Sussex NHS Trust apologizes for delays in cancer treatment before man’s death

A troubled NHS trust has apologized to the family of a man who died after a series of delays led to him having to wait four times longer for surgery than a national cancer target.

Before he died in November 2022, Ken Valder, 66, a former tax inspector and volunteer steward at Brighton & Hove Albion football club, complained of “delays after delays” in his treatment for oesophageal cancer.

University Hospitals Sussex – the focus of a separate police investigation into allegations of surgical negligence and cover-up over dozens of deaths between 2015 and 2021 – admitted that errors, failures and disagreements between surgeons contributed to delays in Valder’s treatment.

They also accepted that the case highlighted patient safety concerns that led the hospital regulator in 2022 to suspend upper gastrointestinal cancer services at the trust, which also includes the Royal Sussex County Hospital belongs in Brighton.

An independent review of the case also found that Valder’s care was “suboptimal” and that if he had undergone surgery earlier it “could have led to a better oncological outcome.”

Valder was referred for a gastroscopy in September 2021 after complaining of swallowing problems. A month later, a suspected tumor was identified in his esophagus.

In early November it was agreed that he needed an endoscopic ultrasound examination, but this did not happen until January 10, 2022 due to equipment failures, administrative errors and holidays.

A date for surgery to remove the tumor was eventually set for January 2022, but it was postponed due to disagreements between doctors over whether Valder was fit enough to undergo the operation as he had lost weight. There were then delays in fitting Valder with a feeding tube. And despite Valder’s desire for surgery, he was told that palliative radiotherapy would be a better option.

In April 2022, Valder’s care was reviewed and he was referred to Guy’s and St Thomas’ in London for surgery which took place on May 18, when he was deemed fit for the operation. According to a national target, patients with cancer should start treatment within 62 days of an urgent referral. In Valder’s case, the waiting period was 254 days.

He survived the operation and showed signs of recovery, but later that year the cancer had spread to his brain and he died in November.

In July 2022, Valder wrote to the trust complaining that he had been “written off and left to die” when he was refused previous surgery.

In August 2022, the Care Quality Commission (CQC) suspended upper gastrointestinal cancer services at the trust due to “serious safety and leadership issues”, including poor attendance at multidisciplinary meetings, leading to an inadequate mix of health care professionals who oversaw cases like Valder’s.

A month later, Dr Sarah Westwell, head of the trust’s cancer unit, said in an email seen by the Guardian: “The delay in this patient’s journey has resulted in harm, at least moderate. This patient’s case should form the basis for a thematic review, given the concerns about the MDM (multidisciplinary meeting) function raised by the CQC.”

An apology letter to Valder’s widow, Margaret, sent on behalf of the trust’s chief executive, Dr George Findlay, acknowledged that some of the CQC’s concerns were “relevant to the care Ken received”. She died in February this year after delays in heart surgery at the same hospital in Brighton.

Before she died, she accused the trust of negligence and “terrible mistakes” in her husband’s care.

An independent review was sent to their son Alex last month. It pointed out a number of delays and a “lack of urgency at every step of the way” had contributed to the cancer becoming more advanced. But it backed the decision to postpone the operation due to concerns about Valder’s condition.

Alex Valder said the review did not answer a series of complaints made by the family.

He said: “Dad and all of us were happy to take the risk of the operation going wrong because we didn’t like the alternative of him disappearing and palliative care. He said he would rather die on the operating table than fade away and become a burden to everyone.

“We don’t want other families to have to experience this.”

Prof. Katie Urch, the trust’s chief medical officer, said: “I extend my sincere condolences to Mr Valder’s family and would once again apologize for the distress caused by the delays and shortcomings in his care.

“Mr Valder’s illness was complex and the team caring for him faced difficult decisions about the most appropriate treatment.

“However, we take his family’s concerns very seriously and have therefore invited an independent specialist to review the care he has received and ensure lessons are learned.

“We remain committed to always improving and have made good progress in reducing wait times for care.”