‘A Practical Guide to Claims Arising from Delays in Diagnosing Cancer’ by Bella Webb


Paperback: 978-1-911035-98-5
Published: November 2018
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It is a sad fact that cancer remains the leading cause of death for both men and women in England and Wales. Cancer survival rates in the UK are and have for some years been a hot topic, with the media having published articles which suggest that Cancer Survival in the UK is the worst anywhere in Europe and indicating that late diagnosis of cancers in the UK may explain the poor survival rates in Britain compared with other countries.

It is not surprising against this background that legal action for delayed cancer diagnosis is on the rise, and yet surprising perhaps that there is so little written to help practitioners through the practicalities of taking on and managing these complex cases. ‘A Practical Guide to Claims Arising from Delays in Diagnosing Cancer’ will equip you with the tools to deconstruct and manage these legally and often factually complex and emotive claims through to trial, and provide a practical and easy to digest guide to the issues that the legal practitioner will need to consider.

The book provides a background to the history of such claims and the data which underlies them. It will guide you through the distinctions between different cancers and the impact of cancer “type” upon how the case is run, as well as understanding the NICE guidelines and other useful sources of information. That background is invaluable to understanding why these claims are so significant and the premise upon which they are based. From those foundations, you will learn how to review a potential claim, prioritising and managing evidence through to instructing experts, considering the often crucial issues of factual and legal causation and framing claims for the seriously ill, dying and bereaved. In each case the author will suggest practical approaches to the problems that such claims throw up.


Bella Webb is a barrister at Old Square Chambers. She has 18 years of experience with a flourishing practise in the clinical negligence and clinical regulatory fields, as well as undertaking broader personal injury work. She is used to working on high value and sensitive claims, where her empathetic, compassionate and professional approach allows her clients (be they Claimant or Defendant) to feel as at ease as possible and to have total confidence in her expertise.  Delayed cancer claims are a particular specialism and an area in which Bella has been developing her practise with great success in recent years. It is a subject upon which she speaks regularly.

Bella is credited in the Legal 500 as an advocate who “inspires confidence in clients.” (2015) and someone who “…is incredibly approachable and clients appreciate her warm and understanding approach.” (2017).


Chapter One – Introduction

Chapter Two – The History and the Science
The History
League Tables and Audits
The Science
Grade and Stage
i. Grade
ii. Stage and Staging Systems
Doubling Times

Chapter Three – The Opening Review of a Case – Use of Guidelines and Statistics
First Steps
Reviewing the Medical Records
Witness Evidence
The NICE Guidelines
How to Maximise Breach of Duty Submissions

Chapter Four – Different Types of Cancer and Their Varied Legal Impact
Multiple Consultations
Why are Some Cancers More Likely to Require Multiple Consultations?
How Does This Affect Breach of Duty?

Chapter Five – Experts
Expert Selection
The Right Experts?
Instructing the Experts

Chapter Six – Causation
Factual Causation
The Pitfalls of Expert Causation Evidence
Reliance upon Data for Differing Cancer Types or Reliance Upon Data at the Expense of Histology and Symptom Presentation
Life Expectancy Data

Chapter Seven – Legal Causation
Causation in a Clinical Negligence Setting
Loss of Chance
Lost Years Claims
Material Contribution? The Future?

Chapter Eight – Client Care and Framing the Case
Framing the Case
How and When to bring Proceedings
The Primary Options
Provisional Damages
Periodical Payments
Drafting Complexities