Delayed Cancer Diagnosis Claims Against GPs in 2026. What the Breach of Duty Evidence Must Show and How Reports Are Prepared

Written By Sama Samy

Delayed diagnosis of cancer is one of the commonest and highest-value claims in primary care, and it turns on two separate questions answered by two kinds of expert. Breach of duty asks whether the GP’s care fell below the standard of a reasonably competent GP, judged against the guidance and practice in force at the time, above all the NICE NG12 criteria for urgent referral for suspected cancer, and that opinion must come from a GP. Causation asks what would have happened with timely referral, and in England it must be proved on the balance of probabilities, because the House of Lords in Gregg v Scott refused to compensate a lost chance of a better outcome that was below 50%. The system context makes these claims frequent. In March 2026, 79.4% of patients in England received a diagnosis or had cancer ruled out within the 28-day Faster Diagnosis Standard against a target of 80%, and 72.8% started treatment within 62 days against 75%. NHS Resolution received 14,428 new claims and reported incidents in 2024/25, with damages of almost £2.3 billion. The Wellness Medico-Legal Wing provides CPR Part 35 compliant GP breach of duty reports for delayed cancer diagnosis claims from £4,950 plus VAT, with records screening opinions from £750 plus VAT, priced at the senior consultant tier. Instructions are accepted nationally from claimant firms, defendant organisations and insurers.

Reviewed by the medical team at The Wellness. Last updated 9 October 2026.

Discuss a delayed diagnosis case on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

Key facts for instructing solicitors

  • Breach of duty in a claim against a GP needs evidence from a GP, applying Bolam and Bolitho.

  • The relevant version of NICE NG12 is the one in force at the date of each consultation, not the current one.

  • Causation needs specialist evidence, usually oncology, and must be proved on the balance of probabilities.

  • Following Gregg v Scott, a lost chance of a better outcome below 50% is not recoverable in personal injury.

  • A records screening opinion tells a firm within 10 working days whether a file justifies full investigation.

What does breach of duty mean in a delayed cancer diagnosis

The standard is that of a reasonably competent GP. Under Bolam, a GP is not negligent if they acted in accordance with a practice accepted as proper by a responsible body of GPs. Under Bolitho, that practice must withstand logical analysis.

NICE NG12 sets out the symptoms, signs and test results that should prompt referral on a suspected cancer pathway or urgent investigation. It is guidance rather than law, and departing from it is not automatically negligent, but a GP who did not refer a patient who clearly met the criteria will need a reasoned explanation. The guideline has been updated many times, so the expert must apply the version in force on the date of each consultation.

The expert also considers the wider standard of care, including history taking, examination, documentation and safety-netting.

What are the commonest breach patterns

Failure to refer when a patient met the criteria for urgent referral, such as a breast lump in a woman over 30, rectal bleeding with a change in bowel habit, or unexplained weight loss with relevant symptoms.

Failure to act on a test result, such as an iron deficiency anaemia left uninvestigated, a raised PSA filed without action, or a faecal immunochemical test result at or above the referral threshold.

Failure to safety-net, so that the patient was not told what to watch for and when to return, or was not followed up when a test was outstanding.

Failure to reconsider on re-attendance, where repeated consultations for the same symptom were treated each time as a new minor problem.

Remote consultation without examination, where a telephone or video assessment was used when the symptoms required the patient to be seen.

Request a screening opinion on WhatsApp or email team@thewellnesslondon.com.

Why is causation the real battleground

Breach alone wins nothing. The claimant must show that, on the balance of probabilities, earlier referral would have led to a different outcome, such as an earlier stage at diagnosis, less radical treatment, a cure that was otherwise lost, or a longer life.

In Gregg v Scott the House of Lords held that a claimant whose chance of a better outcome was reduced, but was below 50% throughout, could not recover for the loss of that chance. Causation therefore needs careful specialist evidence, usually from an oncologist, and sometimes from a radiologist or surgeon on tumour growth, staging and treatment.

A GP breach report should hand causation experts a clean, dated chronology, identifying each point at which referral should have occurred and the earliest date on which the claimant would have been seen.

What should a GP breach of duty report contain

A full chronology from the GP records, hospital letters and test results, with each relevant consultation identified.

