did regarding his care. We are by no means criticising him for the choices he made for his health.

20. Mr J wanted apologies and acknowledgements. The Trust has already apologised for the anxiety its confusing communication will have caused him. He also wanted reimbursement of his private procedure costs. Having reviewed the evidence, we cannot link the events complained about with the costs Mr J has claimed. That is because the NHS was back in touch with him before the private procedure went ahead. We will therefore not be looking at his complaint further.

21. We are sorry to hear of Mr J’s concerns about the care he received from the Trust. We wish Mr J the best for the future.

1. We have carefully considered Mr J’s complaint about the care and treatment he received from the Trust in 2024. We have decided we cannot link the events complained about with the negative impact Mr J has claimed. We explain this in more detail below.

2. We understand the events which caused Mr J to complain are very important to him and we recognise the how anxious he felt about his skin. It would not have been easy for him thinking he had not received correct and timely care.