County Durham and Darlington NHS Foundation Trust

CDDFT

3. Mrs L complains in 2018 CDDFT advised Mrs M that the mole it removed from her foot was not cancerous. She also complains CDDFT did not arrange any follow-up checks after it removed the mole.

4. Mrs L says Mrs M was diagnosed with an aggressive type of skin cancer in 2022. She says Mrs M was advised by her doctor that the mole removed in 2018 was likely to have been cancerous. Mrs L says had it not been for the failings, her mother’s cancer may not have spread to the extent it did between 2018 and 2022 and she may not have died.

5. Mrs L would like financial remedy.

NUTH

6. Mrs L complains Mrs M waited too long to start treatment after she was diagnosed with skin cancer in 2022.

7. Mrs L says Mrs M deteriorated rapidly while she waited for her treatment to start. She says if treatment had started sooner, Mrs M may not have died.

8. Mrs L would like financial remedy.

9. In 2018, CDDFT removed a mole from Mrs M’s foot. It performed a biopsy of the mole and diagnosed her with Bowen’s disease (an early type of skin cancer that affects the cells in the outer layer of skin).

10. Between 2018 and 2022, Mrs L reports that Mrs M suffered swelling and pain in the leg the mole was removed from.

11. In June 2022, Mrs M discovered a pea-sized lump in her groin. She had a biopsy which showed the presence of cancerous cells. Mrs M was referred to CDDFT which advised that the cancer was aggressive, rapidly growing, and was probably metastatic (cancer that has spread outside from its primary site to another part of the body). CDDFT referred Mrs M to NUTH’s Northern Centre for Cancer Care (NCCC) in July.

12. Mrs M attended an appointment at NCCC in mid-August. NUTH arranged a second biopsy to determine whether Mrs M’s cancer was metastatic and to help it consider options for her treatment.

13. In November, Mrs M started immunotherapy (a treatment that helps the immune system recognise and attack cancer cells). Sadly, by this stage, NUTH had determined that Mrs M’s cancer was incurable. In this situation, we understand her immunotherapy treatment was palliative (a treatment focused on easing symptoms and improving quality of life rather than curing cancer). As part of Mrs M’s palliative treatment, NUTH performed surgery to remove the tumour in her groin in May 2023.

14. Very sadly, Mrs M died in January 2024.

15. Mrs L complained to CDDFT and NUTH via an advocate in March 2025. NUTH sent its response in July and CDDFT in September. Mrs L brought her complaint to us at the beginning of December.

18. The law says we cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so. When we receive a complaint, we consider if it is within our time limit. This means we look at whether the complaint was brought to us within one year of when the complainant knew they had a reason to complain. If the complaint is outside our time limit, we consider the reasons for this. Finally, we look at whether the delay in coming to us was reasonable in the circumstances.

19. Mrs L told us Mrs M was informed by NUTH in August 2022 that the mole CDDFT removed from her foot four years earlier had likely been cancerous. We consider this the date Mrs L became aware she had reason to complain to CDDFT. In saying this, we do not reach a view about whether CDDFT should have provided different clinical care to Mrs M in 2018.

20. We recognise Mrs L and Mrs M were understandably not immediately focusing on making a complaint in August 2022. Mrs M had just been diagnosed with an aggressive form of skin cancer, which must have been a huge shock. Naturally, their priority would have been her starting treatment as soon as possible.

21. Having said this, we think it reasonable to say Mrs L had all the information she needed to make a complaint to CDDFT within a year of August 2022. While we recognise Mrs L’s concerns became more significant when Mrs M sadly died in January 2024, we do not think it necessary for her to have known this eventual sad outcome before making a complaint. We have not seen that Mrs M’s death substantially changed the nature of Mrs L’s concerns about CDDFT.

22. We consider Mrs L should have brought her complaint about CDDFT to us by August 2023. This would have been one year from the date she became aware she had reason to complain. Overall, we consider Mrs L’s complaint about CDDFT is about two years and four months outside of our time limit.

23. We have also considered the date Mrs L likely became aware she had reason to complain about the care NUTH provided to Mrs M. We have seen from the available evidence that Mrs L was unhappy that Mrs M had waited between July, when she was referred to NUTH, and November, when she started immunotherapy treatment. Based on this, we think the earliest date Mrs L would have known she had reason to complain to NUTH would have been November 2022.

