Roy Millar

1. 1. lack of follow-up appointments

   “PHNT instigated a Root Cause Analysis following this incident, a copy of which is enclosed”

2. 2. lack of awareness of appointment booking responsibility

   “Neither the previous nor the current Ward Administrator were aware of their responsibility to book follow- up appointments for patients who had been discharged”

3. 3. 146 patients without follow-up appointments

   “146 patients die not have follow-up appointments booked”

4. 4. delayed diagnosis of brain tumour

   “had the follow-up scan been conducted in June 2015 this was likely to have led to a biopsy which would have diagnosed the brain tumour”

5. 5. reduced survival probability

   “he would have had a 50% chance of surviving for a year”

No published response was found on judiciary.uk.