Obstetrics and Gynaecology review

Download Gynaecology & Obstetrics External Review Final Interim Report - (11 May 2021) [pdf] 402KB (opens in new window) >

University Hospitals of Derby and Burton has today (Tuesday 11 May 2021) released an interim Report of Investigation into the ongoing Obstetrics and Gynaecology review. The review concerns the practice of former specialist consultant benign gynaecologist Mr Daniel Hay between 2015 and 2018. By 2022 it is expected that all 383 women whose case notes have been reviewed will have been given the opportunity to share their views about the care and treatment they received.

The review has found that for 50 women there is major concern that they are likely to have been harmed as a result of care under by Mr Hay, with a further 69 women with some concern who were potentially harmed. The full extent of harm will not be known until all the women have had the opportunity to speak with the consultant gynaecologist, and the full report published in 2022.

Examples of the harm these patients experienced include hysterectomies or sterilisation where there was no documentation regarding any trial of medical treatments prior to surgery or any documentation to explain the rationale for a surgery-first approach. The review focusses on women who have had major gynaecology and intermediate gynaecology operations, obstetric care or a gynaecology outpatient appointments. The majority of those harmed had undergone major gynaecological surgery, such as hysterectomies.

Dr Magnus Harrison, Executive Medical Director, said: “I want to make a full and unreserved apology to all those women who have identified as being harmed. When colleagues initially raised concerns in the latter half of 2018 and right through to today we have worked diligently to piece together a picture of the care they received under this consultant in an open andtransparent way.

“I want to make clear that the standard of care these women received was far below that which we strive to provide and for that I am very sorry. The interim report sets out some immediate recommendations and these are either currently underway or will start shortly. One of the recommendations is for each patient to be offered the opportunity to discuss their care. We have now been in touch with all the women who we believe harm is likely to have occurred as a result of a major gynaecological operation and many of these women have now spoken to us in person. We will continue to contact all the women involved through 2021 to offer them the opportunity to discuss their care with us.

“There is still much work to do but the interim Report of Investigation demonstrates that it was the right decision to formally investigate the work of this consultant. I want to thank the patients who have already shared their experiences with us, which I know must be extremely difficult for them. I also want to thank my colleagues in our Gynaecology and Obstetrics service for initially raising their concerns and for the support they have given these patients since. This has not been an easy task, complicated by an absence of clear patient documentation, and the Covid-19 pandemic. I want to thank the independent consultant gynaecologist, retired consultant gynaecologist, six investigation reviewers and NHS England for their work to get us to today. We will share the full report in 2022 and implement its recommendations in full.”

The 383 women whose case notes have been reviewed are being invited to meet with a retired trust consultant so they can share their experiences of the care they received and receive advice about any issues that may not have been addressed to the required standard. Their accounts of their experiences will then be shared with an independent multi-disciplinary review team for evaluation.

The interim report of investigation suggests that a further look back at the practice of the former specialist consultant benign gynaecologist may be required should this be recommended once the full report is complete. The Trust will make a decision about this once the information shared by the 383 women has been fully evaluated and included in the report.

​Members of the public who were not part of the review are asked to continue not to call the hospital switchboard in relation to this issue as all those patients who are potentially affected at this stage have already been contacted directly. However, anyone needing further reassurance should contact the Patient Advice and Liaison Service (PALS) on 01332 786653, email uhdb.contactpalsderby@nhs.net or write to the following address;

Patient Advice and Liaison Service
Royal Derby Hospital
Uttoxeter New Road
Derby
DE22 3NE

April 2021

University Hospitals of Derby and Burton has started to write to women who have had their care independently reassessed as part of the Obstetrics and Gynaecology review. The review was a case note review of 383 women under the care of an Obstetrics and Gynaecology Consultant between 2015 and 2018.

During 2021 each of the 383 women will receive a letter inviting them to meet an independent consultant gynaecologist to discuss their care outcome. These invitations will be first sent to those who underwent major surgery. Once all those women who wish to be seen have had an appointment, a full independent report, including the experiences of the women themselves, will be written and published in 2022.

The Trust proactively announced in April 2020 that a full review was underway following concerns expressed by members of the Obstetrics and Gynaecology Team regarding the practice of their consultant colleague, raised in late 2018, which were subject to a preliminary independent review in 2019.

Dr Magnus Harrison, Executive Medical Director, said: “I would like to again express my sincere apologies to those patients who have received a standard of care that is below that expected".

“I also want to thank the women involved for their patience during this review. I know it has been a long wait at what must be a difficult time. We are now in the position to start to provide patients with the findings of their case note review. This in turn will take time as we want every woman involved to have the opportunity to discuss their care with an independent consultant gynaecologist".

“The review to date has focused only on information from patient notes and the next step is to invite each patient to meet with the independent consultant gynaecologist to discuss their care. In some cases the standard of record keeping was insufficient and we will only fully understand the standard of care they received when we have had the opportunity to meet with them. That’s why it is vital that those women who we contact throughout the year help us to understand their experiences, even those where there were no concerns raised from the initial review.  All patients contacted will have the opportunity to speak to the independent consultant gynaecologist regarding their care.”

​Members of the public who were not part of the review are asked to continue not to call the hospital switchboard in relation to this issue as all those patients who are potentially affected at this stage have already been contacted directly. However, anyone needing further reassurance should contact the Patient Advice and Liaison Service (PALS) on 01332 786653, email uhdb.contactpalsderby@nhs.net or write to the following address

Patient Advice and Liaison Service
The Royal Derby Hospital
Uttoxeter New Road
Derby
DE22 3NE

Once the review is complete the anonymised findings will be published on our website.

