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“Systemic governance problems” are likely to be present across the Health Department, the Minister has said after initial findings from a review of the island's rheumatology found evidence of "inappropriate prescribing" to some patients and poor record-keeping.
Health Minister Karen Wilson said that initial feedback from the review into the rheumatology service indicated that her department had fallen behind “best practice” in a number of areas.
The review, which was initiated in April following concerns that some patients were not receiving the best treatment, is the latest indication of the extent problems facing the Island's healthcare service, and follows a damning report into governance published last year.
Deputy Wilson said that while the review carried out by the Royal College of Physicians had been focused specifically on rheumatology, the initial conclusions indicated the likelihood of governance shortcomings in other parts of the healthcare system.
She said: "This initial feedback highlights some systemic governance problems in the rheumatology service that are likely to be present in other parts of Health.
"The Royal College has said it was reassured to hear that steps were being taken to develop an open and transparent culture and to implement a governance framework that allows scrutiny of all aspects of healthcare, but nobody should be in any doubt about the seriousness of this review and these initial findings."
Pictured: Health Minister Karen Wilson.
The way the healthcare system operates has been in the spotlight since the publication of a review by Professor Hugo Mascie-Taylor into clinical governance arrangements in secondary care last August. In January of this year it was confirmed that a turnaround team would be set up to help senior leaders within the Health Department tackle the challenges faced, while in April Deputy Wilson announced plans to set up an Interim Health Board.
The Health Minister added: “It is clear that over a period of time [the department] had fallen behind ‘best practice’ in a number of areas and now needs to catch up.
“Work is proceeding on improvements recommended last year in the [Mascie-Taylor] review and this initial Royal College feedback underlines the need for a relentless focus on strengthening governance through the establishment of the proposed HCS Board.”
A States Assembly debate into Deputy Wilson's plans for the interim board was due to take place next week, but has now been pushed back to mid-June. The Health Minister said the delay had been initiated by ministers so that “revision and refinement” could be carried out into some of the details.
The rheumatology review has indicated the need for a more integrated relationship between primary and secondary care, closer links with other rheumatology services and a reduced reliance on pharmaceutical companies for drug information and training.
The feedback notes a number of service weaknesses at that time including poor written patient notes, some inappropriate prescribing of biologic agents, and prescriptions that did not include the clinical condition being treated.
Medical Director Patrick Armstrong said that around 340 patients whose treatment included biologic agents, which are used to counter the effects of rheumatoid arthritis, had been the subject of case review.
The current audit into patient notes is set to be completed by the end of June, Mr Armstrong added. He said rheumatology patients with concerns could email the Patient Advice and Liaison Service on pals@health.gov.je or call 443515.
“Rheumatology patients deserve better” - records to be audited
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