24. We considered whether Mrs L might only have known she had reason to complain to NUTH after Mrs M sadly died. As we have explained earlier, we recognise Mrs L’s concerns would have become more significant after Mrs M’s death. However, we can see Mrs L felt she needed to plead with NUTH to start Mrs M’s treatment at the time. We think this means she was aware she had concerns before Mrs M’s treatment even started.

25. For Mrs L’s complaint about NUTH to be within our time limit, we consider she would have needed to bring it to us by November 2023. We understand Mrs L’s father very sadly died around this date. We think a short delay in bringing the complaint to us around this time would have been understandable.

26. We understand there were many practical and emotional matters for Mrs L to deal with after losing both parents within a short time. This included an inquest into Mrs M’s death that looked at matters unrelating to the complaint Mrs L has brought to us. We understand she was managing a lot of this on her own. We are sorry to hear how much Mrs L had to cope with.

27. As we have explained, Mrs L complained to CDDFT and NUTH in March 2025. At this point, her complaint about CDDFT was about one year and eight months outside of our time limit and her complaint about NUTH was about one year and four months outside of our time limit.

28. Had Mrs L approached us sooner than March 2025, it is likely we would have advised that her complaints were not ready for us to consider. This is because Mrs L had not yet asked CDDFT and NUTH to look at her complaints.

29. However, our time limit starts from a year after the complainant first becomes aware they have reason to complain, not from the date they start the complaints process or receive a final response. This means Mrs L’s complaints were still outside of our time limit even before she had raised them with each Trust.

30. NUTH sent Mrs L its response to her complaint on 21 July 2025. In its response, NUTH provided our contact details and advised Mrs L she could ask us to look at her complaint if she remained unhappy.

31. We consider Mrs L knew she was unhappy with the response from NUTH when she received it. We recognise it may have been important to Mrs L that we looked at both of her complaints at the same time. However, we cannot see that she contacted us about this, despite having our details and knowing she was unhappy with NUTH’s response. If Mrs L had contacted us, we could have advised her that she did not need to wait until she had received a response from CDDFT.

32. CDDFT sent Mrs L its response to her complaint on 11 September 2025. It also provided our contact details and advised Mrs L she could bring her complaint to us if she was not happy.

33. By the time Mrs L had received both responses, her complaint about CDDFT was outside of our time limit by two years and one month and her complaint about NUTH was outside of our time limit by about one year and seven months. We can see it was then about three months before Mrs L brought her complaint to us.

34. Mrs L explained she had initially sent us her complaint in October, but unfortunately, the email got stuck in her outbox. She says it was not until December when her advocate prompted her that she realised the email had not been sent.

35. We accept Mrs L’s explanation for the delay between September and December. We know these things can happen and Mrs L would not reasonably have known that her complaint had not reached us. However, we do not consider this shorter delay significantly affects our overall assessment of whether it is reasonable to put our time limit aside. This is because the complaint had already become out of time before Mrs L approached us.

36. Finally, we have carefully considered whether we would have set our time limit to one side if we had decided the date Mrs L became aware of the full extent of her complaint was January 2024, when Mrs M died. Even if we were to take this approach, Mrs L’s complaint would still be outside of our time limit by just under one year. This means that even if we apply the latest possible date Mrs L became aware of her complaint, this does not make a difference to our overall decision.

37. We are very sorry for Mrs L’s sad loss, and we understand the last few years have been extremely difficult for her. We have carefully considered her circumstances when deciding whether to exercise discretion and put our time limit aside. Having looked at the information available to us and considered Mrs L’s explanations, we have not seen that the circumstances were a significant barrier to her bringing her complaint within the time available.

38. We thank Mrs L for the effort she has gone to in bringing us her complaint and sharing information with us. We recognise our decision not to consider her complaint further may be disappointing. Our decision is not intended in any way to diminish her experience. It is important we consider and act within the law and we hope our statement clearly explains the reason why we cannot consider the complaint further.

1. We thank Mrs L for her complaint about County Durham & Darlington NHS Foundation Trust (CDDFT) and The Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH). We were sorry to hear of her concerns about the care CDDFT and NUTH provided her mother, Mrs M. We offer our sincere condolences to Mrs L for her sad loss.

2. We have seen Mrs L’s complaints about CDDFT and NUTH both fall outside of our time limit by over two years. Having carefully considered why Mrs L was not able to bring her complaint to us sooner, we have not seen reason to put our time limit aside. On this basis, we have decided to take no further action on her complaint.