man suffering from testicular cancer

The Importance of Attending Referral Appointments

When we have a health worry, our first port of call is usually to the GP. If the GP is unable to diagnose or treat you then they often request further investigation by a specialist, usually in the form of a referral.  When your GP refers you to a specialist, he or she is recommending you see a doctor whose opinion they trust and who they feel is qualified to diagnose your specific condition. Once this referral request has been made, its down to the patient to follow it up and attend the appointment.

But, what happens when the patient chooses to ignore the referral?


Failure to attend can be Fatal

This was the case recently for a client who was diagnosed with testicular cancer and later died after having chemotherapy treatment. He was first seen in April 2016 with swollen testicles and the GP diagnosed him with orchitis infection. He was prescribed with antibiotics. Client was then seen a few times by his GP in relation to an ankle fracture through the summer period of 2016. During this period no complaints were brought to the attention of the GP.

He was seen again in October 2016 regarding painful and swollen testicles, the GP believed it was a re-current infection and on the second visit in October he was referred for an Ultrasound scan to rule out any serious causes such as cancer. Unfortunately, the client failed to book his ultrasound scan and after 2 reminders from the NHS, his referral was cancelled. He then went back to his GP and was re-referred in December for an urgent scan which then lead to a diagnosis of cancer.

At an inquest, the Judge found that the care afforded to the client was reasonable as was the diagnosis of an infection. He had numerous consultations with the GP regarding his ankle injury throughout the period of April – October 2016, but he did not mention his swollen/painful testicles.  The Judge found that it was incumbant upon the client to arrange the ultrasound scan. Therefore, the causes of action by the GP were reasonable in relation to the care and treatment.

There was a discussion about whether it would be helpful if the NHS system had something in place to let doctors know that a client has not booked an appointment. Both doctors agreed it would be helpful for GPs for non-booking of any radiology so that the GPs can then chase the client.  The Judge intends to write a letter to the NHS regarding the information provided to GPs when a patient has not booked a scan.

I think the key issue here is that the client did not book his ultrasound scan and due to the delay he was dropped off the system.

The Judge concluded that the client passed away due to natural causes –  pulmonary fibrosis, bleomycin toxicity (reaction to chemotherapy treatment) and testicular cancer.


Although this case is extremely sad it serves as a reminder as to the importance of following up appointments and attending referrals if the GP recommends them.


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