A REVIEW of the files of a number of patients who underwent surgery at Our Lady’s Hospital in Navan is to be undertaken in coming weeks, the HSE confirmed yesterday.
It said the terms of reference for the review had still to be drawn up but it is being instituted in the wake of the decision to halt acute surgery at the hospital at the beginning of this month.
In a statement the HSE said “two clusters of cases with poor clinical outcomes were identified” earlier this year and “affected patients and their families have been advised”, as has the Medical Council.
The number of patient files to be reviewed is as yet unclear but may not be confined to the “clusters of cases”. Orthopaedic and gynaecological surgery will not be part of the review.
Dr Barry White, director of quality and clinical care with the HSE, said yesterday the decision to stop acute surgery at Navan hospital on September 1st was as a result of the findings of a preliminary review of outcomes in a number of cases of laparoscopic (keyhole) surgery. Laparoscopic surgery was stopped at the hospital in August on foot of that review and after further consideration of its findings. Earlier findings on the handling of a small number of other surgical cases, and the fact that there were low volumes of particular types of surgery being undertaken at the hospital, also contributed to the decision to immediately stop acute surgery at the hospital, he said.
He said the decision was taken by him not to save money, but on the basis of clinical advice and was supported by the Royal College of Surgeons in Ireland.
The RCSI said it was informed by the HSE that a preliminary investigation had raised concerns about outcomes. “Based on this information and in the interest of patient safety, the RCSI supported the decision of the HSE to cease emergency surgical services at Our Lady’s Hospital in Navan with effect from September 1st, pending a full investigation,” it said. It is this investigation which is now to take place.
There has been much criticism of the HSE decision to call an immediate halt to acute surgery at the hospital without consulting staff in advance. Dr White said the correct decision had been made in the interests of patient safety but “perhaps communication with staff and other hospitals could have been handled better”.
There has also been concern locally that out of about 1,500 laparoscopic procedures undertaken at the hospital since 2003, only four cases appeared to raise concern within the hospital and it is claimed there were valid explanations for each.
Asked about suggestions that outcomes at Navan were no different from those at any other hospital, Dr White said he could not comment until the findings of the review became available. He said if the review now being undertaken found there were no issues of concern then laparoscopic surgery could potentially be restored to Navan hospital.
A number of previous reports recommended ending acute surgery at Navan hospital but the clusters of cases “left the HSE with no option but to accelerate the process of removing emergency surgery on the basis of patient safety concerns”, the HSE said.