University Hospitals Birmingham NHS Foundation Trust

5. Mr A complains about aspects of the care and treatment his stepfather, Mr O, received at the Trust between 2021 and 2022.

6. Specifically, he says it failed to monitor his stepfather’s cancer. It did not conduct regular scans and investigate the change in symptoms (bruising and a cough) in 2021. Further, it did not investigate his raised Prostate Specific Antigen (PSA, a protein produced by the prostate gland) and C-reactive protein (CRP, a protein produced by your liver) detected in blood tests.

7. Due to this, he says the progression of stepfather’s cancer and a large tumour in his liver was not diagnosed until November 2022. It was too late for him to undergo treatment. He feels if the Trust had carried out investigations into his symptoms, he would have been diagnosed with liver cancer earlier and he could have had treatment for it.

8. He says the progression of his cancer later caused his stepfather to develop infections (sepsis and pneumonia) which led to his death.

9. He explains this has also caused him significant distress, in witnessing his stepfather’s deterioration.

10. As a result of complaining to us, he seeks an apology, service improvements, and a financial remedy (between £2000 and £6000).

13. The Ombudsman’s powers are set out in the law. This says a person needs to make their complaint to us within a year of becoming aware they have a need to complain. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so.

Date of events and knowledge 14. Mr A complains in 2021 and 2022, the Trust did not conduct regular scans to monitor his stepfather’s cancer or investigate the cause of his new symptoms. His stepfather had been diagnosed with prostate cancer in approximately 2015 and had no concerning symptoms until 2021. In 2021, he developed new symptoms such as bruising on his arms and a cough.

15. Mr A says he and his stepfather were unaware of the reason behind the new symptoms, until a separate Trust diagnosed a tumour in his liver in November 2022.

16. Mr A explained they had concerns about the Trust’s care before this, particularly because the oncologist seemed to dismiss his reported symptoms. For example, he says the oncologist was dismissive during an appointment in 2021.

17. In November 2022, a separate Trust confirmed his stepfather had liver cancer. This is when Mr A felt if the Trust had monitored his stepfather’s cancer and conducted investigations, the Trust could have diagnosed his liver cancer earlier. In turn, he believes his stepfather could have undergone treatment earlier.

18. Therefore, we consider Mr A’s date of knowledge for this issue is, at the latest, November 2022.

19. Mr A also complains the Trust did not investigate Mr O’s raised PSA and CRP levels.

20. Mr A explains his stepfather’s PSA levels were rising from June 2021 and the Trust left this untreated. The Trust sent a letter to Mr O on 30 September 2021 noting his PSA had risen. Mr A says he was aware of this before his stepfather died in November 2022.

21. Therefore, we consider Mr A would have had concerns the Trust did not treat or investigate further his rising PSA levels at the very latest by November 2022.

22. Mr A says a different Trust sent his stepfather’s CRP results to the oncologist at the Trust in October 2022. This is because his stepfather was in hospital and the separate Trust was treating him for infections (such as pneumonia and a urinary tract infection).

23. He says the Trust did not act upon or investigate his CRP levels urgently. He raises concerns that rising CRP levels are related to cancer, so the oncologist at the Trust should have investigated this promptly.

24. We asked Mr A when he became aware of this issue. He says regarding the issue about the CRP results he was unaware until he requested his stepfather’s medical records shortly after his death in November 2022. He confirmed he received the records in 2023. Mr A explained he was not aware that CRP levels indicate cancer until he began researching this.

25. As Mr A explained to us, he received the records in 2023, and he took some time to research what raised CRP levels may indicate. We consider his date of knowledge for this issue is at the latest December 2023.

Our consideration 26. For Mr A’s complaint about the Trust failings to investigate and monitor his stepfather’s cancer, and the rising PSA levels, he would have needed to complain to us within 12 months of his date of knowledge, which is November 2023.

27. Our records show Mr A complained to us about such issues in November 2025. This means Mr A’s complaint about such issues was made to us approximately two years outside of our 12-month time limit.

28. For Mr A’s complaint about the Trust failing to act upon or investigate his stepfathers CRP levels, he would have needed to complain to us within 12 months of his date of knowledge, which is December 2024.

29. Mr A complained to us in November 2025. This means his complaint was made to us approximately 11 months outside of our 12-month time limit for this issue.

30. We spoke with Mr A to understand the reasons why he could not bring his complaint to us sooner. We also considered the time the Trust took to respond.

31. Mr A complained to the Trust about the issues relating to monitoring and investigating symptoms, on 27 January 2023. This is soon after his stepfather’s death (approximately two months). It is understandable he did not complain to the Trust straight away.

