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Review of Practice at Inverclyde Royal Hospitals Breast Care Service

June 14, 2007 9:32 AM

NHS Greater Glasgow and Clyde has instigated a full review of breast services at Inverclyde Royal Hospital in Greenock in light of concerns that the assessment and diagnosis of possible breast cancer symptoms may not have routinely followed best practice standards. 
The review will centre on the breast clinics run by Mr Ian Morrice and Mr Eric Taylor. Whilst the review is being carried out, Mr Morrice has withdrawn from the breast service but continues with other clinical duties at the hospital – this is normal procedure during a clinical review.
Mr Morrice is scheduled to retire in July this year and Mr Taylor retired in February this year.
No other clinics throughout the Greater Glasgow and Clyde area are affected.
Tom Divers, Chief Executive of NHS Greater Glasgow and Clyde, explained why the review is being carried out. He said: “The first indication of possible differences in practice between Inverclyde and other breast clinics in Greater Glasgow and Clyde emerged following an audit of breast cancer care. This highlighted that, when compared to other centres, a lower percentage of patients seen at Inverclyde had diagnosis confirmed before surgical intervention.
“Further interrogation of these results, including the follow-up of Mr Taylor’s patients by another breast surgeon, has now identified that some patients did not receive the full range of appropriate tests when being assessed for suspected breast cancer. This has prompted us to launch a full review of practices at these clinics.”
We have asked two external breast care experts to assist with the review.
Professor Alistair Thompson of NHS Tayside is one of the UK’s leading breast cancer experts and Professor David George, of Glasgow’s Western Infirmary, is recognised internationally for his contribution to breast cancer care.
The purpose of their review will be:
Ø      To examine procedures and protocols for the management of breast patients in Inverclyde
Ø      To undertake as necessary a systematic review of patient care
Ø      And to make any recommendations on how the delivery of the breast service in Inverclyde could be improved

They will begin their work early in July and expect to produce a report for the Board within four weeks.
In the light of this time scale, NHS Greater Glasgow and Clyde’s Associate Medical Director of Surgery and Anaesthesia, Professor Tim Cooke, has been asked to head up an urgent review of the care provided to patients within the clinics.
Professor Cooke said: “I want to put this initial review into context by assuring patients that I have no expectation that we will find any significant numbers of patients with missed cancers.
“The vast majority of women attending a breast clinic need no more than a clinical examination to determine they have no cancer risk. For other women, the standard assessment of breast care symptoms includes clinical examination, mammography or ultrasound and biopsy – from the review of cases at Inverclyde Royal Hospital, a number of patients who fall into this category appear not to have received this standard assessment.  
“We have looked at the records of 1600 patients going back over eighteen months. This timescale has been chosen as it is likely that missed cancers before that time would have been detected by now.
“Of that 1600 group of patients myself and other breast cancer specialists have identified 198 patients that we would like to recall for a further consultation to ensure that their original diagnosis was correct.”
Also contributing to the review is Dr Liz Jordan, Associate Medical Director for Clyde. She said: “We are very sorry for the anxiety that this review will cause to patients and the families of those patients. 
“Within the past 24 hours, we have contacted by telephone or letter those women whose case notes have been reviewed. 
“We’ve put in place rapid access clinics at both Inverclyde Royal Hospital and at Glasgow Royal Infirmary to ensure that those women we have recalled and others who are anxious are offered a swift consultation and further assessment if necessary.
“We will also ensure that any patient who cannot be given immediate assurance at the clinic on the day of their appointment will have the results of any further tests within the maximum of one week.
“It is our expectation that we will have offered all of the 198 women that we have recalled an appointment by Tuesday evening. Evening and weekend clinics will continue beyond this date – for as long as necessary – to ensure that all those with concerns have an opportunity for a consultation. 
“We’ve also set up a helpline for any patient who has attended the breast clinic at Inverclyde Royal Hospital. The helpline number is: 08000 858531.
“I would urge any patient with concerns to contact this helpline. “

While the review continues, a new team of breast surgeons – who were due to begin in July - has been brought in to the hospital immediately to ensure that there is no disruption to services for patients with breast problems attending the hospital.
Notes to editors
  1. For certain patients, the standard assessment of breast care symptoms includes clinical examination, mammography or ultrasound (depending on age) and biopsy. From the preliminary review of cases at Inverclyde Royal Hospital, a number of patients who fall into this category appear not to have received this ‘triple’ assessment.  
  1. The helpline number is: 08000 858531. Lines are open from 8.00am to midnight on Thursday 14 June and thereafter from 15 June from 8.00am to 6.00pm every day.
The catchment area served by Inverclyde Royal Hospital includes Greenock, Port Glasgow, Gourock, Largs, the Isle of Bute and Cowal Peninsula including Dunoon.
 
Ends
 
For further information contact the Press Office on 0141 201 4429.

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