Sussex NHS trust apologises for cancer treatment delays before man’s death

A troubled NHS trust has apologised to the family of a man who died after a series of delays led to him waiting four times longer for an operation than a national cancer target.

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

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

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

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

Valder was referred for a gastroscopy in September 2021 after he complained of problems swallowing. A month later, a suspected tumour in his oesophagus was identified.

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

A date for surgery to remove the tumour was eventually set for January 2022 but this was delayed amid disagreements among doctors about 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 that took place on 18 May when he was deemed fit enough for the operation. Under a national target, patients with cancer should begin treatment within 62 days of an urgent referral. In Valder’s case the wait was 254 days.

He survived the surgery and showed signs of recovering but later in the year the cancer had spread to his brain and he died in November.

In July 2022, Valder wrote to the trust complaining of being “written off and left to die” when he was denied an earlier operation.

In August 2022, the Care Quality Commission (CQC) suspended upper gastrointestinal cancer services at the trust due to “serious safety and leadership concerns” including poor attendance at multidisciplinary meetings leading to an insufficient mix of healthcare professionals overseeing cases such as Valder’s.

A month later, Dr Sarah Westwell, the head of the trust’s cancer division, said in an email seen by the Guardian: “The delay in this patient’s pathway has led to harm, moderate at least. This patient’s case should form the basis of a thematic review given the concerns over MDM [multi-disciplinary meeting] function concerns raised by the CQC.”

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

Before she died she accused the trust of negligence and “appalling mistakes” over her husband’s care.

Last month, an independent review was sent to their son Alex. It highlighted a number of delays and “lack of urgency to each and every step of the pathway” and that these contributed to the cancer becoming more advanced. But it backed the decision to delay surgery due to concerns about Valder’s fitness.

Alex Valder said the review failed to answer a series of complaints the family had raised.

He said: “Dad and all of us were happy to take the risk of the surgery going wrong because we didn’t like the alternative of him fading away 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 go through this.”

Prof Katie Urch, the trust’s chief medical officer, said: “I send my heartfelt sympathies to Mr Valder’s family and would like to apologise again 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 that is why we invited an independent specialist to review the care he received and ensure lessons would be learned.

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