32. The Trust responded on 4 May 2023. The Trust provided a further response on 23 August 2023. This was following Mr A raising additional concerns about his stepfather’s care.

33. The delay between November 2022 and August 2023 is understandable. Mr A would have been grieving during this time. The Trust responded to Mr A’s complaint letter in May, and he then raised further concerns which is reasonable. The local complaints process can take some time, so we understand the reason for the delay here.

34. We have then carefully reviewed the delay between August 2023 and November 2025, when Mr A complained to us about the issues.

35. When we asked him for his reasons behind the delay, he said he sent the response letters to our organisation once he received the Trust’s responses.

36. Mr A submitted a complaint form to us about this Trust on 25 January 2023. This complaint form did not mention the issues he has now raised and was instead about separate issues.

37. We have been unable to locate any evidence Mr A raised the issues he raised about the Trust failing to monitor and investigate his stepfather’s symptoms, and the raised PSA levels, until 23 October 2025. He asked our organisation when we will look into the issues about the oncology care at this Trust.

38. We can see Mr A explained his concerns about the raised CRP levels to his caseworker in March 2025. Between the Trust’s final response in August 2023 to March 2025 (when he raised this issue with our organisation), we have seen no evidence Mr A raised this issue to us any earlier. Following Mr A raising this in March 2025, he then agreed a scope of his complaint which did not include this issue.

39. Mr A then phoned our organisation on 6 November and asked about a second complaint about the Trust’s oncology care. He said he could not remember how he sent the complaint originally but knew he had not spoken about that element with his caseworker. Mr A said he would now send the complaint about such issues to us.

40. We have reviewed all documents on our system, and have not found any evidence Mr A raised his concerns with us about this Trust failing to monitor and investigate his stepfather’s symptoms and raised PSA levels, earlier than October 2025.

41. We can see he had in-depth discussions with our organisation about a previous complaint. He agreed a scope of his complaint, and the issues he has raised now, were not raised at the time.

42. If our organisation did not receive the documents when he originally sent them to us, we would expect him to have discussed this earlier. We have found no evidence he raised the issues earlier than October 2025.

43. Mr A explained to us he had several complaints to different Trusts, it was a stressful time, and lost track of where he was up to. He says he sent the complaint to our organisation and we must have misplaced it.

44. We have found no evidence he raised the issues earlier. We recognise this must have been a distressing time for Mr A. We would expect Mr A to have mentioned the concerns about the oncology care at the Trust with us previously. Particularly because the previous caseworker investigated his concerns about this Trust. We have found no evidence he did so until October 2025.

45. Taking away the time it took between Mr A complaining to the Trust and in receiving the response, there are still delays with Mr A pursuing his complaint of fifteen months.

46. He raised the issue about the CRP levels in March 2025, however he agreed to not include this within the scope of his complaint. He is now raising the issue to us again in November 2025. We have not seen a strong enough reason to set the time limit aside, as he agreed to not include this within the previous scope of his complaint (about this Trust).

47. We do not consider Mr A’s reasons strong enough to set the time limit to one side. We think his reasons account for only part of the delay. We think Mr A could have raised the concerns with us about the Trust’s care and treatment for his stepfather’s cancer earlier than he did.

Summary of our decision 48. We have carefully considered the reasons for the delays identified above. We recognise how difficult it must have been for Mr A to pursue the complaint in the circumstances at various points. We were sorry to hear about how hard this was and the difficulties he went through.

49. It is clear from the information provide how much distress the events described has caused. We are so sorry to hear about this. When we have considered the time taken, we think it would have been reasonable for him to have complained to us sooner.

50. We have not identified sufficient reasons to enable us to put our time limit to one side. We will therefore be closing the complaint and taking no further action,

51. We thank Mr A for bringing his complaint to us and speaking with us about what happened. We must apply our time limit fairly. We do not underestimate how difficult this period was for Mr A and recognise how important his complaint is to him. Our decision is not intended to detract from these difficult events. We wish him all the best for the future.

1. We have carefully considered Mr A’s complaint about the care and treatment his stepfather, Mr O, received at University Hospitals Birmingham NHS Foundation Trust (the Trust).

2. We extend our sincere condolences to Mr A for the sad loss of Mr O, and recognise the events continue to cause him distress.

3. After careful consideration, we have decided not to consider the complaint further. This is because the complaint falls outside of our time limit. We have not seen strong enough reasons to put our time limit to one side. We will explain the reasons for this below.

4. We know from the information Mr A sent us, how important this complaint is to him and how much this experience has had an impact. We are very sorry to hear about Mr A’s distress, and we appreciate the details he has kindly shared with us.