A coroner has raised concerns about patients who fail to meet NHS treatment criteria and are forced to pay privately for tests after the death of a 24-year-old Cambridgeshire man.
Caroline Jones, assistant coroner for Cambridgeshire and Peterborough, has written a Prevention of Future Deaths report following the death of Gregor Lynn who died in July 2022.
Ms Jones carried out an investigation into Mr Lynn's death after hearing the circumstances of his treatment during an inquest.
In March 2019, Mr Lynn complained to his GP about a "nuisance lesion" on the back of his neck. He was told he did not meet the "referral criteria for NHS treatment" and he sought private treatment.
He was told there was an additional cost for histology and decided not to have the samples sent for analysis.
When the lesion continued to trouble him in May 2020, he returned to his GP who referred him for an ultrasound scan which showed the melanoma had spread to his lymph nodes, chest wall and lungs.
Despite treatment, in June 2022, scans showed it had spread to his brain and he was placed onto a palliative care pathway.
He died at Addenbrooke's Hospital, in Cambridge, on July 8, 2022.
Ms Jones said in her report: "I was not able to conclude that, had the sample been sent for analysis in March 2019, any sign of melanoma would have been detected.
"Nevertheless, it is of concern that the barrier to undergoing a complete procedure, including histological analysis, appears to be one of cost.
"Anecdotal evidence received at inquest from treating clinicians was that the further costs associated with histological or other review, which on the NHS would be routinely included within the procedure at no charge to the patient, was a common disincentive to patients who would regularly opt not to have the further tests carried out.
"While it is acknowledged that there have to be criteria for routine and non-emergency procedures to be conducted on the NHS, my concern relates to the disparity in what is included within the treatment when undertaken privately (where histological analysis is a separate and additional cost) and what is routinely included as part of NHS treatment."
"It therefore seems to me that there is a risk of future deaths if patients not meeting the NHS referral criteria, who have to pay for procedures to be carried out privately, opt on cost grounds not to have the histological analysis which would otherwise be provided on the NHS at no charge, as it is well-established fact that earlier detection and treatment is crucial in minimising the risks of developing metastatic cancers including melanoma."
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