Tuesday 23 April 2019

'Deeply flawed' disclosure policy unchanged – Scally

But CervicalCheck investigator's latest progress report finds work on revised system is 'on track'

Dr Gabriel Scally Photo: Frank McGrath
Dr Gabriel Scally Photo: Frank McGrath
Eilish O'Regan

Eilish O'Regan

The HSE's "deeply flawed" policy on when to tell patients that mistakes have been made in their care is still in place - months after an investigation into the CervicalCheck scandal called for it to be urgently changed.

The revelation is made in a new progress report by Dr Gabriel Scally, who delivered a damning inquiry into CervicalCheck last September.

His latest progress report - on how much headway has been made in implementing his 50 recommendations - found work on a revised system of open disclosure is "on track" but it will not be ready until the end of this year.

Most of the 221 women in the CervicalCheck scandal who developed cancer, and relatives of the deceased, only discovered last year that audits were conducted by the screening service showing they got incorrect smear test results.

The failure to come clean on the audits came despite the HSE having a policy since 2013 of open disclosure when mistakes are made.

An ex-gratia scheme is now being set up by the Government to compensate women and families affected by this breach.

In his inquiry report last September, Dr Scally said the HSE's open disclosure policy "should be revised as a matter of urgency." He wanted the revised policy to reflect the rights of patients to know of any failings in their care.

It was only after CervicalCheck campaigner Vicky Phelan took a High Court case in April last year that the existence of the audits became public.

Dr Scally, in his progress report, also refers to his original recommendation to establish an independent Patient Safety Council and train staff in open disclosure.

He said while the work so far "appears to be a reasonable response", it is notable "that the previous policy, which has been judged to be deeply flawed, remains in place".

The HSE recently indicated an interim open disclosure policy revision has been circulated for discussion.

Dr Scally's latest report - monitoring his recommendations - found that five have been completed and some are behind schedule. Most are "on track".

No actions have been planned yet to follow up on some of his recommendations relating to laboratories which carry out the screening.

His previous report called for further investigation into why laboratories were producing different results for a low-grade abnormality found in some women's slides.

No progress was made on this until CervicalCheck could recruit a specialist known as a Cytopathology lead.

It also emerged that auditing of tests after a woman has been diagnosed with cervical cancer is still on hold by CervicalCheck.

This form of lookback would examine if anything was missed in the test.

Dr Scally's report also found an expert group is reviewing clinical audit processes across all the screening programmes.

He said he is very encouraged with the progress so far.

The HSE and the Department of Health appear to have the resources to complete the actions but the HSE may be over-ambitious in frontloading so many of the recommendations with the aim of completing 82pc at the end of June. There may be "too many activities concentrated in one time period".

His "future progress reviews may find some of the activity has been subject to delay and has been unable to be completed as desired".

Dr Scally also said the Department of Health has few staff for whom implementing the recommendations is their sole job.

Irish Independent

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