Getting admitted to hospital is always a worrying time, even more so if you later find out that you need an operation. However, when you are given a date for surgery but it gets repeatedly postponed, frustration combines with nervousness about the outcome.
If you’re in a lot of pain or your condition is getting worse, you will understandably be concerned about your health and when you are going to receive the treatment you need.
Unfortunately, delays happen. Surgeons may be off sick, an emergency surgery may take priority over yours, or changes to your condition may mean surgery isn’t possible at that time. Not every delay is avoidable, nor does it necessarily amount to negligence.
However, if waiting longer than necessary for surgery does result in further harm that could have been avoided, what then?
When Can a Delay in Surgery Be Considered Medical Negligence?
Medical negligence occurs when the quality of medical care you received (or, in this case, didn’t receive) falls below a reasonably competent standard, and that specific delay caused avoidable harm.
Hospitals and medical professionals have a duty of care to their patients, and when they breach that duty, there may be grounds to investigate whether negligence occurred.
The reason for the delay, the patient’s condition and the consequences of the delay will be considered in detail.
Why Might an Operation Be Delayed?
We have already mentioned some causes of delay: emergency cases taking priority and patients needing further tests or not being fit for surgery on the day origially scheduled.
Delays could also be due to staff shortages or a lack of available theatres.
Administrative errors, missed referrals and communication failures can also contribute to surgery not going ahead as can a failure by a medical professional to recognise when a patient’s condition has worsened.
The key here is distinguishing between what are justifiable delays and what amounts to inadequate care.
What Happens If Your Condition Gets Worse While Waiting for Surgery?
The outcome of any delay will depend entirely on the individual.
The patient’s existing condition and how urgent the surgery has become are two factors that influence what happens if it doesn’t go ahead as planned.
What should’ve been a routine operation could end up leaving a patient experiencing more, or worse, pain, having reduced mobility or enduring a longer recovery period after the surgery has been carried out.
In more serious cases, delaying treatment could result in permanent disability or other long-term issues, meaning a patient could require ongoing care.
It’s not just the immediate effects, either. The consequences of delayed treatment can impact the person’s independence, their ability to carry out everyday activities, their job and their mental health.
On top of that, friends and family feel the effects too.
Relatives may need to take on caring roles, which may strain relationships as well as finances. Young children may struggle to understand why a parent can’t do the things they would normally do together.
It’s at this stage that assistance from an expert firm of medical negligence solicitors will prove invaluable. They’ve been here before with previous clients and know the procedures to follow and the evidence and investigations needed to find out whether clinical negligence has occurred.
Are Some Types of Surgery More Time-Sensitive Than Others?
Yes, they can be.
Hip fracture surgery, for example, should be carried out promptly, particularly if the patient is older or vulnerable. NICE guidelines suggest that hip surgery should be carried out on the day of, or the day after, admission into hospital.
Someone in need of emergency abdominal surgery could suffer catastrophic consequences if treatment is delayed. Certain serious conditions like acute appendicitis or peritonitis can become life threatening in just a few hours, so timing is critical.
Similarly, some spinal conditions, such as cauda equina syndrome, require urgent treatment, not just to relieve pain but also to prevent a potentially permanent and irreversible physical disability.
Because the risks and possible outcomes can vary so drastically from one condition to another, there is no “universally accepted” waiting period. Priority is usually assessed based on the risk of deterioration.
What If Your Surgery Is Delayed Because of NHS Waiting Lists?
When you are sick or in pain, being told you have to wait to receive the treatment you need can be incredibly worrying and stressful. But it’s important to understand how NHS waiting lists work, how they prioritise surgeries and what options you have if your health deteriorates and you believe the hospital was negligent.
The NHS classifies surgical treatment in three broad categories: planned/elective, urgent and emergency. However, long waiting times do not automatically equate to medical negligence.
Long waiting lists, staff shortages and a lack of available hospital beds can all contribute to delays in surgery. However, these pressures don’t automatically mean that the care a patient receives has been negligent. What matters is whether the hospital took reasonable steps to manage the patient’s treatment and respond to their medical needs.
To establish negligence, you must first prove that the delay in treatment was the result of your healthcare provider failing to meet the expected standard of care. Second, it must be proved that the specific delay was avoidable and that it was directly linked to your condition deteriorating or that it led to an injury that would not have happened otherwise.
So, what happens if your condition does deteriorate?
When you are waiting for planned surgery, your priority is usually determined by how your condition presents at the time you are assessed. However, symptoms can change and worsen over time, and if you are subjected to a prolonged delay, you may find yourself going to hospital as an emergency admission.
It’s important that, if your symptoms get worse, your pain levels increase, or you suffer mobility issues, you contact your GP or the hospital immediately. Don’t wait for your planned appointment date.
