In a development that will surprise absolutely no one who has ever tried to book a specialist appointment, a 70-year-old man died of eye cancer after the NHS in Wales failed to schedule a recommended follow-up. Alexandar McDonald passed away at Grange University Hospital in Cwmbran, Torfaen, on 30 November 2025, from metastatic choroidal melanoma - a fancy way of saying eye cancer that spread. An inquest found he could have started treatment six months earlier, which is roughly the amount of time you'd spend on hold with a booking system.

The inquest heard that McDonald attended an urgent ophthalmology appointment in June 2022 after a routine eye test raised concerns following a scan. A consultant determined he needed to be reviewed again in six months. Spoiler: he wasn't. At a routine check-up in June 2023, concerns were raised again, and a further scan finally led to a diagnosis. Gwent area coroner Rose Farmer concluded that had McDonald received the recommended follow-up, the melanoma would have been caught six months earlier, with treatment beginning almost immediately. Instead, he underwent several treatments after the delayed diagnosis, but the cancer metastasised to his liver, leading to his death.

Farmer warned that more patients in Wales are at "significant risk," noting that 140,000 ophthalmology follow-up appointments are awaiting review, with just 65 consultant ophthalmologists available. That's a ratio that would make even the most optimistic NHS statistician weep. In a prevention of future deaths report to the Welsh government's department for health and social care, she cited "substantial delays in ophthalmology follow-up appointments across Wales" and said capacity "appears insufficient to meet the demand." The absence of a national mechanism means those requiring surveillance for ophthalmic conditions "may experience prolonged delays," she added. "This case demonstrates the impact of not having timely follow up appointments," Farmer said. "Similar delays may place other patients at risk of delayed diagnosis of malignancy and death."

The Welsh government responded with the standard-issue statement: "It is vital that lessons are learned from this tragic case, caused by unacceptable failings in the management of referrals, and our thoughts are with the family of Alexander McDonald." They promised that all health boards should have standard operating procedures to manage capacity and ensure patients are reviewed within clinically intended timescales, and that they will "robustly hold health boards to account for performance." Because nothing says accountability like a strongly worded letter.

Mohamed Elalfy, president of the Royal College of Ophthalmologists, said services in Wales face "a number of long-standing challenges, including dilapidated estates, workforce shortages and poor IT infrastructure." He called the implementation of reforms "an urgent priority." Which is reassuring, given that the alternative is apparently just hoping patients remind themselves to come back.

In other news that will make you feel great about the state of the world: a mechanic who falsified an MOT before a crash that killed three people got a community order, a woman died after suffering 55% burns when a paint can exploded in a fire, and Ray Winstone charmed locals in a Welsh market town. Priorities, eh?