In 2007, a review of breast surgery services provided through Solihull Hospital, identified that a surgical technique performed for some mastectomies by one of our consultants, Mr Ian Paterson, required closer scrutiny to establish whether it represented best practice, based upon current clinical knowledge.
The technique involved performing the mastectomy and leaving behind a small amount of residual breast tissue to assist in providing an improved cleavage for the patient.
The Trust understands that this procedure was being carried out in good faith, believing it to be appropriate for patients, to achieve removal of the carcinoma, but with a better cosmetic result than a traditional mastectomy. This procedure was not performed on all patients undergoing mastectomy.
The review highlighted that this was not a usual procedure and the appropriate guidelines had not been followed to introduce this new technique. This Trust’s position, after careful consideration, was that the technique was not an approach considered appropriate going forward, and the method was therefore stopped.
Letters were sent to all patients we identified through our records as having had mastectomies performed under Mr Paterson’s care at Solihull Hospital since 1998 and at Good Hope Hospital between 1994-8, inviting them to attend a special recall clinic to ensure we have reviewed their current clinical condition. The Trust has seen and reviewed all those patients who responded to the recall letters.
We have and continue to work hard to increase our understanding of the clinical issues and any potential consequences of this procedure, and in order to help patients with their treatment decisions. The Trust has undertaken work with the West Midlands Cancer Intelligence Unit (WMCIU) in order to monitor recurrence rates, and we regret that we are currently unable to advise definitively upon whether patients who underwent a CSM are at a statistically greater risk of recurrence than if they had undergone a full mastectomy, as there is no published data available.
Part of the reason for undertaking a full recall, in addition to making sure patients are identified and reviewed, is to be able to gather data on this procedure, to identify whether there is any potential additional risk, or whether recurrences fall within the statistical ‘norms’ of recurrence.
Actions taken update: 9-01-2013
Leading healthcare lawyer to chair review of breast care services at Solihull Hospital
Sir Ian Kennedy has been invited by Heart of England NHS Foundation Trust to chair an independent review into the management of concerns regarding breast care services at Solihull Hospital, arising from incomplete mastectomy procedures.
“It was very important to us to make sure, first of all, that all of the patients concerned were seen and had their care reviewed and this is what we have been focusing on over the past 12 months,” confirmed Dr Aresh Anwar, medical director, Solihull Hospital. “Now that this is completed we have, as promised, asked an experienced independent chair to look at the actions this organisation took, to see if there are lessons to be learned about how to raise concerns into clinical practice and how to take appropriate action.”
The Review will commence on Wednesday, 9 January 2013 and will also examine the timeline of information as it evolved, the Trust’s response to concerns raised by staff, patients and the public relating to incomplete mastectomies, and also consider whether the actions taken in response were appropriate, and carried out in a timely manner.
On completion of the evidence-gathering process, Sir Ian Kennedy will make recommendations to the Trust’s Board in a report that will be made publicly available. The report is expected to be completed in summer 2013.
Trust chairman The Right Hon. Lord Philip Hunt, said: “The Board fully recognises the concerns expressed by patients about the length of time taken to complete the clinical investigation and to take action. It therefore wants a fully open, independently conducted review to determine whether there are lessons to be learned about how the organisation responded to the situation as it evolved, and how it might improve its response to concerns if they are raised in the future. We hope that this review may also assist the wider NHS when facing concerns about individual practitioners.”
Sir Ian Kennedy is an eminent academic lawyer and an expert in the law and ethics of health. He chaired the Bristol Royal Infirmary Inquiry, and is currently chairman of the Independent Parliamentary Standards Authority (IPSA), which independently monitors and controls MPs’ expenses, pay and pensions.
Sir Ian Kennedy, said: “I am delighted to take up this commission and I am keen to talk to patients and staff as part of the evidence-gathering process. I urge anyone who would like to talk to me about their specific experience to come forward. We have set up a dedicated website to keep everyone informed throughout the review process.”
Please get in touch
If you are a patient who has had a mastectomy at any time under Mr Paterson’s care at our Trust and has not been recalled to clinic or are concerned about the procedure you may have had, then we would invite you to contact us on the number below. We will then arrange for you to come to a special clinic to see an alternative surgeon for a review of your treatment and care. This includes patients who may have been discharged.
The contact number, 0121 424 5473, which is our advice line for mastectomy patients, is available between the hours of 9am and 12 midday, Monday to Friday with the opportunity to leave a message at other times. If anyone is at all concerned we would encourage them to get in touch.
For more information on the Review, please visit www.breastcarereview.co.uk
Locals are invited to attend a free health seminar at Good Hope Hospital on bowel cancer, the third most common cancer nationally and second most common cancer in women.
Lead consultants along with members of the bowel cancer specialist nursing team will be presenting during the two hour lecture and will discuss the causes and symptoms of bowel cancer, who is most at risk of developing the disease and how it is treated.
In 2009 alone, there were over 41,000 new cases of bowel cancer registered in the UK. Approximately 72% of bowel cancer cases develop in people who are 65 or over.
Karen Mallows, specialist screening practitioner in bowel cancer says: “Anybody aged between 60-74 can take part in the bowel cancer screening programme. Anyone in this age group can complete a simple test kit and this can be done in the privacy of their home and sent away for testing. If blood is detected in the sample the patient will be sent for an appointment with a specialist nurse, which may lead to a colonoscopy, which is where a camera is used to look at the bowel being carried out. This test can detect bowel cancer and treatment can be offered. The other benefit of the colonoscopy is that the risk of developing bowel cancer can be reduced. That is because growths in the bowel which can become cancerous can be detected and removed before they have a chance to grow into a cancer.
“Anybody wishing to know more about screening should attend the health seminar where the screening nurses will be on hand to answer any questions and bowel cancer and the screening process.”
