Safe care for noncommunicable diseases: Lessons from delayed diagnosis of cancer claims

17 September 2026 marks the seventh World Safety Organisation (WHO) World Patient Safety Day with the slogan “Safe care for life!”. This year the campaign seeks to raise awareness of the patient safety risks of noncommunicable diseases (NCDs).

NCDs are long-term conditions, such as cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, that can affect people of all ages. NCDs typically require ongoing care across multiple settings and over long periods, creating multiple points where patient safety risks can arise - from prevention, early detection and diagnosis to treatment and long-term management. In fact, NCDs account for the majority of global deaths (74% of deaths worldwide) with delayed diagnosis recognised to be one of the most common contributory factors to patient safety incidents and avoidable harm.

World Patient Safety Day highlights the importance of:

• joined up health systems with the ability to provide timely access to care; 
• the need for continuous and coordinated care across the continuum of care and in daily life;
• strong, integrated health systems and a supported heath workforce; and
• meaningful patient engagement with patients, families and caregivers being actively engaged as partners in their care. 

Safe care: Learning lessons from the diagnosis and treatment of cancer 

The diagnosis and treatment of cancer provides a good illustration of some of the patient safety issues relevant to NCDs more broadly. One year on from the publication of NHS Resolution’s ‘Delayed Diagnosis of Cancer - A Thematic Review of General Practice Indemnity Claims’ (October 2025), it is worth revisiting the findings.

The review analysed 105 closed settled clinical negligence claims relating to the delayed diagnosis of cancer in general practice over a seven-year period to March 2023. There were three broad themes identified relating to the diagnostic process, communication within the consultation and beyond, and (lack of) patient power. Many of key findings have wider relevance to the diagnosis and treatment of other NCDs:  

1. Lack of diagnosis, differential diagnosis and diagnostic overshadowing

The data showed that a patient's diagnosis on the first presentation to general practice was key to the safety-netting advice and follow-up instructions subsequently given. Diagnostic overshadowing was apparent as patients who suffered from existing long-term conditions were under several specialists, and those who had been recently discharged by specialists were particularly likely to experience delays in their referral and diagnosis of cancer. 

Patients with NCDs may have several chronic conditions, and care must address their physical health, mental health, functional status, and the social determinants of health and look beyond the established diagnosis.

2. History taking in remote consultations

Remote consultations featured in 53% of the claims analysed, and limited details about the impact of symptoms, progression of symptoms, risk factors or changes in symptoms suggested insufficient history taking was a factor in most claims. Safety net instructions were often not detailed, contributing to poor monitoring and follow-up of symptoms and highlighting an increased need for comprehensive history taking and assessment.

Patients who spoke to NHS 111 and attended out-of-hours services experienced increased fragmentation of care, with these visits not always reflected in GP records, obscuring ongoing care needs and visibility over which actions would be owned by the patient or GP.

3. Management of patients under existing and multiple specialties

Of primary care claims, 24.8% had an associated secondary care claim, with cases where patients were discharged from secondary care with requests for monitoring at specific intervals. These could be missed in documentation – the review found examples of reliance on clinic letters for the transfer of information without a specific call to action. 

4. Gender disparities in early-onset cancer

73.5% of claimants aged under 50 years were female, with higher rates of metastasis at diagnosis, indicating potential gender disparities in early-onset cancer detection. Factors such as caregiving responsibilities, available support, work flexibility, financial stress and reduced leisure time can negatively affect women's ability to access healthcare services. This may inadvertently add further delay to their recognition of ill health and seeking of medical attention, an issue that could also apply to the diagnosis and ongoing management of other NCDs.

Safe care: Applying the lessons to improve the diagnosis and treatment of other NCDs

It is clear that those living with long-term conditions face particular risks at the intersection of complexity and fragmentation - where multiple specialists, repeated consultations and remote care create opportunities for symptoms to be inadvertently misattributed, overlooked or inadequately followed up. 

Whilst the NHS Resolution review is focused on delayed diagnosis in cancer in primary care, it identifies lessons for the safe management of NCDs more broadly. Crucially, the review highlighted that it was the content and outcome of the appointment - rather than access to general practice - where missed opportunities could be identified: the quality of the consultation, the safety-netting advice given, and the patient's ability to advocate for themselves within a complex system are the factors most likely to determine whether harm is avoided and these issues are all equally relevant to the diagnosis and treatment of NCDs. 

Clinicians mush be supported to enable them to adopt a patient-centred approach to diagnosis and treatment, and interventions need to consider system and process design improvements which recognise the role of human factors and rely less on individual resilience. 

This includes configuring digital systems to flag repeat attendance across care settings, strengthening the interface between primary and secondary care to ensure clear accountability for onward referrals and monitoring, and expanding self-referral pathways so that patients can escalate concerns without being dependent on a single gatekeeper through primary care. Addressing health inequalities must also sit alongside these systemic improvements if safe NCD care for life, as called for by World Patient Safety Day, is to be equitable as well as effective.