A patient who did not pay for the test privately dies of skin cancer after being refused it by the NHS

A coroner has issued a warning after a 24-year-old man died from skin cancer after deciding not to pay for a private medical test he may have contracted the disease.

Gregor Lane went to his GP in 2019 complaining of a “disturbing” lesion on the back of his neck but was told it did not fit the health service’s criteria for further investigation.

He then paid £140 to have it removed privately, but chose not to spend an additional £65 to send samples for analysis to see if it was a malignant tumor – a procedure that would have been free on the NHS, the inquest heard.

About 14 months later, with the lesion still bothering him, Mr Lane returned to his GP and was referred to a specialist who diagnosed him with skin cancer.

Scans showed that the disease had spread and despite treatment he died at Addenbrooke’s Hospital in Cambridge just over two years later.

Caroline Jones, assistant coroner for Cambridgeshire and Peterborough, has written to the NHS and Department of Health to raise concerns about the case.

In her report on preventing future deaths, she said that although she could not conclude that a laboratory test in 2019 would have detected Mr Lin’s cancer, she was disturbed that the cost of the analysis prevented it from happening.

Not eligible for NHS care

She said the extra cost was turning away patients who had to turn to the private sector because they did not qualify for NHS care.

“It is concerning that the barrier to undergoing a full procedure, including histological analysis, appears to be cost,” she said.

“Anecdotal evidence received on inquiry from treating clinicians was that the additional costs associated with histological or other review, which the NHS would routinely include within the procedure at no cost to the patient, was a common disincentive for patients who regularly choose not to to do that”. To conduct further tests.

“While it is recognized that there should be standards for routine and non-emergency procedures to be performed in the NHS, my concern is regarding the disparity in what is included in treatment when undertaken privately (where histological analysis is a separate and additional procedure) ). Cost) and what is routinely included as part of NHS treatment.

“Therefore it seems to me that there is a risk of future deaths if patients who do not meet the NHS referral criteria, and who have to pay for procedures to be carried out privately, on a cost basis choose not to have the histological analysis which could have been provided.” Otherwise.on the NHS free of charge, as it is a well-established fact that early detection and treatment is crucial in reducing the risk of metastatic cancer including skin cancer.

The inquest heard in August that Mr Lane first went to his GP in March 2019.

“He had a lesion at the back of his neck that was privately resected but the resected material was not sent for histological analysis, likely due to the additional cost associated with having to analyze the samples privately,” Ms Jones said.

“The consequence of Gregor not meeting referral criteria for NHS treatment on his initial presentation with a bothersome lesion on the back of his neck was that he had to self-refer for private treatment at an advertised cost of £140.

“He was informed that the additional cost of histological analysis of the extracted samples would be £65 and so he decided not to send the samples for analysis.

“More resection was done.”

“When the lesion continued to bother him in May 2020, he returned to his GP who referred him to a dermatology department, where a further excision was performed and analyzed and found to be skin cancer.

“An ultrasound scan showed that the melanoma had spread to the lymph nodes, chest wall and lungs.

“Despite immunotherapy and targeted oral therapy, the melanoma continued to spread, and in June 2022, scans showed it had spread to Gregor’s brain such that his condition had become fatal.

“He was placed on a palliative care pathway and after being admitted to Addenbrooke’s Hospital on 6 July 2022, he died on 8 July 2022.”

Mrs Jones recorded a verdict of death from natural causes.

The Department of Health, NHS England and the Cambridgeshire and Peterborough Integrated Care System have until February 14 to respond to its concerns.