NHS Chief Executive, Matthew Kershaw (Brighton and Sussex University Hospitals), has released a statement informing of a “clinical error” which has now left patient, Brian, with terminal lung cancer.

In January 2010, Brian was referred to the hospital from his GP as he had severe anaemia. He was a life-long smoker who had recently lost weight. That day Brian had a blood transfusion as well as a chest x-ray. He was feeling much better the next day and was discharged, but no one had followed up on his chest x-ray.

In 2013, Brian went to see his GP for a cough which he couldn’t shake off, and was again referred to the hospital. Another chest x-ray was performed, showing a mass in his lung. Only then was the previous x-ray looked at where it became apparent that a smaller and less obvious mass had been there in 2010.

The patient was then invited to their public board meeting in which he was asked what, if he had the opportunity, he would say to a group of F1 (Foundation) doctors about to embark on their hospital careers. He answered: “I’d tell them to be careful and the rest is up to you – they’re your doctors”.

Matthew Kershaw then responded with, “He is of course right. The extensive changes we have made to our systems and processes will reduce the likelihood of the same mistake happening again. But despite our best efforts people are fallible, they get distracted, they forget things and they make mistakes.”

This story of Brian shows yet another failing of the NHS, where a patient has been discharged without thorough checks, and now has to live with terminal lung cancer. Brian’s life would have likely turned out very differently if the mass had been spotted back in 2010.