Nine year old Dylan Cope died from sepsis. His GP had suspected appendicitis and sent him to hospital. A paediatric nurse practitioner assessed him in A&E without reading the GP’s referral. His abdominal pain was attributed to flu and he was discharged without a documented examination by a doctor. The coroner concluded that his death could have been avoided. Dylan’s family have suffered an unimaginable loss. As a doctor working in general practice, what stands out to me is that his GP had recognised the possibility of appendicitis and referred him for further assessment. That concern needed to be heard and acted on. When we refer a patient with a suspected serious illness, we need to know that the concern prompting that referral will be properly assessed. A different diagnosis may emerge, but the referral’s findings must be considered before a patient is sent home. Dylan’s father told the inquest that he believed the practitioner assessing his son was a doctor. He also repeatedly raised concerns about appendicitis. Families deserve clarity about who is treating their child and to have their concerns heard. This case raises serious questions about how referrals are handled and when an examination by a doctor must take place. Employers must ensure that supervision arrangements translate into the assessment a patient actually needs. There is also a wider discussion about advanced practitioner roles. The BMA recognises their valuable contribution within healthcare teams. It calls for nationally agreed limits of practice and clear supervision requirements, with advanced practitioners supporting medical teams rather than replacing doctors on clinical rotas. Its position is that they should not independently diagnose or manage patients whose underlying condition has not yet been established. I support those safeguards. Clear responsibilities protect patients and support staff to practise safely. Dylan’s parents are asking for children referred to A&E by a GP with suspected serious illness to receive a documented, face to face examination by a senior doctor before discharge. That is a call we should take seriously. They should not have had to lose their son to ask for it. telegraph.co.uk/news/2026/10…