New Hotline for Cancer

Last week the Times Newspaper reported on a new Hotline for cancer. Specialist cancer nurses will be available to advise patients worried about their symptoms, if they are not being listened to or are having difficulty accessing their GP.

There is a lot of talk in the press about the "tsunami" of people who haven't come forward during the pandemic and are now seeking help. Over stretched GPs may struggle to see their patients. Some may be reluctant or unable to see them face to face. This raises the question of when to see and when not to see a patient.

The NICE guidelines set out recommendations on the appropriate diagnostic tests for patients:

How soon diagnostic tests or a consultation should be carried out depending on the signs and symptoms (e.g. within 48 hours, 2 weeks etc);

Recommendations for 'safety netting' patients;

Recommendations on the information and support to provide to people with suspected cancer and their families and/or carers.

The Guidelines set out the benefits of an early referral which include:

Earlier diagnosis of cancer, leading to increased survival;

A reduction in cancers diagnosed via an emergency route;

Optimised diagnostic processes;

More appropriate referrals to secondary care for suspected cancer.

It is often a difficult balance for a GP or other health care professional faced with the demands of a busy practice and the addition of having to deal with the pandemic. This should not however detract from their primary duty to act appropriately.

A health care professional will be deemed negligent if the treatment, or lack of it, is deemed to have fallen below the standard expected of a reasonably competent clinician, dealing with the patient's particular condition at that time.

For example, a patient with a painful and increasing lump or lesion on their leg, seeks a consultation. Their doctor is unable to see them face to face, arranges a telephone consultation and takes the view they still do not need to see the patient. The lump turns out to be cancerous. If most doctors agree they would have done the same thing, then that would not be considered negligent. If some would and some wouldn't, that would still not be considered negligent. If most of them are of the view the treatment was below standard, then it would be considered substandard and negligent.

The patient would then have to prove an earlier referral would have made a difference to the outcome. If an earlier referral would have made no difference, then there is no causative effect and no claim.

Expert evidence is usually required to prove this, but this can be expensive. It is sometimes possible to obtain insurance to fund these costs and household insurance may cover the experts' fees which is why it is always worth checking. If cover is available, they may appoint their own panel solicitors, although there should be a choice to instruct a lawyer of their choice

If insurance isn't available, we may be prepared to act on a no win no fee basis. We may be able to obtain some after the event insurance to fund the case.