"Nothing!"

About: University College Hospital

What I liked

Nothing!

What could be improved

I had thyroid nodule biopsy. No one was getting back to me with the result despite my numerous phone calls to the secretary. Almost a month later I was informed that my result is abnormal and I need to be seen urgently.

I was diagnosed with Thyroid cancer and required surgery. At the time of review with both Endocrinologist and Surgeon the USS report was not “on the system“. I was asked to have another USS urgently. When went to book it, the clerk advised that the report was on the system so I had to ask for copy and inform the consultant. I was then left to decide as to who much of my thyroid I would like to remove (total vs. partial). I found it extremely difficult to reach a decision without doctor’s guidance given that I also had to cope with psychological aspect of the cancer diagnosis. When I asked as to when my case will be discussed at the MDT meeting (as all cancer cases should), I was advised that that was not necessary as “we now what to do”.

Surgery was booked. I have made arrangement at work for sick leave. Suddenly, the consultant phones me to say that the surgery is cancelled as I might not need one. I was told that repeat USS+FNA will be organized. 2 weeks later I heard nothing.

Anything else?

I went to my GP to ask to transfer my care to an alternative hospital as it was almost 4 months since my initial appointment at UCLH and no progress with my treatment.

I was seen at Royal Marsden hospital the following week. Repeat FNA was normal. The slides from UCLH were reviewed and reported as normal as well.

In a way I was lucky that UCLH was so inefficient and disorganized. Otherwise my thyroid gland could have been taken for no reason with the need to take medication for the rest of my life. Let alone taking unnecessary risk of a neck surgery and its possible complications

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Responses

Response from University College Hospital

We are extremely saddened to read about the experience of this patient. We pride ourselves on offering a high quality service and the comments left by this patient indicate, that on this occasion, we did not offer the level of care that we would have expected.

The thyroid nodule biopsy (diagnostic test referenced in this case) can be arrange on the day as either a walk-in request or following a referral from the doctor and patients are offered an outpatient appointment two weeks after the date of their procedure to discuss the results so it is highly unusual for someone to wait a month without their results.

In the unfortunate circumstances that an abnormal result is found, we offer patients an appointment with a specialist very quickly to discuss the results and any possible treatment options. All patients with confirmed cancer should be discussed at the frequent MDTs (multi-disciplinary team) meetings where all clinicians agree on the most appropriate course of treatment for the patient. We would very much like to review the details of this case to understand whether or not this case was discussed at the MDT and if not, why it wasn't discussed. However, without the specific patient details, we are unable to check whether or not the patient was discussed at the MDT and why it took so long for the results to be communicated to the patient.

When patients require surgery or any form of treatment, our doctors and nurses counsels each patient on a one-to-one basis to ensure that they are aware of, and understand, all the options available to them. The team would always offer the patient their professional opinion on the most appropriate clinical course of treatment but would also ask the patient what type of treatment they feel is right for them. There are lots of reasons why patients may wish to consider alternative treatments and we take this into account when discussing their care plan with them. Again, we are unable to comment on the specifics of this case without more details but are saddened that the discussions around possible treatments was not conducted in a sensitive and helpful manner in the case of this patient.

The experience of our patients is very important to us, and in order for us to improve we would like to review the specifics of this case in much more detail as the patient raises some very valid points. We would encourage whoever made these comments to provide us with some more personal information so that we can fully investigate his / her case. You can reach us in confidence via Patient Advice and Liaison (PALS) on 020 3447 3042 or PALS@uclh.nhs.uk.

We are pleased to read that the patient did not require surgery and received excellent care at the Royal Marsden. We wish them the very best for the future and thank them for their comments.

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