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The Health Department decided to change which 18 rheumatology patients had their clinical notes put forward for an external review of the department, it has emerged – and the Government is refusing to explain why.
Published last week, the Royal College of Physicians' review of Jersey's Rheumatology Department found the standard of care was “well below” what would be considered acceptable in the 18 cases that were reviewed.
However, it has now emerged that the Government changed which patient notes were provided to the external reviewers ahead of the assessment – and is refusing to explain why.
The original terms of reference of the Royal College of Physicians' review stipulated a mix of selected and random cases from patients who received rheumatology care between January 2019 and December 2021.
This was to include cases highlighted by the Health Department where specific concerns had been raised; six cases selected at random (every nth case from the time period chosen); and six cases selected by the consultant in general medicine.
However, it has now emerged that all 18 cases were provided to the reviewers by Jersey's Health Department – and were only selected from a specific group of rheumatology patients who had all had been treated with biologic drugs.
Express understands that the consultant working in the rheumatology department at the time – named only as Dr Y in the report – was told ahead of the review that he could choose six rheumatology patients to put to the Royal College of Physicians to evaluate.
However, this opportunity was not provided.
Following inquiries from Express, the Royal College of Physicians confirmed that their Invited Review team was provided with clinical records for 18 patients by Jersey's Health Department.
"The original terms of reference stipulated a mix of selected and random cases, however all 18 cases provided were randomly selected from patients diagnosed with a rheumatological condition and who were treated with biologics," the report explained.
The Royal College of Physicians said that the review team was "content to proceed on this basis" as they were "satisfied the sample of cases would still allow the reviewers to identify any potential issues [or] themes with service delivery".
However, the external reviewer said that any questions on how the cases were selected would need to be directed to Jersey's Health Department – which had provided the 18 "randomly selected" selected patient notes.
Despite repeated inquiries from Express, the Government has refused to confirm how the 18 cases were randomly selected; why a decision was made to only select the cases from patients who were treated with biologics rather than from the wider pool of all rheumatology patients; and who made this decision.
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