Switalskis’ specialist medical negligence solicitors express their concerns after an investigation found evidence that patients have suffered harm following delays in diagnosis and access to specialist care through the NHS referral process.

An investigation by the Health Services Safety Investigations Body (HSSIB) has highlighted concerns about the way the NHS Advice and Guidance (A&G) system has been introduced and used.

The system is intended to allow GPs to seek advice from hospital specialists before deciding whether a patient needs a hospital appointment. When it works well, this can help GPs access specialist expertise quickly and ensure patients receive the right care without unnecessary referrals.

However, HSSIB's investigation found evidence that problems with the way the system has been implemented have contributed to delays and missed diagnoses, with some patients experiencing serious harm.

The safety body has called for the rollout of the system to be paused while concerns about its implementation and monitoring are addressed.

Delays in diagnosis can have serious consequences

Clare Thompson , a Director at Switalskis and specialist medical negligence solicitor said: “For patients, the most important issue is not necessarily how a referral is categorised, but whether they receive the appropriate investigation, diagnosis and treatment within a reasonable timeframe.

"For patients, the important question is whether the system worked safely in their individual circumstances. A request for specialist advice should not become a barrier to further investigation where a patient's symptoms continue or their clinical picture changes.

"This can be particularly significant in cases involving conditions such as cancer, heart disease and neurological disorders, where earlier diagnosis and treatment can make a substantial difference to a person's prognosis and recovery.”

HSSIB's findings demonstrate the potential risks when communication between primary and secondary care breaks down, or when responsibility for progressing a patient's care is unclear.

There are also concerns that the pressure on the NHS to reduce waiting lists and hospital referrals could create additional risks if decisions about referrals are driven by targets or expectations rather than the individual needs of patients.

‘Patients must receive the right care at the right time’

The specialist medical negligence solicitors at Switalskis are concerned that any system designed to reduce pressure on NHS services must not inadvertently create barriers to patients accessing appropriate specialist care.

Clare added: “Where a GP believes that a patient requires specialist assessment, there must be confidence that the referral or request for specialist advice will be dealt with appropriately and within a timeframe that is safe for the patient.

“There must also be clear communication about what happens next.

"If a referral is declined or redirected, it should be clear who is responsible for ensuring that the patient's symptoms are appropriately investigated and that they are not simply lost between different parts of the NHS.”

The HSSIB investigation also highlights the importance of effective monitoring. If incidents are not being reported or systems are not being reviewed when things go wrong, it becomes much harder to identify risks and prevent similar harm happening to other patients.

When can a delayed referral amount to medical negligence?

A delay in receiving a hospital appointment or specialist assessment will not automatically mean that medical negligence has occurred.

However, healthcare professionals have a responsibility to provide care that meets an appropriate standard. Where a patient should have been referred for further investigation or treatment, but this does not happen within an appropriate timeframe, the consequences can sometimes be serious.

A medical negligence claim may be possible where there is evidence that:

• a patient's symptoms should have prompted a referral or further investigation;
• an appropriate referral was not made;
• a referral was not acted upon or followed up appropriately;
• important test results were not reviewed or acted upon;
• communication between healthcare professionals contributed to a delay; or
• the delay resulted in avoidable injury or a worsening of the patient's condition.

Whether a claim is possible will depend on the individual circumstances and, in most cases, independent medical evidence will be needed to establish whether the care provided was negligent and whether this caused avoidable harm.

Understanding what happened to you

Patients may not always know why there was a delay in their diagnosis or treatment.

They may simply have been told that a referral was rejected, that their GP needed to provide more information, or that they needed to wait for a further appointment. It can be difficult to understand what happened behind the scenes or whether appropriate steps were taken to progress their care.

If a patient has subsequently suffered harm, it may be appropriate to investigate the care they received.

At Switalskis, our medical negligence solicitors can obtain and review medical records, investigate the sequence of events and work with independent medical experts where necessary to establish whether the standard of care was appropriate.

We can also help families understand what happened and, where negligence is identified, pursue compensation and seek answers on their behalf.

Our specialist medical negligence team supports patients and families who have suffered harm following delayed diagnosis, delayed treatment and failures in communication between healthcare professionals.

If you are concerned that a delay in referral or diagnosis has affected your health or the health of someone close to you, we can provide confidential advice about your circumstances.

How Switalskis medical negligence experts can support you

For compassionate advice from our experienced medical negligence team , contact us today. Call us on on our dedicated medical negligence support line on 0800 995 6068  or email help@switalskis.com .