The government has published an update on their response to the recommendations of the Independent Inquiry into the issues raised by the criminal malpractice of convicted breast surgeon Ian Paterson in a statement made to the House of Commons on 23 March 2021 by Nadine Dorries MP, Minister of State (Department of Health and Social Care).
In her earlier statement to Parliament on 28 April 2020, Ms Dorries announced a delay due to the Covid-19 pandemic and today’s statement is presented as a ‘pragmatic response’ to five of the 15 recommendations made by the Independent Inquiry with a promise of a fuller official response during the course of 2021.
In addition three immediate legislative actions were announced to improve patient safety and scrutinise the care provided by the independent sector, including the appointment of a Patient Safety Commissioner (PSC) for England with responsibility for medicines and medical devices (a role established in the Medicines and Medical Devices Act which achieved Royal Assent on 11 February 2021) and legislative proposals for the Health and Care Bill to extend the remit of the Health Service Safety Investigation Branch to private providers.
The statement described the following specific responses to the recommendations made by the Independent Inquiry:
- Information to patients (recommendation 2 of the inquiry): it should be standard practice that consultants in both the NHS and the independent sector should write to patients, outlining their condition and treatment, in simple language, and copy this letter to the patient’s GP, rather than writing to the GP and sending a copy to the patient. NHS England and NHS Improvement will review guidance on writing outpatient clinical letters addressed to patients and how the use of simple language can be incorporated into the requirements of the NHS standard contract.
- Consent (recommendation 4 of the inquiry): patients should be allowed more time to reflect on their diagnosis and treatment options before giving consent as part of ‘Good Medical Practice’. The GMC will work with organisations across the UK’s health services to support doctors to embed this into their everyday practice.
- Multidisciplinary teams (recommendation 5 of the inquiry): as a matter of urgency the Care Quality Commission (CQC) should assure itself that all hospital providers are complying effectively with up-to-date national guidance on Multidisciplinary Team (MDT) meetings, including in breast cancer care, and will work to ensure this is a mandatory element in its future assessments and inspections.
- Patient recall and ongoing care (recommendations 7 and 8 of the inquiry): Specifically, the government response was that University Hospitals Birmingham NHS Foundation Trust should check that all patients of Paterson have been recalled and communicate with any not yet seen. In the private sector, the Minister of Sate recommended that Spire Healthcare should check that all patients of Paterson have been recalled and have been given an ongoing treatment plan in the same way that has been provided for patients in the NHS.
Kashmir Uppal comments:
“I welcome this interim update from the government, especially the legislative measures designed to improve patient safety and transparency and look forward to the promised fuller response later in the year. The extension of scrutiny by the Health Service Safety Investigation Branch to the private sector is also important. We need to ensure that the disparity between the NHS and the private sector in relation to liability and indemnity is addressed to ensure better clinical governance and thereby patient safety. I also note that Spire Healthcare have contacted all known patients treated by Ian Paterson at their hospitals (approximately 5,500), and I trust that Spire will agree to a sensible way forward for dealing with any claims that arise out of this recall.”