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Trust failed to offer combined chemotherapy, resulting in distress and need to travel long distance for treatment

Organisation we investigated: Northern Lincolnshire and Goole NHS Foundation Trust 

Date investigation closed: 19 September 2019

The complaint 

Complainant E complained about their medical treatment for pancreatic cancer and a disagreement over what treatment the Trust wanted to use to treat Complainant E’s cancer. Complainant E said that the Trust would not provide a combination chemotherapy known as GemCap and recommended using a single treatment known as Capecitabine alone.  

Complainant E travelled to another trust, which agreed to provide the GemCap treatment. Complainant E said the events caused them distress and wasted their time, and they felt pressured about the treatment and confused by different clinical options. Complainant E said that travelling to a different hospital for chemotherapy treatment resulted in additional costs.

What we found 

The Trust should have considered and offered the use of GemCap dual chemotherapy treatment. Although this treatment was not part of the national guidance at the time, this treatment was available at the Trust and Complainant E had been confirmed as a good candidate for dual treatment after their surgery. Moreover, the Trust should have considered the known the benefits of using GemCap rather than Capecitabin alone.   

Complainant E was distressed by the events and had no option but to travel to another hospital that offered them the dual treatment. In its complaint response, the Trust did not accept that it should have offered Complainant E this treatment.

Background 

Complainant E was diagnosed with pancreatic cancer and referred for chemotherapy treatment. Their consultant recommended treatment with the single agent Capecitabine. Complainant E told us that that their previous surgeon advised them that dual chemotherapy treatment, GemCap, would be more suitable. GemCap is a combination of chemotherapy drugs Gemcitabine and Capecitabin. 

Complainant E queried the treatment available with the consultant during an appointment before they began treatment. Complainant E sought a second opinion at a different NHS trust that was quite far from their home, but which had been recommended in an internet forum about pancreatic cancer. The other trust offered Complainant E GemCap treatment and they went on to have their treatment at the other trust.

Putting it right  

We recommended that the Trust send a written apology to Complainant E to acknowledge the impact of the failings we identified in this report. We also recommended that the Trust update its local guidelines to ensure they are up to date. We recommended that the Trust pay £750 to Complainant E in recognition of the distress and upset caused.  

The Trust complied with our recommendations.

This case summary is featured in the Ombudsman's Casework Report 2019.