Source · PSOW (Public Services Ombudsman for Wales)

Cwm Taf Morgannwg University Health Board

PSOW (Public Services Ombudsman for Wales) Not Upheld Reference PSOW-202106889 Sector Health Category Clinical treatment in hospital Decided 10 August 2023

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Full decision

Mrs Q complained about the care and treatment that her late husband, Mr Q, received at Prince Charles Hospital (“the Hospital”) for his condition of non-Hodgkin’s Lymphoma (“NHL”) and in regard to his subsequent admissions with COVID-19. Specifically, Mrs Q complained that: • A specialist scan conducted on 27 January 2020 failed to collect a sufficient tissue sample and had to be repeated. This was traumatic for Mr Q and delayed his diagnosis.

• Mr Q was told that the second biopsy indicated a treatable and curable condition but this was later revised to a treatable but incurable condition. This mis-diagnosis was severely traumatising for Mr and Mrs Q and they were not provided with appropriate counselling or support.

• A further specialist scan, requested on 15 June 2020, was not completed and reported on until 14 August 2020. This adversely delayed Mr Q’s ongoing chemotherapy treatment.

• Despite being immuno-compromised and vulnerable, Emergency Department (“ED”) clinicians and a Consultant Haematologist declined to admit Mr Q when he tested positive for COVID-19 and again, when on 26 December 2020, his condition deteriorated.

• Mr Q was subsequently admitted as an emergency to the Hospital on 9 January 2021 with COVID-19 and pneumonia. However, he was prematurely discharged 2 days later without being reviewed by the Haematology Team. The management of his medication was left to his GP. Once home, he again deteriorated and required re-admission on 18 January 2021. This admission was also managed by his GP as the Haematology Team had declined to arrange this.

• While on the COVID-19 Respiratory Ward and following transfer to the Intensive Care Unit (“ICU”) (where sadly, he died on 4 February), Mr Q was not reviewed by the Haematology Team and during this time, no updates on his condition were provided to his family.

The Ombudsman’s investigation found: • A second biopsy did not delay Mr Q’s NHL diagnosis.

• Mr Q was not mis-diagnosed at any point.

• There was no delay in Mr Q’s ongoing chemotherapy treatment due to a CT scan that was correctly scheduled.

• Despite Mr Q being COVID-19 positive, his symptoms and presentation did not indicate that he should be admitted to hospital.

• Mr Q was discharged appropriately as his condition had improved.

• The Haematology Team communicated appropriately with both the Respiratory Ward and ICU in managing Mr Q’s NHL while he was COVID-19 positive.

The Ombudsman did not uphold the complaint.

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Other decisions involving Cwm Taf Morgannwg University Health Boa…

Reference Date Summary Outcome
PSOW-202511046 29 Apr 2026 Mrs A complained that Cwm Taf Morgannwg University Health Board failed to respond to her complaint. The Ombudsman found that … Resolved / Early Resolution
PSOW-202510579 28 Apr 2026 Ms B complained that the Cwm Taf Morgannwg Health Board failed to respond to the concerns she raised in her … Resolved / Early Resolution
PSOW-202509919 27 Apr 2026 Miss B complained that Cwm Taf Morgannwg University Health Board failed to send its complaint response to her Social Worker. … Resolved / Early Resolution
PSOW-202510338 27 Apr 2026 Miss A complained that Cwm Taf Morgannwg University Health Board had not fully addressed her complaint about care and treatment … Resolved / Early Resolution
PSOW-202501014 24 Apr 2026 Mr C complained about the care and treatment he received from Cwm Taf Morgannwg University Health Board. Specifically, the investigation … Not Upheld
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