Seminar organiser, membership and community engagement manager, Sandra White, said: “We hope people will come along to the seminar and leave feeling a lot more knowledgeable about bowel cancer and the signs and symptoms to look out for. Attendees will have the opportunity to ask our experts questions and to discuss their own thoughts and experiences of the disease. The Hospital is committed to educating the public about their health.”
Researchers at Heartlands Hospital will be leading the way nationally in treating prevention of blindness in diabetics through a study in partnership with Aston University.
The Hospital is one of only 11 European Union (EU) centres selected towin a £260,000 EU funded grant to support the trial of a new eye drop treatment to prevent or stop the progression of the early stages of diabetic retinopathy. Diabetic retinopathy is an eye disease that can occur in people with diabetes. It can lead to severe loss of vision or even blindness and is the leading cause of preventable blindness in diabetic patients.
The clinical trial will involve patients being given one of three different types of eye drops which are hoped to protect the eye by preventing the retinal nerve damage which causes the loss of vision. It is believed that their use in the early onset of the disease will be of most benefit to patients. Patients who take part in the research will be closely monitored with regards to their progress.
Professor Jonathan Gibson, consultant ophthalmologist at Heartlands Hospital is leading the research. He commented: “Diabetic retinopathy is the main cause in blindness in the UK in those of working age, and therefore this research is potentially very important. We will be testing whether these special eye drops can prevent the development of diabetic retinopathy, and therefore prevent later visual loss. If they work it will be a major breakthrough for diabetic patients. The research team at Heartlands has a fantastic reputation and successful track record of ophthalmic research and I believe this is the basis they have been selected as one of 11 centres across Europe to be involved in this study.”
A first of its kind service for babies and young people was officially opened this week designed to make having a blood test quicker and less traumatic at Birmingham Heartlands Hospital.
The walk in service means under 16s needing to have a blood sample taken now have a dedicated service and no longer have to visit the Hospital’s adult outpatients department. A paediatric-trained phlebotomist is also on hand to take their blood samples in a child friendlyenvironment. Locals who previously would have needed to take their children to Birmingham Children’s Hospital for a blood test will also be able to take their babies to the unit.
The phlebotomy unit, which has already seen more than 7,000 babies and children through its doors since it first commenced service nearly 12 months ago, has proved a big hit with Hospital clinicians and GPs alike.
Afiya Razaq, from Ward End, brings her four week old daughter Sikandar Waqas to Heartlands Hospital to have blood tests through the new service. She said: “I’m pleased the Hospital has an area for kids, it’s a good thing, especially for babies. I have two children, both born prematurely and it’s good that there is an area away from everyone else and dedicated just for children.”
Heartlands phlebotomy manager, Valerie Wall said: “Our younger patients needing blood tests used to be referred by a GP to the paediatrics unit or went to the outpatients department. Having this unit with specially trained phlebotomists is unique as far as I am aware. It works well and the staff are all really proud of it.
“Having this service in place means it is a much less distressing experience for the children as the waiting time is reduced and they are in a calming environment. Because we have this dedicated service we are saving staff time and set up to serve a growing population with a more easily accessible.”
The newly renovated emergency department at Good Hope Hospital has won a prestigious award for the detail given to crime prevention at the design, layout and construction of the building.
The £5 million project was awarded the UK Police award in recognition of the Hospital’s work with the West Midlands Police to ensure the layout of the building conforms to the highest standard of crime prevention and security.
The West Midlands Police worked with the Hospital during the design and the building stages of the new facilities to ensure it conformed to rigorous security standards.
Good Hope lead security management specialist, Phil Chambers, said: “I am pleased that the quality of design of this new development has been recognised by an external body. We have succeeded in providing an exceptionally high quality of built with all the right measures to keep staff, patients and visitors safe and which sets the benchmark nationally.”
Chief superintendent Lorraine Bottomley, from Birmingham North local policing unit, said: “It’s fantastic that Good Hope Hospital is fully committed to reducing crime in the area as much as we are. This is the second part of the building phase to receive the award which is a great achievement for them.
“The design of the building will make a significant difference to the safety of patients, staff, and visitors. It’s great that they are working with us to reduce crime in the area.
“Local officers will now work to complement the design of the building to further reduce the potential for crime in this area.”
The soon to be officially opened newly refurbished emergency department at Good Hope Hospital brings the minor injuries unit and majors areas into close proximity of each other, and provision of an enlarged resuscitation area. The new facilities provide increased cubicle and clinical space to provide an improved patient experience and meet increasing demand.
The award certificate was presented to Good Hope’s executive lead director, Sue Moore by chief superintendent Bottomley from the West Midlands Police on 1 February 2013.
Having a blood test is now less traumatic for young patients at Birmingham Heartlands Hospital thanks to a first of its kind service dedicated to taking blood tests for children and babies.
The walk in service means under 16s needing to have a blood sample taken no longer have to visit the Hospital’s outpatients department and have improved access to a paediatric-trained phlebotomist to take their blood samples in a child friendly environment. Locals will also be able to take their babies to the unit for blood tests where previously they would have needed to go to Birmingham Children’s Hospital.
The unit, which has seen more than 7,000 babies and children through its doors since it first commenced service nearly 12 months ago, has proved a big hit with Hospital clinicians and GPs alike.
Heartlands phlebotomy manager, Val Wall said: “Our younger patients needing blood tests used to be referred by a GP to the paediatrics unit or went to the outpatients department. Having this unit with specially trained phlebotomists is unique as far as I am aware. It works well and the staff are all really proud of it. Having this service in place means it is a much less distressing experience for the children as the waiting time is reduced and they are in a calming environment. Because we have this dedicated service we are saving staff time and set up to serve a growing population with a more easily accessible.”