A health watchdog has ruled that an unnamed medical practice in the Highlands failed to act quickly enough on warning signs of pancreatic cancer in a patient who later died, and has ordered the practice to apologise to the person's family. The Scottish Public Services Ombudsman (SPSO) found that despite the patient's own concerns about a possible cancer diagnosis, clinicians did not refer them for further investigation until months after symptoms first appeared.
The patient, referred to as "A" in the SPSO's report, had initially been diagnosed with diabetes after experiencing unexplained weight loss. When their symptoms persisted over the following months, they directly asked their GP whether the underlying cause could be pancreatic cancer. A was eventually referred to gastroenterology specialists, and blood tests subsequently led to a diagnosis of pancreatic cancer. The patient died roughly six weeks later.
What did the ombudsman find?
The SPSO concluded that guidance available to the practice was unambiguous about the significance of A's early symptoms.
"We found that relevant guidance was clear that A had red flag symptoms for pancreatic cancer from their initial presentation. From this point until the urgent suspicion of cancer referral, there were missed opportunities to recognise the significance of A's symptoms and refer them onward for further investigation."
According to a regional news report, the ombudsman also directed the practice to apologise for its "unreasonable reliance" on telephone consultations while assessing A's condition, in addition to the delay in recognising the cancer symptoms and shortcomings in end-of-life and palliative support. The same report notes that by the time scans confirmed the diagnosis, A had only about six weeks left to live.
How has the practice responded?
The SPSO acknowledged that the practice engaged properly with the process once the family raised concerns, cooperating fully with both the complaint and the subsequent investigation.
The watchdog's findings were based on independent clinical advice from a GP who reviewed the care given to A throughout the case. The complainant, identified in the ombudsman's report as "C" and described by the regional outlet as A's spouse, brought the case forward after the patient's death.
What is pancreatic cancer and how is it treated?
Pancreatic cancer develops in the pancreas, an organ situated in the upper abdomen, and is known to be notoriously difficult to detect and treat. The National Health Service states that treatment options can include surgery, chemotherapy, radiotherapy and supportive palliative care, depending on how far the disease has progressed by the time it is diagnosed.
Has NHS Highland faced similar criticism before?
This is not the first time the ombudsman has raised concerns about diagnostic delays within Highland health services. An earlier SPSO investigation into NHS Highland previously highlighted problems with delayed cancer diagnosis and inadequate record-keeping, suggesting a recurring pattern of concern around timely detection of serious illness in the region.
Key Facts
- The patient, known as "A", was first diagnosed with diabetes after unexplained weight loss.
- A personally raised the possibility of pancreatic cancer with their GP before a formal referral was made.
- The practice must apologise for delays in recognising symptoms, over-reliance on telephone consultations, and inadequate end-of-life care.
- A died approximately six weeks after the cancer diagnosis was confirmed.
- The SPSO noted the practice cooperated constructively throughout the investigation.
