Betsi Cadwaladr: MS patient felt doctors did not believe him

A patient suffered "significant injustice" after a consultant in England failed to diagnose him with multiple sclerosis, an ombudsman has found.

David Purnell, 47, from Anglesey, said he felt doctors did not believe him.

He was referred to services in England by Betsi Cadwaladr health board.

Public Services Ombudsman for Wales Michelle Morris said the health board had "failed" in "adequately monitoring and overseeing commissioned care".

In a report following a complaint from Mr Purnell, she added the failure to diagnose him with multiple sclerosis (MS) had led to "unnecessary anxiety and uncertainty".

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Betsi Cadwaladr University Health Board has apologised and said it was "implementing changes" in monitoring care for those referred to trusts in England. 

Mr Purnell, who is noted as "Mr A" in the report but has since spoken to BBC Wales, described how he was referred by his GP to neurology services at Ysbyty Gwynedd hospital in Bangor in February 2018.

This was after he displayed "mobility issues, tiredness, jerks and spasms".

Mr Purnell was first of all referred to Ysbyty Gwynedd in Bangor

Three months later, he was seen by a consultant neurologist at a trust in England and underwent an MRI scan.

While Mr Purnell said it explained the root cause of his sciatica, he felt it had not explained other symptoms.

He argued for further tests and a second opinion, but the first neurologist pushed for psychological reports due to his "severe anxiety and depression", the report added.

After returning to his GP several months later, Mr Purnell was referred to another consultant neurologist at a trust in England who saw him on 19 September 2019.

He was diagnosed with MS on 14 November that year - 16 months after his initial referral.

"When I noticed problems, I started to run to get myself fit, but I felt like I was running in potholes every time I took a step, so I thought 'there is something wrong here'," Mr Purnell said.

Ombudsman Michelle Morris said "unnecessary anxiety and uncertainty" was caused

Though doctors told him his scans were clear, he was adamant there was something wrong and kept pushing.

During the period of waiting for a diagnosis and lobbying for treatment, Mr Purnell said his condition deteriorated, adding: "Stress is a really bad thing for MS.

"No-one believed me, so things were getting worse and I was having to go to work because I was getting no support - everything was really hard."

Mr Purnell said finally getting his diagnosis was really important as it meant he was able to claim benefits and get help.

Ombudsman Ms Morris emphasised that an earlier diagnosis would not have altered his illness, but expressed concern over the delay and the attribution of his symptoms to psychological factors, which caused "unnecessary anxiety and uncertainty".

She found the time taken to diagnose the condition fell below the appropriate standard of care and this had caused Mr Purnell to miss out on some benefits, ordering the health board to pay him £6,835.38.

'Significant injustice'

Ms Morris said when the concerns were escalated to the health board, she was troubled to learn the trust in England did not properly review the care delivered.

Though Mr Purnell received his treatment in England, Betsi Cadwaladr health board was deemed to be responsible for its monitoring and overseeing, as it had commissioned the care.

"This was a significant injustice," Ms Morris said.

"I am concerned that the health board, both at commissioning level and in its own right, failed to ensure that the trust fully acknowledged and recognised the extent of failings evident in the case."

In conclusion the ombudsman upheld Mr Purnell's complaint that there was a failure to diagnose him with MS between May 2018 and September 2019.

However, it did not uphold a complaint that the health board should have explored a local referral due to local waiting lists.

Betsi Cadwaladr health board's deputy chief executive, Gill Harris, said she "sincerely apologised" to Mr Purnell.

"We have accepted the ombudsman's recommendations and are implementing changes in how we monitor patient care for those referred to hospital trusts in England," she added.

Ms Harris said the report would be shared with the NHS Trust in England that provided the care to support improvement.