The guidance and practice in force at each date, including the relevant version of NICE NG12.

A clear opinion, consultation by consultation, on whether the care was within the range of reasonable practice, with reasons and the range of opinion where it exists.

The date by which, on the expert’s view, a reasonably competent GP would have referred, and the likely time to specialist assessment.

Concessions where the records require them. Reports that concede what should be conceded carry more weight, which matters in a system where 83% of clinical claims are resolved without court proceedings.

What about limitation

The primary limitation period for personal injury is 3 years from the date of the injury or, if later, the claimant’s date of knowledge, under the Limitation Act 1980. In delayed diagnosis claims, the date of knowledge is often when the claimant learned that the delay may have made a difference. Different rules apply to children, to people who lack capacity and to claims after death. Instructing solicitors should obtain a screening opinion early when limitation is close.

What do delayed diagnosis expert reports cost

Across the market, breach and causation reports from consultant-level experts commonly run from £1,500 to £3,000 plus VAT and considerably beyond in complex claims, with hourly rates from £250 to £450 plus VAT, senior experts above £500, and court attendance at £1,000 to £3,000 per day.

The Wellness Medico-Legal Wing prices at the senior consultant tier. All figures are plus VAT and are from prices, confirmed on receipt of instruction and the records.

  • Court attendance, from £3,500 per day and £2,250 per half day.

  • GP breach of duty report for a delayed cancer diagnosis claim, from £4,950.

  • Commentary on opposing expert evidence, from £1,450. Joint statement and expert discussion, from £1,450.

  • Records screening and merits opinion within 10 working days, from £750.

  • Part 35 questions, from £650. Records review and chronology preparation, from £395.

  • Expedited 5 working day turnaround at a 50% surcharge.

Fees are payable on instruction, with account terms of up to 30 days from invoice available to established instructing firms, and are never conditional on outcome.

Why instruct The Wellness Medico-Legal Wing

Because breach of duty comes from GPs in active practice, the peer group the law requires.

Because the report applies the guidance in force on each date, consultation by consultation, rather than today’s standards in hindsight.

Because the chronology is built for the causation experts, with each referral date identified.

Because concessions are made where the records require them, which is what gives a report weight.

And because the screening tier gives firms, funders and insurers a fast, priced answer before money is committed.

Related reading

Medical negligence expert reports covers primary care breach and causation generally, instructing a medical expert witness covers CPR Part 35 and the letter of instruction, inquest medical reports covers evidence for coroners, and life expectancy expert reports covers catastrophic claims.

Instruct a report on WhatsApp or call 020 3951 3429.

Frequently asked questions

Who should give breach of duty evidence in a claim against a GP

A GP. Courts expect breach of duty to be judged by the standard of the same discipline, so evidence on what a reasonably competent GP should have done comes from a GP in practice.

Is not following NICE NG12 automatically negligent

No. NICE guidance is not law, and departing from it is not automatically negligent. A GP who did not refer a patient who clearly met the criteria will, however, need a reasoned and logical explanation, and the version in force at the time applies.

Can you claim for a lost chance of survival

Not in English personal injury law where the chance was below 50% throughout. In Gregg v Scott the House of Lords refused to compensate a reduced chance of a better outcome. The claimant must prove on the balance of probabilities that earlier diagnosis would have changed the outcome.

How long do I have to bring a delayed cancer diagnosis claim

Generally 3 years from the injury or the date of knowledge, if later, under the Limitation Act 1980. Different rules apply to children, people who lack capacity and claims after death.

How much does a GP expert report cost for a delayed diagnosis claim

At The Wellness Medico-Legal Wing a GP breach of duty report is from £4,950 plus VAT and a records screening opinion from £750 plus VAT, payable on instruction.

Do you act for defendants as well as claimants

Yes. The wing accepts instructions from claimant firms, defendant organisations and insurers, which keeps the expert’s independence meaningful.

The Wellness is a doctor-led private healthcare group providing medical care and independent medico-legal reporting from our London clinics, including Marylebone. All doctors are GMC-registered. Expert reports are prepared in accordance with CPR Part 35 and the expert’s overriding duty to the court. This article is general information and not legal advice about any individual case.

Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

References

Sama Samy
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