If your condition deteriorates while you’re waiting for surgery, it’s important that your medical team is made aware. Depending on the nature of the changes, your clinical priority may need to be reassessed. Your GP can update your medical records and request an urgent referral, providing details of your increased risk status. From there, the hospital then has a duty to re-triage your case and, if necessary, move you to priority status.
In a potential medical negligence claim, the failure to act appropriately and in a timely manner to a patient’s deteriorating symptoms, can often be more significant than the length of the original waiting time.
In other words, if a patient is on a year-long waiting list for a routine surgery, it’s unlikely there will be grounds for a negligence claim. However, if that same patient presents at their GP or the hospital with serious new symptoms and those symptoms are missed, aren’t correctly triaged, or not communicated properly, that failure could amount to medical negligence.
This breakdown in the management of patient care, if it results in a permanent disability, long term injury or life-threatening situation, could be grounds to make a claim.
Can You Still Make a Claim If the Surgery Eventually Goes Ahead?
Good question.
You may think that, regardless of whether you underwent a successful operation, the wait was unacceptable. However, simply because you had to wait a long time doesn’t necessarily mean the care you received prior to the surgery was inappropriate.
But what happens if you undergo the surgery you were scheduled for, and are left with further complications because it wasn’t carried out soon enough?
Where there were unreasonable delays caused by administrative errors or failures to re-triage the patient, from a negligence point of view, the question becomes “what were the consequences of that delay?”
To bring a successful claim, you would generally need to show that the delay was more likely than not to have caused additional harm that could have been avoided if the operation had taken place sooner.
Negligent delay could have several consequences:
- The patient experiences preventable complications that require additional treatment.
- There is a longer recovery time because the patient was in a more weakened state, and post- operative rehabilitation takes longer and is more painful.
- The long-term success rate is negatively impacted. For example, because the surgery was delayed, the patient is left with permanent issues, pain or a lesser quality of life.
Essentially, the claim must prove that the patient was caused avoidable harm by the negligent delay, not that they simply had to wait to receive treatment.
How Can You Establish Whether a Surgical Delay Caused Harm?
It’s vital to obtain the necessary evidence.
An experienced medical negligence solicitor can help you obtain copies of your medical records and a comprehensive timeline of events such as when the surgery was first recommended, the date it was scheduled for and the reason(s) it was postponed.
How your condition was monitored while you waited for the surgery will also provide key evidence. Your solicitor will look for things like:
- Did your GP or the hospital carry out routine reviews to check your condition was stable?
- Did the clinical team respond and reassess your case if you reported a change or deterioration of your symptoms?
- Is there a record of calls, emails or letters to prove that you contacted the hospital to report your worsening symptoms?
Independent medical experts will be brought in at your solicitor’s request to review your file. They will seek to identify whether the delay was, in fact, unreasonable and whether having the surgery sooner would have changed or improved the outcome.
One of the medical expert’s most difficult tasks is separating the effects of your original condition from any additional harm caused by the delay.
What Should You Do If You’re Concerned About a Delay in Surgery?
Be proactive.
Your first port of call should be the medical team treating you to find out why the operation has been postponed. Request a clear explanation and ask for a new expected date.
You should also ask whether the risks of waiting have changed and if your condition needs to be reassessed. If your symptoms get worse, don’t wait until your next appointment. Speak to your GP or the hospital to let them know your condition is deteriorating.
Make sure you keep a record of all cancelled appointments, communications (emails, letters, phone calls) and names of the staff you speak to. It’s also wise to keep a symptom diary so you can note down any changes.
You are entitled to make a complaint if you believe your treatment (or management of the waiting list) has been mishandled. You do this by writing to the hospital’s Patient Advice and Liaison Service (PALS). In Wales, you can raise concerns through the NHS Wales Listening to People process. To lodge a more formal complaint, you can use the NHS complaints procedure.
If you are not satisfied with the way you have been treated or think that you have suffered avoidable harm as a result of a surgical delay, you may wish to seek legal advice.
Getting Legal Advice About Delayed Surgery
When you’re waiting for an operation that feels like it’s never going to happen, it can be incredibly frustrating and worrying. Your life feels on hold while you wait.
Unfortunately, long NHS waiting lists can make this a very real scenario for many people, but when a delay causes you further pain and suffering that could have been avoided, you could be eligible to make a claim for compensation.
At Mooneerams we have a dedicated team of medical negligence solicitors who will investigate your case thoroughly and give you an honest assessment as to whether we think you have grounds to make a claim.
We will listen, act with compassion and work hard to get you the compensation you deserve. We know no amount of money can make everything right, but it can go a long way toward making your life more comfortable and getting you back, as far as possible, to normality.
For more information or an informal chat, call us on 029 2199 1927 or complete our enquiry form.
Posted in Medical Examinations
