A CANCER patient who was misdiagnosed, mistakenly given the all-clear and later died formed the crux of a complaint against the Great Western Hospital, a newly released report shows.

The report by the Parliamentary and Health Service Ombudsman revealed Great Western Hospitals NHS Foundation Trust was investigated over its handling of treatment for the patient, named as Ms T.

The woman who was in her early 20s, underwent a colonoscopy and biopsy of the cervix in spring 2013 and was diagnosed with cervical cancer. After a hysterectomy, she was given the all-clear. But when she was later referred to a specialist cancer centre it was found she had neuroendocrine cancer.

In the summer of 2014 Ms T complained to the trust which responded that its pathologists followed correct procedures and that Ms T’s uncommon cancer made early diagnosis difficult. She died in autumn 2014.

Her friend, Ms K, complained to the PHSO in October 2015, saying the trust failed to acknowledge Ms T’s complaint and then delayed responding to it. This was partly upheld with the PHSO ruling the trust did not respond in a timely enough fashion and caused ‘distress’ to Ms T.

The PHSO found the trust had used an appropriate technique to examine Ms T’s biopsy samples, in line with relevant guidance and followed usual practice for examination of tissue samples.

When the diagnosis was found to be wrong, PHSO found the trust followed protocol by sending samples to a regional centre to confirm the results.

But the PHSO found it took two weeks for Ms T’s letter to reach the trust which was expected to respond within a month. However it took nearly six weeks to respond.

The PHSO said: “The trust explained that the complaint had taken longer to respond to because of its complexity and the need for the views of several staff. The trust’s explanation was reasonable in our view. We did not find that the delay in responding was sufficient to be a failing but it was very unfortunate due to the high sensitivity of the circumstances.”

The report said Ms T was not advised by the trust what to do if she wanted to escalate her complaint. “In our view these were failings that added to Ms T’s distress,” the report said.

The trust apologised to Ms K and Ms T’s parents and produced an action plan toshow what it learned prevent it happening again.

A trust spokesman said: “We have apologised for how this complaint was handled and, following an audit of the complaints process, have made improvements to the way patients and their families are involved in their complaint.

“All complaints are brought to the attention of the most appropriate senior leader, who personally writes to each complainant to share the outcome of our investigation. We take all issues raised by patients very seriously and work closely with them and their families to establish what may have gone wrong and how things can be improved in the future.”

Gill May, executive nurse at Swindon Clinical Commissioning Group, said: “Swindon CCG works very closely to monitor compliance around complaints with the Great Western Hospitals NHS Foundation Trust (GWH). Since this incident in 2014, the Trust has worked intensively to ensure that they improve on meeting the timelines to acknowledge and respond to complaints.”