NHS Greater Glasgow and Clyde has apologised.
13:36, 24 Jul 2026Updated 16:04, 24 Jul 2026
Royal Infirmary(Image: Getty Images)
NHS Greater Glasgow and Clyde has apologised after a man undergoing chemotherapy for bowel cancer died after his surgery was delayed twice.
The Public Service Ombudsman, who investigated the incident, said that the man had developed abdominal pain and took advice from a cancer helpline, which admitted him to the Beatson Cancer Centre. A CT scan found that he had a bowel blockage and a transfer was planned to the Glasgow Royal Infirmary for surgery.
However, it was delayed twice due to the lack of available beds. During this time, the man’s condition declined significantly, and a scan confirmed his bowel had become perforated.
He was rushed to the hospital for an emergency surgery, but he suffered complications. It was deemed that further surgery was unlikely to be successful.
Treatment was withdrawn, and the man later died. A Significant Adverse Event Review (SAER) found that the delayed transfer directly contributed to his death.
The review identified ‘multiple additional failings’ in his care that ‘led to substandard care’. The man’s partner complained to the Public Service Ombudsman about the care and treatment of their parent.
They found ‘poor overall clinical management also played a significant role’ in the man’s death and that the board ‘did not provide reasonable care and treatment.’
In their report they wrote: “We took independent advice from an colorectal surgeon adviser. While the board acknowledged the delayed transfer, we found that poor overall clinical management also played a significant role. As a result, we upheld the complaints that the board did not provide reasonable care and treatment to A and did not reasonably administer their transfer.
“C (his partner) also complained about delays and shortcomings in the SAER process. Although the board apologised for delays, we found that the review was too narrow in scope, focusing mainly on the transfer issue and failed to address broader concerns about earlier care and decision-making. This limited the potential for wider learning. We upheld this aspect of the complaint.”
NHS Greater Glasgow and Clyde was ordered to apologise, and recommendations were set out. These include:
Patients with potential surgical issues in a non-surgical setting should have early consideration of surgical input and/or transfer to reduce the risk of misdiagnosis. Patients with a diagnosis of bowel obstruction and risk of perforation should be escalated for urgent consideration of surgery, even where observations and bloods are stable.There needs to be provision of same day and out of hours CT scanning of patients presenting with acute symptoms. Reporting of urgent CT scans needs to be timely and in real time to ensure prompt treatment.CT scan reports should be clear and detailed to guide diagnosis and treatment.Unwell patients should have ongoing daily input at consultant level, including weekends.Adverse event reviews should be broad enough to identify areas of missed learning, rather than focussed on the obvious cause.The board should ensure the SAER recommendations fully address the failings found.
Russell Coulthard, NHS Greater Glasgow and Clyde, Chief Operating Officer for Acute Services said: “We would like to reiterate our apology to the family of this patient, and we send our condolences for their loss.
“Patient safety is our highest priority, and we are sorry that the level of care that this patient received did not meet the standard required. Due to patient confidentiality and respect for the family’s privacy, it would not be appropriate to comment further on the individual circumstances of this case.
“We have fully considered the report and accept the recommendations that have been made. We are working with our teams to ensure learning is taken forward and that the recommendations are met in full.”