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Over half of rheumatology patients prescribed powerful drugs which suppress the immune system and can make individuals more susceptible to infections did not meet the accepted criteria for the treatment, an records audit has revealed – and the finding may be symptomatic of other serious problems in Health.
However, the department said that it was "too early" to establish whether anyone had suffered harm as a result as it released the initial findings of its audit this afternoon.
The audit was carried out by Health following an investigation by the Royal College of Physicians in response to concerns raised about the department.
The audit involved checking the past treatment and diagnosis of a group of 341 rheumatology patients – all of whom who were prescribed a group of drugs known as ‘biologics’ in the period before January 2022.
Biologics are a group of powerful drugs derived from natural sources such as human, animal, fungal or microbial cells. These drugs work by suppressing the immune system and disrupting the inflammation process that leads to joint pain.
However, they can make patients more susceptible to life-threatening infections.
Pictured: Rheumatology deals with arthritis and several other conditions that affect the joints, tendons, muscle, ligaments.
Preliminary findings from the audit indicate that over half of the 341 patients receiving biologic therapy did not meet the accepted criteria for starting this treatment.
The Health Minister said that it was "too early to determine whether anybody's been harmed by [the inappropriate prescribing of biologic agents]".
The preliminary findings of the audit also indicated that there was insufficient evidence in the patient case notes to confirm the diagnosis of around one-third of patients who were first diagnosed with a rheumatological condition in Jersey.
However, this may not necessarily mean patients were misdiagnosed. Some of these patients may have been accurately diagnosed but their patient records may not have adequately recorded the reasons for their diagnosis.
The Minister for Health and Social Services, Deputy Karen Wilson admitted that these "serious problems" around the diagnosis and treatment of rheumatology patients may also extend into other areas of healthcare.
Pictured: The Health Minister, Deputy Karen Wilson admitted that these "serious problems" may also extend into other areas of healthcare.
Expanding on these comments, Deputy Wilson explained that "when you get findings like this, it sorts leads to an additional line of inquiry to see whether or not there are any other patients who are affected".
The Health Minister confirmed that the care and treatment of a wider group of patients, including other rheumatology patients, will now also be reviewed.
She added: "Findings like this can cause concern and it's my job to make sure that we cover all bases so that patients can be assured that there is no cover up and that we're being open and transparent about what needs to be done."
The Chair of Jersey Arthritis Society, Maureen Parris, described it as "reassuring to note that Jersey’s rheumatology service is now being run by a specialist Consultant Rheumatologist on the General Medical Council’s Specialist Rheumatology Register".
When asked why this wasn’t previously the case, the Health Minister admitted that the Rheumatology Department had been "working with what they had at the time".
"I think any specialist area of practise should have people with specialist knowledge and expertise," she said. "What I'm really pleased about is that we've managed to secure that for the [rheumatology] department now."
The Health Department hired a new full-time Head of Rheumatology last month with the appointment of Dr Sofia Tosounidou, who trained in the Medical School at the University of Ioannina in Greece.
The final report of the Royal College of Physicians review is expected in the autumn of this year and Deputy Wilson confirmed that this will be made public.
Patrick Armstrong, Medical Director at HCS said: “This audit clearly indicates that some of our rheumatology patients on biologic drugs may not have been properly diagnosed or properly treated in the period before January 2022.
"I am satisfied that in recent months these HCS patients have been reviewed by specialist rheumatologists, but the audit suggests we now need to review the care and treatment of a wider group of patients including our other rheumatology patients. We will be doing this as quickly as possible.
Pictured: "The audit suggests we now need to review the care and treatment of a wider group of patients including our other rheumatology patients."
“HCS will be starting this further review immediately and if there is a need for any patient to be seen in person they will be contacted directly. In the meantime, patients should continue to take their medication as prescribed and attend their hospital and doctor appointments as normal.”
Any patient requiring further information about this matter can contact the HCS PALS information service by email on pals@health.gov.je or by telephone on 01534 443515.
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