December 2020

University Hospitals of Derby and Burton NHS Foundation Trust has this week written to a further 110 women as part of a review into the past treatment provided by a former consultant in Obstetrics and Gynaecology. Each of the women contacted have been advised there are no concerns regarding their current health.

The Trust proactively announced in April 2020 that a review was underway following concerns expressed by members of the Obstetrics and Gynaecology Team regarding the practice of their consultant colleague, raised in late 2018.

These further 110 patients had an outpatient appointment, but not a surgical intervention, between April 2017 and July 2018 at Ripley Hospital. The outpatient note review will be conducted by independent NHS Gynaecology clinicians who work outside of the Trust. 

Dr Magnus Harrison, Executive Medical Director, said: “We have widened the review to a specific outpatient clinic that took place at Ripley Hospital to understand the care being provided there. As with the review of intermediate surgery, such as a diagnostic test, in September we are doing this proactively, rather than in response to any specific concerns, so that the review is as thorough as possible. Each of the women have been informed that there are no concerns regarding their current health."

​Members of the public who have not received a letter are asked to continue not to call the hospital switchboard in relation to this issue as all those patients who are potentially affected at this stage have already been contacted directly. However, anyone needing further reassurance should visit the Trust website for details of how to get in touch. Once the review is complete the anonymised findings will be published on our website.

September 2020

University Hospitals of Derby and Burton NHS Foundation Trust has this week written to a further 79 women as part of a review into the past treatment provided by a former consultant in Obstetrics and Gynaecology.

The Trust announced in April 2020 that a review was underway following concerns expressed by members of the Obstetrics and Gynaecology Team regarding the practice of their consultant colleague, raised in late 2018.

An initial 57 cases were independently reviewed, primarily regarding gynaecology outpatient and surgical treatment. For eight of these cases we have identified lapses in care which have resulted in unnecessary harm. The Trust has since apologised to these women for the care they received.

An independent clinical review of the wider work of this consultant. To do this the Trust contacted a further 136 women who were patients of this consultant between 2015 and 2018 and who received a major obstetric or gynaecological intervention in the three years prior to this development to ask them to engage in the review process.

The latest 79 women included are part of a review of intermediate care, such as a diagnostic test, that took place between April 2017 and June 2018. Although there are no current concerns about the care these women received, the review has been expanded to ascertain whether women who required intermediate care need to be included.

Dr James Crampton, Medical Director for Quality and Safety, said: “It is important to widen the review at this time to investigate whether those who underwent intermediate care from this consultant received safe care. We are doing this proactively, rather than in response to any specific concerns, so that the review is as thorough as possible. We will continue to work closely with NHS England to establish the full facts of the care provided by this consultant and will provide all the necessary support they need during their review.”

The review, which has been slowed due to the Covid-19 pandemic, is necessarily complex and will determine whether patients have been managed appropriately and whether any harm has been caused by any deficiencies in their care. As with the initial review we are writing to the patients this week to informed them that their patient records will be confidentially shared as part of the review.

​Members of the public are asked to continue not to call the hospital switchboard in relation to this issue as all those patients who are potentially affected at this stage have already been contacted directly. However, anyone needing further reassurance should visit the Trust website for details of how to get in touch. Once the review is complete the anonymised findings will be published on our website.

University Hospitals of Derby and Burton NHS Trust is reviewing the past treatment provided by one of its consultants in Obstetrics and Gynaecology. An initial 58 cases have been independently reviewed, primarily regarding gynaecology outpatient and surgical treatment. For eight of these cases we have identified lapses in care which have resulted in unnecessary harm.

The Trust has this week written to all 58 patients advising them that their past treatment has been thoroughly reviewed. The review was set up following concerns expressed by members of the Obstetrics and Gynaecology Team regarding the practice of their consultant colleague, raised in late 2018. The consultant involved has not undertaken clinical activity at the Trust since June 2018.

Furthermore, an independent clinical review has been established for the wider work of this consultant, which will conclude fully following the Covid-19 pandemic. To do this the Trust has contacted 136 women who were patients of this consultant and who received a major obstetric or gynaecological intervention in the three years prior to this development to ask them to engage in the review process.

Both groups represent all women who may have been affected and each has already been contacted by the Trust and invited to contribute to the review.

Dr Magnus Harrison, UHDB Executive Medical Director, said: “I would like to express my sincere regret and apologies to any patients who may have received a standard of care that is below that expected. The Trust took immediate action as soon as serious concerns about specific aspects of this consultant's practice were brought to our attention.

"These concerns were raised by the Obstetrics and Gynaecology Team themselves in a clear demonstration of their commitment to the highest quality of patient care and their duty to work in an open and transparent way. We will be working closely with NHS England to establish the full facts and will provide all the necessary support they need during their review.”

The review is necessarily complex and will determine whether patients have been managed appropriately and whether any harm has been caused by any deficiencies in their care. In writing to the patients this week the Trust informed them that their patient records will be confidentially shared as part of the review.

​Members of the public are asked not to call the hospital switchboard in relation to this issue as all those patients who are potentially affected at this stage have already been contacted directly. However, anyone needing further reassurance should contact the Patient Advice and Liaison Service (PALS) on 01332 786653, email uhdb.contactpalsderby@nhs.net  or write to the following address

Patient Advice and Liaison Service

The Royal Derby Hospital

Uttoxeter New Road

Derby

DE22 3NE

Once the review is complete the anonymised findings will be published on our website.