A practice in the Hounslow area

2. Mrs H complains that during an appointment on 19 January 2021 the Practice failed to examine or make any referrals when she mentioned that she had blood in her stools. She says the Practice told her it was probably piles.

3. Mrs H has since been diagnosed with stage four bowel cancer. Her mental health has suffered, and she is undergoing chemotherapy.

4. Mrs H would like an apology and service improvements.

7. Mrs H says she attended the Practice on 19 January 2021. She says that at the end of the consultation she mentioned she had blood in her stools and the GP told her it was probably piles. Mrs H says she was relieved by this as she had feared it was something worse.

8. The Practice said in its complaint response that the GP could not recall Mrs H making this comment. It said there was no record of it in her notes. It said the consultation was 45 minutes and the main discussion was relating to a lump on her breast.

9. Mrs H was diagnosed with bowel cancer on 8 March 2022. The cancer subsequently spread to her liver and lungs. She has undergone operations to remove the cancer from her bowels and liver and completed two years of chemotherapy. That must have been incredibly difficult for Mrs H and her family.

10. Section 15 of the GMC guidelines said doctors must ‘adequately assess the patient’s conditions’, ‘promptly provide or arrange suitable advice’ and ‘refer a patient to another practitioner when this serves the patient’s needs’. Any investigation of Mrs H’s complaint would focus on whether the Practice did those things for her.

11. Unfortunately, we do not think we could establish what happened in order to compare it to the GMC guidance. Mrs H disputes the Practice’s version of events that she did not mention the bleeding to the GP during the consultation on 19 January 2021. The GP has no recollection of the comments. We have reviewed the GP’s note from this appointment and there is no record in the notes of Mrs H mentioning the blood in her stools.

12. Considering the comments from the Practice and Mrs H there are two versions of what happened in relation to what was said in the consultation. On one hand we Have Mrs H’s version, that she mentioned the bleeding, and on the other the version contained in the Practice’s records that she did not.

13. While we have no reason to doubt Mrs Hs’ version of events, we cannot reconcile that with the Practice’s version of events. Even if we were to start an investigation, we do not have enough evidence to say Mrs H told the Practice about the bleeding, and that it then failed to act. We would not be able to make an evidence-based decision either way. We have therefore decided not to consider her complaint further.

14. We know that decision will be disappointing for Mrs H. Finding out a year later that she had bowel cancer must have been devastating for her.

1. We have carefully considered Mrs H’s complaint about the Practice. We have decided to take no further action on Mrs H’s complaint because we would be unable to reconcile the differing accounts of the consultation on 19 January 2021. We understand the distress and worry this has caused her, and we are very sorry to hear about her cancer diagnosis.